Having a cold sore can be worrisome for new parents. You may wonder if it’s safe to kiss your baby when you have an active cold sore. Here is a quick overview of what parents need to know about cold sores and newborns:
What are cold sores?
Cold sores are small, painful blisters that develop on the lips or around the mouth. They are caused by the herpes simplex virus (HSV). There are two types of HSV that can cause cold sores:
- HSV-1 – Also known as oral herpes, this virus typically causes cold sores on the lips or mouth.
- HSV-2 – Also known as genital herpes, this virus more often causes sores on the genitals. However, HSV-2 can sometimes cause cold sores on the mouth as well.
Once a person is infected with HSV-1 or HSV-2, the virus remains dormant or inactive in the body. It hides out in nerve cells and can reactivate later, causing cold sores to recur. Certain triggers like stress, illness, sun exposure, or menstruation may prompt the virus to become active again.
Are cold sores contagious to babies?
Yes, cold sores are very contagious to newborns and infants. Babies have an immature immune system that makes them more susceptible to infections.
HSV-1 is typically transmitted through direct contact. Usually this happens when someone with an active cold sore kisses, shares utensils with, or has other direct contact with the mouth of someone who is not infected. Contact with saliva is the most common way babies get exposed.
Most adults carry HSV-1 antibodies by adulthood, meaning they have already been exposed to the virus at some point. Their immune system can fight off infection. But when a baby is exposed for the first time, there is no protection.
What is the danger of kissing with a cold sore?
Kissing a baby with an active cold sore can transfer the herpes virus to the infant. This poses a serious health risk because newborns and young infants are vulnerable to HSV complications.
Problems that can develop if a baby catches HSV-1 include:
- Neonatal herpes – Newborn infection in the first month of life. This can involve rashes, eye infections, mouth sores, brain inflammation, seizures, and more.
- Herpes whitlow – Finger infection
- Eye infection
- Mouth ulcers
- Skin rash
In rare cases, neonatal herpes infection of the central nervous system can cause long-term damage. Even localized skin infections can spread. Herpes in infants requires urgent medical treatment.
What about kissing other places like the head or feet?
It’s best to avoid kissing your baby anywhere while you have an active cold sore. The herpes virus can spread from contact with sores but also through viral shedding.
Viral shedding refers to when the virus is active and being released from the skin surface even though no sores are present. This is another way HSV can be transmitted. There is a risk of spreading the virus to your baby through viral shedding if you kiss their head, hands, feet or anywhere on their body.
Is it safe to kiss if I feel a cold sore coming on?
No, it’s not considered safe to kiss your baby if you feel the telltale tingle of a cold sore about to erupt. Here’s why:
- Viral shedding occurs in the days leading up to a cold sore outbreak, meaning the virus can be transmitted even though a sore has not appeared yet.
- The warning tingling sensation means the virus is reactivating in your body.
- Even if you don’t develop an actual cold sore, you can still shed and spread the virus during this time.
So it’s important to avoid kissing right from the first sign that a cold sore might be starting. This helps prevent passing HSV-1 on to your infant.
Can I kiss if I have a healing cold sore?
You should wait until the cold sore has completely healed before kissing your baby. Here are some tips for knowing when a cold sore is no longer contagious:
- Wait until the blister is completely dried out and crusted over.
- Make sure the site has completely healed over with new skin.
- It should no longer be painful, swollen, or red.
- Be diligent about not picking or peeling the sore before it’s ready, as this can prolong healing.
- It can take anywhere from 8 to 14 days for a cold sore to fully heal.
Keep in mind that even when the cold sore lesion goes away and looks healed, the virus still remains dormant in your body. Recurrences are always possible in the future.
What precautions should parents take?
If you have an active cold sore or feel one developing, here are some precautions to take:
- Avoid kissing and direct contact with your baby’s face, hands, and skin until fully healed.
- Wash hands frequently, especially after touching the cold sore.
- Don’t share food, utensils, cups, lip balm or anything else that has mouth contact.
- Keep sores covered with a bandage.
- Take antiviral medication to help speed healing.
- Avoid close face-to-face contact until the cold sore has resolved.
If someone else in your household has a cold sore, ask them to follow these same precautions until it goes away.
What if someone kisses the baby despite a cold sore?
If your baby comes into direct contact with someone who has an active cold sore, it’s important to watch them closely for any developing signs of infection.
Call your pediatrician right away if your baby has any of these symptoms within a few days of exposure to HSV-1:
- Fever
- Lethargy or lack of appetite
- Sores in or around the mouth
- Rashes or blisters on skin
- Swollen or irritated eyes
- Excessive crying or irritability
Your doctor can do tests to determine if your baby has a herpes infection. Prompt treatment with antiviral medication can help shorten the course and severity. Alert your doctor about any direct cold sore contact your baby has had recently.
When is it safe to kiss again?
Once the cold sore has fully resolved and the area has healed completely, viral shedding should stop. At this point, it is generally safe to kiss your baby again provided these precautions are followed:
- Do not kiss if another sore appears. Go through the full healing process again.
- Ask your doctor about daily antiviral medication to help prevent future outbreaks.
- Always wash hands before touching your baby, especially after applying creams or ointment to cold sores.
- Keep lips moisterized to avoid cracking.
- Practice healthy habits to boost immune system.
- Avoid triggers like stress, fatigue, sunlight exposure.
While these measures can help reduce risk, there is always a low chance of asymptomatic viral shedding. People with known HSV-1 infection should be careful about contact with infants and consult their doctor.
What if my baby gets recurrent cold sores?
Unfortunately, once your baby has been exposed to HSV-1, they may continue to get periodic cold sores. Some options include:
- Antiviral medication – Oral acyclovir or valacyclovir can be prescribed to treat outbreaks and suppress the virus.
- Avoid triggers – Keep their lips moisturized, limit sun exposure, reduce stress.
- Boost immunity – Ensure they get adequate sleep, nutritious diet, and exercise.
- Lysine supplements – Some studies show lysine can help reduce recurrence when taken regularly.
- Natural remedies – Applying lemon balm, licorice root cream, or ice may help alleviate sores.
- Numbing gels – Over-the-counter preparations can temporarily numb pain.
Talk to your pediatrician about the best treatment options. While recurrent cold sores can be frustrating to deal with, rest assured most infants and children build up antibodies and eventually develop resistance to problems from HSV-1 as their immune system matures.
The Bottom Line
Here are the key takeaways about kissing babies when you have a cold sore:
- Don’t kiss your baby anywhere on the body – including the head – if you have an active cold sore or feel one starting.
- Wait until the cold sore has fully healed before kissing again.
- Avoid contact with your baby’s hands, skin and belongings as the virus is easily spread through viral shedding.
- Take medication to speed healing if needed.
- Always wash hands thoroughly before touching baby, especially after treating a sore.
- Watch for any signs of infection in baby for up to 2 weeks after exposure.
While it can be difficult not to kiss a newborn, protecting their health is paramount. With some care and precaution, cold sores can be managed to avoid passing HSV-1 on to your precious baby.
