Hi,

This mom should speak to an infectious disease person.  But here are my 2 
cents worth.  It is my understanding that HSV1 is less likely to reactivate when 
it infects unusual areas.  I am sure there is no research that specifically 
measures whether or not taking prophylaxis while breastfeeding eliminates viral 
shedding.  Even when studies are done to check for shedding with herpes in 
genital areas while there is less likely a chance to shed it during prophylactic 
treatment but then again it can still occur.  Transmission is skin to skin or 
mucous membrane to membrane.  I don't think it can directly occur through the 
milk  (but this is something to check out).  

Some considerations.  

If she decides to provide her milk, I would definately recommend that she 
take prophylaxis.  
Would a nipple shield be enough to fully protect her infant?  Should she feed 
EBM until the infant's immune system is mature enough to handle the 
infection.  Should the infant be treated with prophylaxis?  If you do a literature 
search can you find any cases written up of an infant contracting HSV 1 in this 
scenario?  Did she get infection of both nipples or just one?  If its just one 
can she Breastfeed on that side and do EBM on the other?  

Christine Betzold NP CLC MSN

www.theBFclinic.com

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