What You Need to Know About Chickenpox in Babies and During Pregnancy

Varicella, more commonly known as chickenpox, might be one of the least enjoyable parts of growing up that many children (and their parents) have to endure. Luckily though, the symptoms of chickenpox don’t usually last more than a week or so, and more serious complications are rare.

Keep reading for pointers on how to alleviate the symptoms if your little one breaks out in a tell-tale rash of itchy spots, when it might be necessary to seek treatment or a vaccine, and what it could mean for you and your little one if you happen to catch chickenpox when you’re pregnant.

What Is Chickenpox?

Chickenpox, also known as varicella, is a highly contagious infection caused by the varicella zoster virus. Its best-known symptom is a rash that appears as an outbreak of itchy red spots.

Chickenpox doesn't usually cause serious illness in healthy children, but in adults, adolescents, pregnant women or newborn babies it can be more severe and may occasionally lead to complications like pneumonia.

The good news is that the chances of catching the disease in early or late adulthood are low, because most people have already had it as a child. This usually gives them immunity for life.

For at-risk people who aren’t yet immune to chickenpox there are ways to reduce the risk of infection, including a vaccine.

The Symptoms and Stages of Chickenpox

Chickenpox usually starts with a temperature or mild fever that may be accompanied by a headache.

Within a few hours of this other typical symptoms of chickenpox appear, including:

• A rash consisting of clusters of red spots that mostly appear on the trunk, although they may also spread to other parts of the body. These spots soon develop fluid-filled blisters that are incredibly itchy. In a few days these blisters will dry out and crust over.

• Fever

• Aches and pains

• Loss of appetite.

How Does Chickenpox Spread?

Chickenpox is highly contagious, and it can be caught by touching the rash of someone who already has the infection or by handling infected objects like clothing or bedding. It can also be transmitted through the air in tiny droplets by coughing or sneezing.

The most infectious period for chickenpox starts one or two days before the rash appears and lasts until all the blisters have crusted over. This is usually about five to six days after the symptoms first start appearing.

If your little one gets chickenpox, keep your child at home until all the spots have crusted over, to avoid spreading the infection to others.

It’s also a good idea to alert other parents whose children might have come into contact with your child during the infectious period.

In particular, avoid contact with newborn babies and people who may not yet be immune to chickenpox – especially if they’re pregnant or have a compromised immune system.

Because it’s such an infectious disease, children with a sibling who has chickenpox are also highly likely to get the infection as well, if they don’t already have immunity.

Chickenpox Treatment

Chickenpox in otherwise healthy children usually clears up by itself in around a week without treatment, but even mild cases can make your little one miserable.

If your child does get chickenpox, here are some ways you can ease the discomfort:

• Give your baby or toddler plenty of fluids to stay hydrated

• Prevent scratching by putting mittens or socks on your child’s hands

• Cut your baby’s nails to avoid skin damage from scratching

• Apply soothing cream or gel to areas of dry or cracked skin

• Ask your doctor or pharmacist about antihistamine medicines to alleviate severe itching

• Give cool baths – heat can make the itching worse – and dry the skin with a patting motion instead of rubbing

• Dress your child in loose clothes to reduce skin irritation

• Ask your doctor or health visitor about what medicines are suitable for relieving aches and pains, or for bringing down a fever.

When to Call the Doctor

Chickenpox doesn’t always need medical treatment, but if you do visit a doctor’s surgery it’s best to phone ahead. They may want to see you separately from other patients, to prevent the infection from spreading.

Check in with your doctor or paediatrician to discuss treatment if

• you suspect your newborn might have chickenpox

• you’re pregnant, and you’ve never had chickenpox before and you think you may have been in contact with someone who’s infected

• your child has a rash or other symptoms, but you’re not sure that it’s chickenpox

• your baby is dehydrated

• the area around the blisters is painful, hot or red – this could be a sign of infection

• your little one finds it hard to breath or shows other symptoms of pneumonia

• you’re worried or your child’s condition seems to be getting worse.

Preventing Chickenpox

Chickenpox is highly contagious, so the best way not to catch it is to be immune to the virus that causes it. There are two ways of becoming immune to chickenpox:

• By having had chickenpox. Having chickenpox isn’t a happy experience, but the upside is that you only get it once. After that most people are immune for life.

• By getting vaccinated. The chickenpox vaccine is offered on the NHS to some people – for example, those who spend time around people with a weakened immune system. It’s also available privately to people who choose to be inoculated against chickenpox.

People without immunity can try to avoid infection by steering clear of anyone who may be infected with chickenpox and/or shingles (another skin infection caused by the varicella zoster virus).

Chickenpox Vaccine

The chickenpox vaccine is not routinely offered free-of-charge to children on the NHS in the UK, although it is available privately to those who would like it.

However, if you or your child are not yet immune and regularly come into contact with someone who has a weakened immune system or has a high risk of complications from chickenpox, it may be advisable to have the vaccine.

If this is the case, you will probably be eligible for immunisation on the NHS.

Eligibility also applies to people in certain professions, like healthcare workers. Speak to your doctor, midwife or health visitor if you think you might be a candidate to receive the chickenpox vaccine.

Chickenpox in Babies

Chickenpox is usually a mild disease, but it can be serious in newborn babies, especially if they were born prematurely or have a compromised immune system.

If you, as the mum, have had chickenpox at some time in your life, you’re immune to the disease and you’ll pass on some chickenpox antibodies to your baby. This will make him or her temporarily immune to the virus for the first few weeks or months after being born.

The immunity wears off after that, but chickenpox antibodies are also passed on in breast milk, so if you breastfeed your baby, it may last a little longer.

Colostrum – the first breast milk you produce immediately after giving birth – is especially rich in antibodies.

If you think your newborn baby could have chickenpox, call your doctor straight away.

Chickenpox and Pregnancy

It’s very rare to get chickenpox when you’re pregnant, but if you haven't had the virus yet, and you haven’t been vaccinated, there is a very small chance of this happening.

Even if you do catch the virus, the risk of complications for you and your little one is still low. Still, it’s important to tell your doctor straight away if you notice any symptoms or if you’ve been in contact with someone who may have chickenpox.

Possible Complications for You

If you get chickenpox when you’re pregnant, complications for you as the mum-to-be are very rare. Although they can be serious if they do occur, modern antiviral therapies and intensive care are usually effective at dealing with them.

Possible complications of chickenpox for you when pregnant include:

• Pneumonia (inflammation of the lungs)

• Hepatitis (inflammation of the liver)

• Encephalitis (inflammation of the brain).

Possible Complications for Your Baby

• If you contract chickenpox in the first 28 weeks of your pregnancy, there’s a small chance of your baby getting congenital varicella syndrome. This can affect the baby’s skin, eyes, limbs, brain, bladder or bowel.

• If you’re infected between 28 weeks and 36 weeks of pregnancy, your baby will be born with the chickenpox virus in his or her body, but without symptoms. In this case, there’s a chance that the dormant virus could become active sometime in the next few years, causing shingles – a similar illness caused by the same virus. Shingles can cause a painful skin rash in older children and adults of any age.

• If you get varicella after 36 weeks, your baby could be born with chickenpox, or could start to show symptoms of the disease sometime within seven days of being born. Your doctor will be able to advise on what treatment, if any, is needed in this case.

If you haven't had chickenpox yet and you’re pregnant or planning to get pregnant, ask your doctor for advice about the chickenpox vaccine and whether immunisation is advisable in your case.

Like so many other childhood illnesses, chickenpox is never welcome, and the symptoms – especially the itchy rash – can be tough for your little one.

Although it's good to know how to help make your child comfortable, it’s always best to ask your child’s doctor for personalised treatment advice.

Most children who get infected are back to being their old selves within a week or so without any major complications. The added bonus is that once your child’s had it, he or she will almost certainly never get chickenpox again!