This sheet talks about exposure to chickenpox or shingles in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is chickenpox?
Varicella, commonly called chickenpox, is a viral infection that usually happens in childhood. Chickenpox is caused by the varicella-zoster virus (VZV). The most common symptom of chickenpox is a rash which first appears as small, reddish spots or pimples. These spots will blister and then scab over. New spots appear for up to 3-5 days. Often a fever and body aches occur before the rash appears. Pneumonia also occurs in 10-15% of teenagers and adults who have chickenpox.
Is chickenpox contagious?
Chickenpox is very contagious. This means that it can spread easily from person to person. A person who has chickenpox is contagious 1-2 days before they break out in a rash and continues to be contagious until all of their spots are scabbed over. If you have never had chickenpox before and someone in your household is infected, there is a 90% chance that you will catch it as well. Infection happens less often after exposure in other places, such as a school. People develop symptoms about 7-21 days after being exposed to chickenpox.*
I’m pregnant and have just been exposed to chickenpox. I had chickenpox when I was a child. Is there risk to my baby?
When a person has chickenpox, he/she makes antibodies to the virus. These antibodies usually last a long time and keep a person from getting chickenpox again. (The person becomes immune.) People who are immune are not likely to develop chickenpox if they are exposed to the virus again.*
I am pregnant. I don’t think I ever had chickenpox and have recently been exposed. Is there anything I can do?
Talk to your healthcare provider as soon as possible. There is a blood test that can tell if you have antibodies to the chickenpox virus. Up to 95% of women who do not think or know if they ever had chickenpox will have antibodies on a blood test. This means that they have already had chicken pox and are immune.
If the blood test shows that you do not have antibodies to the chickenpox virus, then you are not immune. If you are not immune, you have a chance of being infected if exposed to the virus. Women who become infected with chickenpox during pregnancy often have more severe symptoms than adults who are not pregnant.
If you have recently been around someone with chickenpox and do not have immunity, talk to your healthcare provider about what steps you can take to avoid getting chickenpox, or to reduce the severity of the symptoms.
I had chickenpox at 10 weeks of pregnancy. Does my baby have an increased chance for birth defects or other pregnancy complications?
In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. About 2% of babies (1 in 50) whose mothers have chickenpox in pregnancy will have one or more birth defects due to the infection. 1% (1/100) of pregnancies that are infected with chickenpox in the first trimester have birth defects related to chickenpox (and 99% do not). When chickenpox occurs between 13 and 20 weeks of pregnancy, the chance for birth defects related to the chickenpox infection is to 2% (98% of pregnancies do not have related birth defects). The chance for birth defects is greatest when the mother develops chickenpox between 7 and 20 weeks of pregnancy.
Babies with birth defects related to the mother’s chickenpox are said to have congenital varicella syndrome. The birth defects include scars on the skin, eye problems, poor growth, underdevelopment of an arm or leg, small head size, or delayed development and/or intellectual disability. Some babies may have only one of these problems while others have some or all. Preterm delivery (delivery before 37 weeks of pregnancy) is more common in women who have chickenpox in the first half of their pregnancies. However, most babies born to women who have chickenpox in pregnancy are healthy.
My due date is in 3 weeks, and I have just been exposed to chickenpox. Is there any risk to my baby if I develop chickenpox at this stage of pregnancy?
If you already had chickenpox or had the vaccine, you do not need to be concerned because your past infection should protect you. If you have not had chickenpox or the vaccine, talk to your healthcare provider right away. If you develop chickenpox 5 days or less before delivery or 1-2 days after delivery, there is a 20-25% chance your newborn baby could also develop chickenpox. Chickenpox infection in this time period is called neonatal varicella. Neonatal varicella can be severe.
If you develop chickenpox between 6 and 21 days before delivery, there is still a chance your newborn could develop neonatal varicella. However, because your baby will get some of your newly-made chickenpox antibodies, the neonatal varicella is more likely to be mild.
What is shingles?
Shingles is viral condition caused by the same virus that causes chickenpox. It causes painful blisters or and a rash that usually affect a small area of the body. When someone has recovered from chickenpox, the virus can stay inactive in some of the nerves in the body. If the inactive virus is reactivated, it causes shingles, also known as herpes zoster. Shingles can lead to skin infections, nerve pain, and hearing or vision problems.
My co-worker has shingles. Is there any risk to my baby?
Shingles is not passed to other people the same way that the chickenpox virus is. However, if you have contact with (touching) the blisters and you have never had chickenpox, it is possible to get infected with chickenpox.
If you have had chickenpox or had the vaccine, you likely have antibodies (are immune) to the chickenpox virus.
Does having shingles in pregnancy cause birth defects or other complications?
Shingles is rare in pregnancy. There are not a lot of studies that look at the effects of shingles and pregnancy. However, shingles has not been seen to increase the chance of birth defects or other pregnancy complications directly due to the mother’s shingles. If you are pregnant and develop shingles, talk to your healthcare provider about treatment.
Can I breastfeed while sick with chickenpox or shingles?
The chickenpox virus has not been found in breast milk of women with a chickenpox infection. Breast milk might contain antibodies that can help to protect your baby from getting chickenpox. Because chickenpox is very contagious, talk to your child’s pediatrician right away if you come down with chickenpox. It is important to prevent your baby from coming into direct contact with your rash or the affected areas in order lower the chances of your baby from getting the virus. If you suspect your baby has any symptoms that could be due to chickenpox or shingles, contact the child’s healthcare provider.*
If a man has chickenpox or shingles, does it increase the chance of infertility or birth defects?
There are no studies looking at possible risks to a pregnancy when the father has chickenpox or shingles. A study that tested a man’s semen while he had chickenpox did not find any signs of the virus in his semen. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. However, if the father of the baby has a partner that is not immune to chickenpox, there is a risk of the pregnant woman becoming infected. If your partner has chickenpox and you have not had chickenpox or the vaccine, talk to your healthcare provider right away. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
* Section Updated May 2020
References Available By Request