Neonatal Herpes: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Neonatal Herpes?
A neonatologist, a doctor who cares for sick newborns, usually leads treatment in the hospital. A pediatric infectious disease specialist, a doctor who treats serious infections in children, may also help. A baby with signs of neonatal herpes needs to be seen right away. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is neonatal herpes?
Neonatal herpes is an infection in a newborn baby. It is caused by the herpes simplex virus, or HSV. A baby can catch HSV before birth, during birth, or after birth. It can lead to a deadly infection in a baby.
Herpes may show up only as a skin infection. It can also spread through the body. This is called disseminated herpes. Herpes in the brain is called herpes encephalitis. The liver, lungs, and kidneys may also be involved.
Symptoms
Herpes in a baby may only affect the skin. Small blisters filled with fluid may appear. They break, crust over, and heal. A mild scar may remain.
Babies whose infection has spread to the brain or other parts of the body are often very sick. Signs can include:
- Skin sores or blisters filled with fluid. There may or may not be blisters on the skin.
- Bleeding easily.
- Rapid breathing, short periods without breathing, nostril flaring, grunting, or a blue look.
- Yellow skin and yellow whites of the eyes.
- Weakness.
- Low body temperature.
- Poor feeding.
- Seizures, shock, or coma.
Causes and who gets it
HSV type 2 is the most common cause of HSV infection in newborns. HSV type 1 can also cause it. A baby can catch the virus in three ways:
- In the womb. This is unusual.
- While passing through the birth canal. This is the most common way.
- Right after birth, from a kiss or other contact with someone who has cold sores.
If the mother has an active outbreak of genital herpes at delivery, the baby is more likely to get infected. Some mothers do not know they have HSV sores inside the vagina. The risk is high when a mother first gets genital herpes near the time of delivery.
How doctors diagnose it
Doctors test for the virus by taking a scraping or sample from a blister. They may also test the fluid around the spinal cord. An MRI scan of the head may be done. A lab test called PCR is the test of choice for HSV infections of the brain and body, including neonatal herpes.
Treatment
Babies with HSV are treated with antiviral medicine given through a vein, called an IV. The baby may need the medicine for several weeks. The CDC says every newborn with neonatal herpes should be promptly evaluated and treated with acyclovir, an antiviral medicine that works through the whole body.
Babies may also need treatment for the effects of the infection, such as shock or seizures. Because these babies are very ill, care is often in the hospital intensive care unit.
Outcomes vary. Babies whose infection has spread to the brain or body often do poorly, even with antiviral medicine and early treatment. In babies with skin disease, the blisters may keep coming back after treatment ends. Some children have developmental delay, which means slower learning, or learning disabilities.
Prevention starts in pregnancy. A mother with a history of genital herpes should tell her provider at her first prenatal visit. If she has frequent outbreaks, she is given a medicine in the last month of pregnancy to help prevent an outbreak at delivery. A C-section is recommended if she has an active outbreak of herpes sores and is in labor.
People with cold sores should not come in contact with newborns. A caregiver with a cold sore should wear a mask and wash hands carefully before touching an infant.
When to see a doctor
If your baby has any signs of herpes, have the baby seen right away. This includes skin blisters with no other signs. Call 911 or go to the emergency room if your baby has trouble breathing, looks blue, or has a seizure.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your herpes history before or during pregnancy and help you share it with your pregnancy care team. After the hospital stay, the doctor can help coordinate follow-up with specialists.
Common questions
Is neonatal herpes serious?
Yes. It can lead to a deadly infection in a baby. Babies with infection that has spread to the brain or body are often very sick and often do poorly, even with early treatment.
Can neonatal herpes be prevented?
Not completely. Steps can lower the risk, such as telling your provider about a herpes history at the first prenatal visit, a C-section when the mother has an active outbreak in labor, and keeping people with cold sores away from newborns. A C-section does not remove the risk entirely.
Can a kiss give a baby herpes?
Yes. A baby can catch HSV right after birth from being kissed or having other contact with someone who has cold sores.
Sources
- MedlinePlus - Pregnancy and herpes
- Centers for Disease Control and Prevention - Herpes - STI Treatment Guidelines
- Centers for Disease Control and Prevention - About Genital Herpes
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
