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Cytomegalovirus (CMV) in Newborns

What is CMV in newborns?

CMV is a herpes virus. It is very common. It affects people of all ages and parts of the U.S. Most of the time, CMV causes mild or no symptoms. But, it can cause serious problems in a fetus or newborn.

What causes CMV in newborns?

CMV is a virus that is spread from a person with the virus to someone else. The virus can spread:

  • To the fetus during pregnancy (congenital CMV)
  • To the newborn during delivery or through breastmilk (perinatal CMV)
  • In households with young children and in daycare centers 
  • By contact with infected saliva, urine, vaginal fluid, or semen

What are the symptoms of CMV in newborns?

Most babies with CMV present at birth (congenital) do not have symptoms. Symptoms may include:

  • Hearing loss. It may be found during regular newborn hearing screening.
  • Small size, including small head size
  • Enlarged liver and spleen
  • Yellow color to skin (jaundice)
  • Small broken blood vessels under the skin
  • Eye problems

Babies with perinatal CMV may not have symptoms. Signs and symptoms may develop between 3 weeks and 6 months of age. They may include:

  • Abnormal blood test results. For example, the results may show low platelet levels, low white blood cell counts, or abnormal liver function.
  • Enlarged liver and spleen
  • Swelling (inflammation) of the lungs (pneumonitis)

The symptoms of CMV may look like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is CMV in newborns diagnosed?

Most CMV infections in the mother are not diagnosed because the virus causes few symptoms. Tests for diagnosis include:

  • In the fetus, amniotic fluid or fetal blood may be checked for CMV.
  • In the newborn within 3 weeks from birth, urine and saliva cultures may find CMV.

Other tests may include:

  • Blood tests, including complete blood count (CBC) and liver function tests
  • CT scan of the brain
  • Hearing exams
  • Eye exams

How is CMV in newborns treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Health care providers usually recommend against treating newborns without symptoms. They do not agree on the treatment for many newborns with symptoms.

Treatment with medicine that works against the virus (ganciclovir) is recommended for some babies with CMV. Babies with the following may get this treatment:

  • Swelling of the lungs
  • Very low platelet counts
  • Eye problems that may lead to vision loss

Babies with hearing loss or small head size may take ganciclovir long-term.

What are the complications of CMV in newborns?

Possible complications of CMV may include:

  • Nervous system problems, like seizures
  • Problems with growth and development
  • Feeding problems

Can CMV in newborns be prevented?

Because it is so common, it is difficult to prevent a CMV infection. The following measures may help to prevent CMV infection, especially in pregnant women:

  • Wash hands with soap and water, especially after changing diapers, feeding children, wiping a child's nose or mouth, or touching toys.
  • Avoid kissing young children on the mouth.
  • Do not share forks, spoons, cups, or food with young children.

Key points about CMV in newborns

  • CMV can be passed to a fetus during pregnancy and to a newborn during delivery or in breastmilk.
  • Most babies with congenital CMV do not have symptoms. 
  • CMV can cause serious problems in the fetus and newborn. 
  • Some newborns with CMV may be treated with antiviral medicine.
  • Washing hands with soap and water works well to remove the virus from the hands to prevent spreading CMV.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.