Wise ones,

   I searched the archives for this particular situation and could not
   find.  Permission to post:  Certified Nurse Midwife has hx of primary
   HSV 1 nipple lesions (confirmed by culture) occurring after
   breastfeeding toddler ( age 2) with HSV 1 lesion on mouth  She had no
   prior hx of HSV 1.  She is very knowledgeable re:  latch/position, etc.
   but still had nipple break down first month of nursing--has very fair,
   sensitive skin.  Now, a year later, she is pregnant with second child
   and has questions about nursing her future newborn:   Is there a risk of
   transmitting HSV 1to baby if nipples have breakdown (not herpes lesion)?
   If she already has tissue breakdown from normal nursing, how will she be
   able to identify a lesion beginning to form? What about prophylactic
   treatment prior to delivery?
    She does not want to put her newborn at risk and is cognizant of
   seriousness of herpes in neonates.  She has discussed this with her
   pediatrician, who contacted a neonatologist.  Neither had experience
   with this particular situation nor could offer advice.  Lawrence and
   Riordan both state OK to nurse with HSV 1 if no active lesions, but
   don't address risk if nipple breakdown (not HSV 1 lesions) is present.
    Best case is no nipple breakdown to begin with, but she is not
   confident that will be the case, despite best breastfeeding practice.
   Anyone have experience with nursing newborns after previous HSV 1
   outbreak on nipples?

Thanks for your help,

Carolyn Jacobson, RNC, IBCLC

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