Yes, I guess the mom could get herpes on her breasts/ nipples from the
toddler nsg, but I would continue anyway. She has herpes too, not
currently with outbreak, but may not get iton breast due to immunity.
Fastidiousness is very helpful.  Premies are a special case, being esp.
vulnerable to any infectious agent.   But what people need to understand
about herpes is that the primary infection (1st time case) is the main
problem. And genital primary case is the concern with pregnancy and
delivery. Even an "old" infection/outbreak at time of delivery has low
incidence of passing to newborn, but c-sxn is still advised to be safe.
Yes, mom can transfer virus from mouth to breast with her hands. Baby can
too, so. handwashing is important.  I cannot see how this will affect the
current pregnancy.   If mom has a genital lesion at time of delivery,
that is a probable csxn. Newborns should not be kissed by soemone with
active lesion on mouth. The toddler may be too uncomfortable to nurse. If
mom is scared of getting it on breasts (would be painful) she could
express and feed to toddler if he would take that til the antivirals
kicked in. Outbreaks usually last a week or so, so would 48 hrs really be
protective? I would nurse.
laurie wheeler, rnc, mn, ibclc
violet la usa