Over the summer, I was diagnosed with shingles. Whenever someone has found out that I had shingles, they have been surprised. “I thought only the elderly got that,” is usually the response. It turns out, you can develop shingles at any age, but you’ll only get it if you have had chicken pox (varicella). It started out with a small rash between my bellybutton and my hip. I thought it was an allergic reaction to something, but by the next evening it had spread up towards my rib cage. I don’t know why I immediately thought it was shingles, but I decided to go to the doctor the next morning. Sure enough, it was shingles.
I had chicken pox when I was 10 months old. Having chicken pox before you are two years old puts you at greater risk for developing shingles. Once you have chicken pox, the virus remains dormant in your body. You cannot contract chicken pox more than once, but you can develop shingles, or varicella zoster. Contrary to popular belief, you don’t have to be a certain age to develop shingles. Shingles usually develops due to stress, or a weakened immune system, which is why it is more common in older populations.
But what is shingles?
Shingles is a painful, itchy rash that develops on nerve endings. The bumps turn into blisters and then the blister pop and scab over. The nerves can be damaged for months afterwards. As a matter of fact, two months later and I still have some discoloration from the blisters.
The next question I received over and over again, “Is it contagious?”
The answer to this is twofold. If you have had chicken pox, then no - you cannot catch shingles. However, if a person has not had the chicken pox, then they can catch the chicken pox from someone who has shingles. My husband was fine because he had already had chicken pox. Even my son, who is three and a half, didn’t concern me too much because he has had the varicella vaccine. But my daughter, Chloe, at five and a half months old, still has not had the varicella vaccine. That meant that in our house, she was the most vulnerable. She is also the one who spends the most time attached to me because she is still exclusively breastfed. One of my biggest concerns was how to keep her safe and not give her the chicken pox.
When I was seen by the doctor, I was started on antivirals which were safe for nursing mothers. I was really concerned over whether I should continue nursing or whether I should pump and have her bottle fed. Because the rash was not on my breast or near my areola, and on an area of my body that I could reasonably keep covered, I was assured by my doctor that I could continue to nurse and that it was probably beneficial for Chloe if I were to continue to do so, because she would be receiving some of my antibodies.
However, I was told to take a couple of precautions. If you are diagnosed with shingles, please consult your medical professional to determine whether it is safe for you to continue to nurse. (I am simply stating my own experiences and I am not a medical professional.)
- Keep the area covered. Because of where my rash was located, there was no way for me to nurse Chloe without her touching that part of my body. But I was able to double layer my clothing so that there was always a barrier between Chloe and the rash.
- Wash my hands constantly. I washed my hands every single time I was going to pick Chloe up, eat, or basically do anything. Every time I changed my clothes or dressed the rash, I washed my hands. I also had hand sanitizer handy in case I could not wash my hands.
- Take extra care when the blisters burst. The rash is contagious when someone comes into contact with the puss from the blisters. When I thought they were close to this stage, I kept them covered with gauze and bandages. This way, even if the blister burst, the puss would not get on my clothes.
Grecia Ferreyra, BSN, RN, RNC-NIC, CLC, CBC a lactation specialist with the Neonatal Intensive Care Unit at Nicklaus Children’s Hospital, emphasized that breastfeeding mothers who have contracted the shingles virus should continue breastfeeding.
What about varicella?
Varicella-zoster Virus (VZV) is another member of the herpes family, and is the causative agent for chickenpox and zoster (shingles). After a person recovers from chickenpox, the virus stays dormant (inactive) in the body. Scientists aren’t sure why the virus can reactivate years later, causing shingles. Shingles cannot be passed from one person to another. However, the virus that causes shingles, the varicella zoster virus, can spread from a person with active shingles to cause chickenpox in someone who had never had chickenpox or received chickenpox vaccine.
The virus is spread through direct contact with fluid from the rash blisters caused by shingles. A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear. Once the rash has developed crusts, the person is no longer infectious. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered. A breastfeeding mother who acquired this virus (VZV), should continue to breastfeed. (Heuchan & Isaacs, 2001).
Breastfeeding is not considered to be a significant route of transmission for VZV (HMBANA, 2011). The baby should be protected from direct contact with the mother’s skin lesions until they are fully crusted. Development of maternal zoster during pregnancy has not been associated with intrauterine VZV infection (presumably due to preexisting maternal anti-VZV antibody).
Here are some helpful tips from the Centers for Disease Control (CDC) to avoid transmission:
- Have the mother cover lesions on the breast may require temporary separation of the mother from the baby until lesions are dried.
- Cover the rash/lesions.
- Avoid touching or scratching the rash/lesion.
- Wash your hands often to prevent the spread of varicella zoster virus.
- Cover other lesions, and avoid contact of lesions with the baby (Mannel, Martens, & Walker, 2013).
Avoid contact with the people below until your rash has developed crusts:
- Pregnant women who have never had chickenpox or the chickenpox vaccine
- Premature or low birth weight infants
- People with weakened immune systems, such as people receiving immunosuppressive medications or undergoing chemotherapy, organ transplant recipients, and people with human immunodeficiency virus (HIV) infection.
I followed these guidelines, and all of my doctor’s instructions, including taking my antivirals, and thankfully nobody in my house caught the chicken pox! If you think you may have shingles, see your doctor right away!