HPV after diagnosis in infants

Overview

HPV (human papillomavirus) is a common virus that can be passed from a mother to her baby during birth. In infants, it can cause growths called papillomas, most often in the throat (a condition called recurrent respiratory papillomatosis, or RRP). These growths can affect the baby’s breathing and voice. HPV in infants is different from HPV in adults – it does not cause cancer at this age. Many infants clear the virus on their own over time.

No, HPV-related problems in infants are rare. Recurrent respiratory papillomatosis occurs in about 2 to 4 out of every 100,000 children.

It affects infants and young children, most often those born to mothers who have genital HPV infection or warts during pregnancy.

Symptoms

Common symptoms

• Hoarse or weak cry
• Noisy breathing (stridor), especially when breathing in
• Difficulty breathing or rapid breathing
• Chronic cough or frequent croup-like episodes
• Small, flesh-colored bumps on the genitals or anus (genital warts)

Symptoms in children

• Same as common symptoms: hoarseness, stridor, breathing trouble, chronic cough.
• In older children, symptoms may also include voice changes or a feeling of something stuck in the throat.

Symptoms in older adults

• In adults, HPV usually causes no symptoms or can cause genital warts. Some types can lead to certain cancers, but this is not a concern in infants.

Causes

Main causes

• Infection with human papillomavirus (HPV), most often types 6 and 11.
• Transmission from mother to infant during vaginal delivery when the mother has an active HPV infection.

Risk factors

• Mother has genital warts or an HPV infection during pregnancy
• Vaginal birth (the virus can be passed through the birth canal)
• Prolonged labor or trauma during delivery

When to see a doctor

See a doctor urgently if:

• If your baby has any difficulty breathing, noisy breathing, or stridor
• If your baby has a hoarse cry that suddenly gets worse
• If you notice any lumps or warts on your baby’s skin or genitals

Book a routine appointment if:

• If your baby has a mild hoarse voice or occasional noisy breathing that does not get worse
• For regular check-ups with an ear, nose, and throat (ENT) specialist if your baby has been diagnosed with RRP

Diagnosis

A doctor will examine your baby, often using a thin, flexible camera (laryngoscopy) to see the throat and airway. A small sample (biopsy) may be taken to confirm the diagnosis.

Tests that may be done

• Laryngoscopy (camera examination of the voice box and airway)
• Biopsy of the growths to check for HPV
• Sometimes imaging (like X-ray or CT scan) if the growths are deeper

What to expect at your appointment

The laryngoscopy is usually done under general anaesthesia so your baby sleeps comfortably. The doctor will look for papillomas and may remove a small piece for testing. Your baby will be monitored after the procedure and can usually go home the same day.

Treatment

Treatment aims to remove papillomas that cause symptoms, especially to keep the airway open. The virus itself may not be cured, but the body’s immune system often controls it over time. Some children need only one or two treatments; others may need repeat procedures if the growths return.

Self-care at home

• Keep your baby calm and avoid situations that worsen breathing (like crying hard)
• If your baby has genital warts, keep the area clean and dry, and do not pick at the warts
• Use a cool-mist humidifier to soothe a hoarse cry (check with doctor first)

Medical treatments

The main treatment is surgical removal of papillomas. This is done using a microdebrider (a small rotating blade) or a laser. In severe cases, antiviral medications may be given to help control the virus, but this is decided by a specialist. No specific drug names are mentioned here.

When is surgery considered?

Surgery is needed when papillomas cause significant breathing problems, stridor, or voice changes. The goal is to remove the growths and keep the airway open. Some children may need surgery many times, but the need often decreases as they get older.

Living with this condition

Your baby will need regular check-ups with an ENT specialist to monitor for new growths. Watch for signs of breathing trouble – a hoarse cry, noisy breathing, or fast breathing. Most children with RRP grow up to lead normal lives with proper care.

Lifestyle tips

• Avoid exposing your baby to second-hand smoke or strong irritants (like perfume, dust) that can worsen breathing
• Keep your baby’s immunisations up to date
• Follow your doctor’s plan for follow-up visits

Diet and exercise

A normal diet for your baby’s age is fine. Encourage physical activity as your baby grows – being active helps overall health. If breathing is a problem, follow your doctor’s advice on activity levels.

Mental health and emotional wellbeing

Having a child with a chronic condition can be stressful. It is normal to feel worried or overwhelmed. Talk to your healthcare team about your concerns. They can connect you with support groups or counselling.

Prevention

HPV vaccination before sexual activity prevents most genital HPV infections and can reduce the risk of passing the virus to a baby. However, the vaccine is not given to infants. If a mother has active genital warts during pregnancy, a caesarean section may lower the chance of transmission, but this is not routinely recommended. Many babies clear the virus without problems.

Vaccines

HPV vaccination is recommended for adolescents (age 12–13 in the UK) and young adults. It is not given to infants.

Screening programmes

There is no routine screening for HPV in infants. Diagnosis is based on symptoms and examination.

Complications

If left untreated

• Airway blockage that can cause severe breathing difficulty
• Spread of papillomas to the lungs (very rare)
• Long-term voice changes or hoarseness
• Difficulty feeding or growing well if breathing is laboured

Long-term outlook

The outlook for infants with HPV is generally good. Most children with recurrent respiratory papillomatosis respond well to treatment, and the disease often becomes less active as the child grows. With careful monitoring and timely surgery, children can lead healthy, normal lives. The immune system often helps clear the virus over time.

Find support

International organisations

• RRP Foundation ↗

Local organisations

• NHS – Human papillomavirus (HPV) ↗ · United Kingdom

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