Is Maternal Herpes Simplex compatible with breastfeeding? Do we have alternatives for Maternal Herpes Simplex?

Maternal Herpes Simplex

September 19, 2016 (High Risk)

Herpes simplex virus (HSV) causes oral (HSV type I) and genital lesions (HSV types II and I). It is considered a sexually transmitted virus.

The neonatal infection is more common in case of primary infection of the mother than in case of recurrent herpetic lesions (50% vs. 5%).
Most transmissions occur at the time of the partum by contact with genital lesions (Tremolada 2008).
During the neonatal period the disease can be very serious; beyond this period it does not usually have serious consequences.

Although HSV DNA 1 and 2 are frequently found in breast milk (Kotronias 1999), there is only one allegedly documented case of transmission of HSV-1 through breast milk in the absence of skin, oral or genital lesions in the mother (Dunkle 1979).
In other cases the transmission was due to herpetic lesions in the breast (Field 2016, Parra 2013, Sullivan 1983, Quinn 1978).
There are also published cases of reverse infection: oral lesions of an infant with herpetic gingivostomatitis were transmitted to the nipple of the mother (Sealander 1989 Dekio 1986) and a sexually transmitted herpetic mastitis (Brown 1996).

Breastfeeding is contraindicated only if there are lesions on the breast, but it should be allowed to breastfeed a baby from the unaffected breast (Garcia-Loygorri 2015, Lawrence 2004, Henrot 2002, Grossman 1981).

For other locations standard preventive measures should be taken: thorough hand washing, covering the lesions so that the infant does not come into contact with them; wear masks and avoid lip contact (kissing) if the mother has herpes in the lips or stomatitis.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Maternal infection for Herpes Simplex Virus Type 1
  • Maternal infection for Herpes Simplex Virus Type 2
  • Maternal infection for HSV 1
  • Maternal infection for HSV 2

References

  1. Field SS. Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions. J Hum Lact. 2016Abstract
  2. OWH-Oficina para la salud de la mujer. Infecciones de transmisión sexual, embarazo y lactancia materna. Folleto informativo. 2015 Full text (link to original source) Full text (in our servers)
  3. OWH-Office on Women's Health. Sexually Transmitted Infections, Pregnancy, and Breastfeeding. Fact Sheet. 2015 Full text (link to original source) Full text (in our servers)
  4. Garcia-Loygorri MC, De Luis D, Torreblanca B, March GA, Bachiller MR, Eiros JM. La leche materna como vehículo de transmisión de virus. [Beast Milk as vehicle of transmission of virus]. Nutr Hosp. 2015Abstract Full text (link to original source) Full text (in our servers)
  5. Parra J, Cneude F, Huin N, Bru CB, Debillon T. Mammary herpes: a little known mode of neonatal herpes contamination. J Perinatol. 2013Abstract
  6. Red Book. Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, Red Book 2012
  7. Jaiyeoba O, Amaya MI, Soper DE, Kilby JM. Preventing neonatal transmission of herpes simplex virus. Clin Obstet Gynecol. 2012Abstract
  8. Lawrence RM, Lawrence RA. Breast milk and infection. Clin Perinatol. 2004Abstract
  9. Henrot A. [Mother-infant and indirect transmission of HSV infection: treatment and prevention]. Ann Dermatol Venereol. 2002Abstract
  10. [No authors listed] ACOG practice bulletin. Management of herpes in pregnancy. Number 8 October 1999. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000Abstract
  11. Kotronias D, Kapranos N. Detection of herpes simplex virus DNA in maternal breast milk by in situ hybridization with tyramide signal amplification. In Vivo. 1999Abstract
  12. Brown H, Kneafsey P, Kureishi A. Herpes simplex mastitis: Case report and review of the literature. Can J Infect Dis. 1996Abstract
  13. Ruff AJ. Breastmilk, breastfeeding, and transmission of viruses to the neonate. Semin Perinatol. 1994Abstract
  14. Sealander JY, Kerr CP. Herpes simplex of the nipple: infant-to-mother transmission. Am Fam Physician. 1989Abstract
  15. Dekio S, Kawasaki Y, Jidoi J. Herpes simplex on nipples inoculated from herpetic gingivostomatitis of a baby. Clin Exp Dermatol. 1986Abstract
  16. Sullivan-Bolyai JZ, Fife KH, Jacobs RF, Miller Z, Corey L. Disseminated neonatal herpes simplex virus type 1 from a maternal breast lesion. Pediatrics. 1983Abstract
  17. Grossman JH 3rd, Wallen WC, Sever JL. Management of genital herpes simplex virus infection during pregnancy. Obstet Gynecol. 1981Abstract
  18. Freymuth F, Daon F, Langeard MM, Venezia R, Laloum D, Kobilinski G. [Maternal buccal herpes simplex : contamination of the newborn. A case]. Nouv Presse Med. 1980Abstract
  19. Dunkle LM, Schmidt RR, O'Connor DM. Neonatal herpes simplex infection possibly acquired via maternal breast milk. Pediatrics. 1979Abstract
  20. Kibrick S. Herpes simplex virus in breast milk. Pediatrics. 1979Abstract
  21. Quinn PT, Lofberg JV. Maternal herpetic breast infection: another hazard of neonatal herpes simplex. Med J Aust. 1978Abstract