Christmas visitors and a newborn: cold sores, kisses and coughs

Quick answer: Only close family and carers should kiss a newborn, and only on the top of the head. Avoid kisses near the mouth, nose or eyes. Anyone with a cold sore now or recently shouldn't kiss the baby at all. Everyone should wash their hands first, and visitors with coughs or colds should wait.

What parents need to know

The NHS says babies are thought to be most at risk from herpes simplex, the virus that causes cold sores, in the first 6 weeks after birth. For a baby born in mid-November, those 6 weeks run through Christmas. Neonatal herpes is rare in the UK. It can still be very serious, because a young baby's immune system may not be ready to fight the virus, and babies born prematurely are particularly at risk.

A cold sore is contagious from the first tingle until it has completely healed. That means a relative can pass it on before any blister shows.

Kisses: the top of the head only

The NHS advice on neonatal herpes is to discourage anyone who isn't a close family member or carer from kissing your baby. The safest place for a kiss is the top of the head. Avoid kisses near the mouth, nose or eyes.

Most people pick up the cold sore virus as children, through close contact such as kissing. It then stays in the skin for life. The NHS cold sores page lists illness, sunshine and periods as possible triggers, so a relative who gets cold sores regularly could have one starting on the day they visit.

• Anyone with a cold sore now, or who has had cold sores recently, shouldn't kiss your baby.
• Known herpes infection. Anyone with a cold sore or a herpes blister should avoid touching your baby. If they're a close family member or carer, they should wash their hands carefully before they do
• Blisters on the fingers caused by herpes (herpetic whitlow) can spread the virus too.

Coughs, colds and washing hands

Everyone should wash their hands before handling your baby, the NHS says. NCT suggests asking every visitor to do this before they hold a newborn, to lower the chance of an infection in the early weeks.

The NHS bronchiolitis page advises keeping newborn babies away from anyone with a cold or the flu, especially babies born prematurely or with serious health conditions. Bronchiolitis is usually caused by RSV, which spreads easily in coughs and sneezes. Babies under 6 months are among the most likely to become seriously ill with it. There's more detail in Bronchiolitis and RSV in Babies: What UK Parents Should Know This Autumn.

• Wash your hands and your baby's hands often.
• Wash or wipe down toys and surfaces regularly.
• Avoid sharing cutlery and cups.
• Use disposable tissues and throw them away as soon as they've been used.
• Ask smokers to smoke outside and wash their hands thoroughly before holding the baby. The NHS says children who breathe in cigarette smoke have a higher risk of severe bronchiolitis.

Common beliefs about cold sores and babies

If you or your partner gets a cold sore

If you develop a cold sore or any sign of a herpes infection, the NHS advises these precautions. They apply to your own baby as well as other people's.

• Don't kiss any babies.
• Wash your hands before contact with a baby and before breastfeeding.
• Cover any cold sores, lesions or other signs of herpes anywhere on your body.
• Blisters on the breast. Don't feed from that breast, or give expressed milk from it, until all the blisters have healed. You may need to take medicine as well, so speak to your GP or midwife

Treating the cold sore

A pharmacist can recommend antiviral creams, which work best when you start them at the first tingle, and patches that cover the sore while it heals. See a GP if a cold sore hasn't started to heal within 10 days, is very large or painful, or you're unsure it is a cold sore.

How to set limits politely

Send a message before the day so the awkward part isn't happening on the doorstep. Keep it short and give the reason, so it comes across as advice you're following. Nobody needs to feel singled out.

• Before the visit. "We're following NHS advice for the first few weeks, so we're asking everyone to wash their hands before a cuddle and keep kisses to the top of her head"
• To someone who's unwell. "If you've got a cold or feel a cold sore coming, could we see you once it's cleared up? We'll send photos"
• Pass the baby over once hands are washed, and keep them with you during busy moments if being passed round gets too much.
• Ask your partner or a relative to repeat the house rules so you aren't the only one saying them.

Frequently asked questions

How can a visitor tell a cold sore is starting?

It usually starts with tingling, itching or burning, and one or more small fluid-filled blisters appear over the next 48 hours. It's contagious from that first feeling, so they shouldn't kiss the baby until it has completely healed. Visitors who aren't close family or carers should avoid touching the baby. Close family and carers should cover the sore and wash their hands carefully before touching the baby.

Can I breastfeed if my baby is being treated for herpes?

Yes. The NHS says you can breastfeed during treatment unless you have herpes sores around your nipples. If you're taking antiviral medicine too, some passes into breast milk, but it isn't thought to harm your baby.

Can older brothers and sisters kiss the baby?

They're close family, so a kiss on the top of the head is fine as long as they don't have a cold sore now and haven't had one recently. If they have a cough, cold or the flu, they shouldn't kiss or hold the baby until they're better. Most people catch the cold sore virus as children, so check their lips and wash their hands first.