A Parent's Guide to Neonatal Herpes Simplex Virus (HSV)

Learning that your newborn has a herpes simplex virus (HSV) infection is a terrifying experience. The Neonatal Intensive Care Unit (NICU) can feel overwhelming, with its alarms, monitors, and complex medical terminology. This guide is designed to empower you with the facts you need to understand your baby’s diagnosis, partner with your care team, and advocate for your child’s health.

Herpes Simplex Virus is incredibly common in adults, but it behaves very differently in newborns because their immune systems are still developing. Whether your baby was exposed during pregnancy, during delivery, or shortly after birth, rapid action and specialized treatments are required to protect their developing brain and organs.

This resource will guide you through:

Can I Hold and Feed My Baby?

One of the most agonizing parts of a neonatal HSV diagnosis is the fear of touching your baby. While precautions are strictly necessary, your physical presence is still incredibly valuable to your child’s healing.

• Physical Contact and Hygiene: Because the virus can spread through contact, strict hand hygiene is mandatory. You must wash your hands thoroughly with soap and water or use hospital-grade sanitizer before and after touching your baby. Your care team will guide you on when it is safe to hold your baby or perform skin-to-skin care, and whether you need to wear a gown or gloves.
• Breastfeeding: Breast milk provides excellent immunological support for your baby. However, there is a crucial safety rule: mothers with active HSV lesions on their breast must avoid breastfeeding from the affected breast, as this can transmit the virus to the baby ^[1]. If you have a history of genital herpes but your breasts are clear of lesions, breastfeeding or pumping is generally safe and encouraged. Always discuss your feeding plan with your baby’s neonatologist and your own doctor to ensure it is completely safe.

A Note on Maternal Health

Because the vast majority of neonatal HSV cases are transmitted during the birthing process, this diagnosis often means the birth mother experienced a primary (first-time) or recurrent HSV infection without realizing it ^[2]. It is vital that the mother is evaluated by her own OB/GYN or primary care doctor. You may need your own examination or antiviral treatment. Taking care of your own health is a critical part of caring for your baby.