# how to avoid herpes outbreak at birth?



## jenP (Aug 22, 2002)

So, I am ten days from my due date. I have had genital herpes for about ten years. Sometimes I have a stretch of frequent outbreaks, sometimes I go for months without any. Sometimes the blisters are on the labia, sometimes they are on my, for lack of a more clinical word, butt-crack (almost at the top - far from the perineum.)
For my first birth, three years ago, I used Valtrex 500mg once a day for about the last 4 weeks of pregnancy to suppress a possible outbreak at labor/delivery. I tolerated it fine and had a normal vaginal birth (no outbreak.)
I've taken valtrex in the past, both for suppressive therapy and for episodic treatment and always tolerated it well.
So I figured I would take it again. I got started late, I was in week 37 (last week) and finally got around to taking the pill. Took one Friday afternoon. Friday evening I had some loose stools; Saturday morning and into the afternoon I had horrible diarrhea! Not painful, but frequent blowouts! I went on a rice diet and took a few probiotics and slept for a while and by evening I was fine. I havent' taken another valtrex since and I am afraid to, I can't go around feeling sick like that, I have a three year old to take care of and a lot of stuff to finish around here before the baby comes. On the other hand, I can't bear the thought of having to have a surgical delivery! Maybe some diarrhea is a small price to pay to prevent a c-section. Or maybe the diarrhea was a coincidence (I did accidentally have some dairy on Thursday, before taking the pill Friday; I don't have dairy problems that I know of but I've been vegan for a long time, maybe I lost my ability to digest dairy??)
My midwife said if there is an outbreak on my lower back/butt at time of delivery they would cover it with gauze and it should be fine. But if there is one on the labia they would STRONGLY SUGGEST surgical delivery.

Should I try the valtrex again? Maybe half a pill? Are there any ways to minimize the side effects?
Are there any homeopathic remedies to prevent outbreaks?

Thanks!!

Jen


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## massagemom (Apr 6, 2005)

i had the same thing happen when i started taking valtrex before my labor.
not as severe, but i did have abdominal cramping and some loose stools.

i almost stopped taking it myself, but decided to stick it out b/c i did not want a c section. the symptoms i described went away in a few days and i had no other problems after that.

i would just weigh the pros/cons for yourself, maybe even write it down if that would help. you'll make the right decision for you!


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## LoveChild421 (Sep 10, 2004)

I don't have any personal experience with herpes but just wanted to add that RAW garlic is a powerful antiviral/ antibacterial...maybe you could go a more natural route? maybe extra vit C too to rev up your immune system.??


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## WriterMama (Mar 27, 2002)

I don't have genital herpes, but I get cold sores on my mouth--I know the viruses are part of the same family. Anyway, I take 3 l-lysine when I feel one coming on, and then, take 1 or 2 a day until after it goes away. It really shortens the time they last. I wonder if you added that into your diet now, along with garlic, vit C and probiotics, that it would strengthen your immune system enough to avoid them. I would also try another valtrex (or half) just to see if the diarrhea was a coincidence or not.

Oh, and check out this link--it talks specifically of cold sores, but more generally about herpes and how lysine inhibits herpes outbreaks, but arginine promotes them. Some arginine-rich foods to avoid are chocolate, peanuts and other nuts, seeds, and cereal grains. http://alternative-medicine-and-heal.../coldsores.htm

Good luck to you!


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## massagemom (Apr 6, 2005)

on the valtrex site they mention that headaches, nausea and abdominal pain are common side effects.

wishing you the best!


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## lioralourie (Aug 22, 2004)

I also have herpes, since I was 19. Although luckily after a few years it became very mild, and I've had no outbreak in years now.

But when I feel maybe a little *tingly* down there, and think an outbreak might be coming on, I take L-Lysine and it always subsides. I didn't think about taking it during my pregnancy, though, and don't know how much is ok to take.

Since it's only an amino acid, one that's found in everyday foods anyway but in much higher doses for the supplement, I wouldn't think it's much (if any) problem. Maybe do some internet research. Probably better than the docs. Good luck.


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## jenP (Aug 22, 2002)

Thanks for all the tips, everyone!
Yesterday and today each I took a half a pill and so far no GI problems. I will take a whole pill tomorrow. Maybe there was something else going on to make me more sensitive to the valtrex last week. I always knew the GI troubles were listed on the package insert as common side effects, however it took me by surprise to actually have the side effects as I have taken this drug so many times in the past (even when pregnant before) and never had a problem.
I'm also taking L-Lysine 3 times a day.
And taking probiotics 3 X a day; this is partly to stave off GI troubles and for general health AND to hopefully help make sure I'm GBS neg. (I refused the test as I wouldn't take the ABX either way at labor, but I am doing what I can to avoid a GBS problem with the baby.) So I am also cutting back on sugar and putting raw garlic in the vagina ('cause actually eating raw garlic makes me ill. Gassy to the point of nausea) and drinking pure cranberry juice.
So hopefully all these natural measures, as well as the valtrex, will help me avoid a surgical birth! I actually have an outbreak right now, it is on the back however so I would still be able to birth vaginally. I guess the other thing I'm forgetting to avoid an outbreak is to avoid stress!! I will be able to relax more now; the last few weeks have been crazy with buying a new house, trying to get things in order for the birth and new baby, having a birthday party for DD, and such. Just a little more to do around here and then I can relax and wait for baby, I just hope s/he gives me a few more days!
Please keep any more tips coming. For instance, I can't seem to find anything homeopathic to fight herpes?
Thanks!

Jen


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## mwherbs (Oct 24, 2004)

this is the info I have on it maybe you should call your provider also look at the drugs that cross react with it-

What are the possible side effects of valacyclovir?

• Stop taking valacyclovir and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).
• Other, less serious side effects may be more likely to occur. Continue to take valacyclovir and talk to your doctor if you experience
· nausea, vomiting, diarrhea, constipation, or abdominal pain;
· headache;
· dizziness; or
· tremors.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect valacyclovir?

• Probenecid (Benemid) and cimetidine (Tagamet, Tagamet HB) may increase the effects of valacyclovir and possibly lead to dangerous side effects. You may need a dosage adjustment or special monitoring during treatment if you are taking probenecid or cimetidine.
• Drugs other than those listed here may also interact with valacyclovir. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.


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## JohnnysGirl (Dec 22, 2003)

I never thought of taking garlic and vitamin C to try to minimize chance of an outbreak,







what a great and obvious idea!
I have never had an outbreak while pregnant or birthing, in fact have had very, very little signs of the virus at all since my initial outbreak (I just have a really strong immune system that keeps the virus well below the surface), so I'm maybe blithely confident about not having one when birthing (I typically forget that I have it at all).... although it is the only reason I haven't tried to plan a homebirth.


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## MamaChel (Mar 28, 2003)

I've never heard of L-lysine, I'll have to try that. When I was pg with my first I took Valtrex 500mg once per day for the last 2 weeks to try to prevent an outbreak. Since my primary outbreak was during that pregnancy, there was a little concern and my ob tried to convince me to just schedule a c-section.

The second time around, I took Vit C and bee propolis on the advice of my midwife to boost my immune system (and try to treat the GBS+) and kept my stress levels down. I had a successful homebirth, with no complications. I did have the Valtrex on hand should I have felt an outbreak coming. My midwife was less worried about the herpes than she was about the GBS test.


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## DreamsInDigital (Sep 18, 2003)

My midwife didn't even bat an eyelash about my herpes, she just said the Valtrex in the last few weeks would usually prevent an outbreak. I, too, have not had an outbreak in forever and have almost completely forgotten I have it at times.


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## merrick (Dec 8, 2003)

From what I've read, most if not all cases of herpes infection in a newborn is from a primary infection during pregnancy, as in the first outbreak. So, since you've had it for years, it really probably won't be a problem anyway. But of course you don't want to take any chances with your baby, but I thought it might make you feel better to hear that.


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## UmmBnB (Mar 28, 2005)

There are a couple of recent studies, which of course I no longer have the information on, that suggest that L-lysine really doesn't help outbreaks much. I really don't have any personal experience with it. I take it during outbreaks and have taken it for suppression but my outbreaks are so infrequent that its hard to tell if it helps or not. I've only ever had 1-2 a year myself and they are pretty mild so I keep a bottle of acyclovir (valtrex isn't on my HMO's formulary) around just in case but I rarely even take it when I do have an outbreak.

Both pregnancies I took it for the last 2 months however, even with my infrequent outbreaks. _Any_ chance of a stupid herpes outbreak ruining my birth is too much, you know. I know some mw's who, depending on the placement of the leisons, are willing to do a vaginal birth even during an outbreak (I honestly don't know if mine is one of them) but for me, I wouldn't go there. I couldn't live with myself if I passed this on to my baby, you know.


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## massagemom (Apr 6, 2005)

that's exactly how i felt about taking valtrex: better to be safe than sorry. i would have been devastated if i'd had to have a c section b/c of an outbreak. i dislike taking any prescription medication, but in this case i was definitely willing to make an exception.

again, good luck to the op!


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## lioralourie (Aug 22, 2004)

from http://www.chclibrary.org/micromed/00049310.html

An imbalance in the amino acids lysine and arginine is thought to be one contributing factor in herpes virus outbreaks. *A ratio of lysine to arginine that is in balance (that is more lysine than arginine is present) seems to help the immune system work optimally.* Thus, a diet that is rich in lysine may help prevent recurrences of genital herpes. Foods that contain high levels of lysine include most vegetables, legumes, fish, turkey, beef, lamb, cheese, and chicken. Patients may take 500 mg of lysine daily and increase to 1,000 mg three times a day during an outbreak. Intake of the amino acid arginine should be reduced. *Foods rich in arginine that should be avoided are chocolate, peanuts, almonds, and other nuts and seeds.*

this has always helped me. Although I crave chocolate at times, and do eat some nuts.


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## jenP (Aug 22, 2002)

well, the combination of valtrex and natural immune-boosters and some luck worked, because I had no outbreaks and had an all-natural vaginal delivery on July 12. Hard to believe Arlo is 12 weeks old now!
I was doing some reading on the New Zealand herpes foundation website, and some studies seem to indicate that cesarean does not necessarily reduce risk much, even if vaginal lesions are present, if it is not the primary outbreak. Interesting. http://www.herpes.org.nz/pregnancy.html
I probably would have still gone for a vaginal birth if I had had lesions on my lower back, but probably a c/s if I had vaginal lesions. Thank goodness it didn't end up being an issue!
Good luck to any other mamas trying to avoid outbreaks at delivery!

Jen


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## applejuice (Oct 8, 2002)

Boost your immunity with everything here suggested and do not eat anything sugary or anything that will lower your immunity.


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## UmmBnB (Mar 28, 2005)

I take acyclovir for outbreaks and took it the last month of each pregnancy. I know immune boosters can help, l-lysine is believed to help (although I've not had great results with it over the years) but it wasn't worth the risk. My birth at home was far more important than going the natural route for outbreak prevention.


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## richella (Nov 30, 2004)

Congrats JenP! Glad you had a good birth. I just found this thread and wanted to add that passing herpes from mother to baby is rare, because mother has antibodies that she passes on to baby in her blood and via colostrum/breastmilk. The number I read was 3-4%, but I imagine it's probably lower if the breastfed babies are separated from the ffed ones.

Something to think about when weighing the factors and making a decision.


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## jenP (Aug 22, 2002)

Quote:


Originally Posted by *richella*
Congrats JenP! Glad you had a good birth. I just found this thread and wanted to add that passing herpes from mother to baby is rare, because mother has antibodies that she passes on to baby in her blood and via colostrum/breastmilk. The number I read was 3-4%, but I imagine it's probably lower if the breastfed babies are separated from the ffed ones.

Something to think about when weighing the factors and making a decision.

Yes, the risk is low if the mother has had the virus since before becoming pregnant. Something like one in five adults in the U.S. has genital herpes, yet fewer than 1 in 1000 babies become infected (I think.) The biggest risk if you are having the first outbreak at delivery.
But even knowing risk is low if it is an old infection, you still don't want to have lesions present at delivery time!
Jen


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