Medical Conditions

My Baby Has Congenital CMV (Cytomegalovirus)

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published CDC, NIH, AAP guidelines

Editorial policy

Last reviewed:

If your baby has been diagnosed with or you suspect has congenital cmv (cytomegalovirus), here is what the evidence says.

The short answer

Congenital cytomegalovirus (CMV) infection occurs when CMV is passed from mother to baby during pregnancy. It is the most common congenital infection, affecting about 1 in 200 babies. Most babies with congenital CMV (about 90%) have no symptoms at birth and do well. However, about 10% are symptomatic at birth and may have hearing loss, vision problems, developmental delays, or other complications. CMV is also the leading non-genetic cause of hearing loss in children. Early identification and antiviral treatment can improve outcomes for symptomatic babies.

Key takeaways

  • Congenital cytomegalovirus (CMV) infection occurs when CMV is passed from mother to baby during pregnancy. It is the most common congenital infection, affecting about 1 in 200 babies. Most babies with congenital CMV (about 90%) have no symptoms at birth and do well. However, about 10% are symptomatic at birth and may have hearing loss, vision problems, developmental delays, or other complications. CMV is also the leading non-genetic cause of hearing loss in children. Early identification and antiviral treatment can improve outcomes for symptomatic babies.
  • Usually normal when: Your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well
  • Call your doctor if: Your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work
  • Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

Parents everywhere have the same worry. You are doing the right thing by looking into it.

What Parents Should Know

According to CDC, NIH, AAP guidelines, congenital cytomegalovirus (CMV) infection occurs when CMV is passed from mother to baby during pregnancy. It is the most common congenital infection, affecting about 1 in 200 babies. Most babies with congenital CMV (about 90%) have no symptoms at birth and do well. However, about 10% are symptomatic at birth and may have hearing loss, vision problems, developmental delays, or other complications. CMV is also the leading non-genetic cause of hearing loss in children. Early identification and antiviral treatment can improve outcomes for symptomatic babies. At 0-1 month (diagnosis), congenital CMV must be diagnosed within the first 3 weeks of life (by testing urine or saliva) to distinguish it from CMV acquired after birth. Symptomatic babies may have petechiae (tiny red spots), jaundice, small head size, enlarged liver or spleen, or abnormal brain imaging. If your baby is diagnosed with symptomatic congenital CMV, antiviral treatment (valganciclovir) started within the first month of life has been shown to improve hearing and developmental outcomes. It is generally considered normal when your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well. However, you should contact your pediatrician promptly if your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well
Your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work
Your baby is receiving antiviral treatment and is tolerating it well with regular monitoring
Your baby has seizures or sudden developmental regression — seek emergency medical evaluation
Your baby's hearing tests have been normal so far and you are continuing regular follow-up
Your baby seems to not respond to sounds or voices as expected

By Age

What to expect by age

0-1 month (diagnosis)

Congenital CMV must be diagnosed within the first 3 weeks of life (by testing urine or saliva) to distinguish it from CMV acquired after birth. Symptomatic babies may have petechiae (tiny red spots), jaundice, small head size, enlarged liver or spleen, or abnormal brain imaging. If your baby is diagnosed with symptomatic congenital CMV, antiviral treatment (valganciclovir) started within the first month of life has been shown to improve hearing and developmental outcomes.

1-6 months

For symptomatic babies, antiviral treatment typically continues for 6 months. Blood counts and liver function are monitored during treatment, as the medication can cause side effects. Hearing tests should be performed at diagnosis and repeated regularly, because CMV-related hearing loss can fluctuate or worsen over time — even in babies who initially pass their newborn hearing screen.

6-12 months

Both symptomatic and asymptomatic congenital CMV babies need regular hearing monitoring. About 10-15% of babies who had no symptoms at birth will develop hearing loss, often during the first year of life. If hearing loss is detected, early hearing aids or cochlear implants can make a significant difference in speech and language development. Developmental assessments are also recommended.

1 year+

Children with congenital CMV should have hearing monitored through at least age 6, as late-onset hearing loss can occur. Those with hearing loss benefit from early intervention services, hearing aids, or cochlear implants. Many children with congenital CMV, even those who were symptomatic, develop well with appropriate support. Speech therapy and educational support may be needed for children with hearing-related language delays.

What to Tell Your Pediatrician

  • Describe when you first noticed has congenital cmv (cytomegalovirus) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems to not respond to sounds or voices as expected.
  • Mention if your baby is not babbling by 6 months or has concerns about speech development.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well
  • Your baby is receiving antiviral treatment and is tolerating it well with regular monitoring
  • Your baby's hearing tests have been normal so far and you are continuing regular follow-up
Mention at your next visit when...
  • Your baby seems to not respond to sounds or voices as expected
  • Your baby is not babbling by 6 months or has concerns about speech development
  • Your baby had congenital CMV and is not meeting developmental milestones
  • You are pregnant or planning another pregnancy and have questions about CMV prevention
Act now when...
  • Your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work
  • Your baby has seizures or sudden developmental regression — seek emergency medical evaluation

What You Can Do at Home

  • Keep track of when you notice has congenital cmv (cytomegalovirus) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well — this is generally within the range of normal.
  • At 0-1 month (diagnosis), focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work.

My Baby Has Auditory Neuropathy — What Does This Mean?

Auditory neuropathy spectrum disorder (ANSD) is a hearing condition where the inner ear (cochlea) detects sound normally, but the signal is not transmitted properly to the brain via the auditory nerve. This means your baby may pass one type of hearing test (OAE) but fail another (ABR). ANSD affects about 10-15% of children diagnosed with permanent hearing loss. The hearing ability of children with ANSD is highly variable — some hear almost normally, others have severe hearing loss, and hearing can fluctuate. Early intervention with hearing aids or cochlear implants, combined with speech therapy, gives the best outcomes.

How Dangerous Is My Baby's Jaundice? (Kernicterus Prevention)

Jaundice (yellowing of the skin from bilirubin) is extremely common in newborns — about 60% of term and 80% of preterm babies develop it. Most jaundice is harmless and resolves with or without phototherapy. However, very high bilirubin levels can cross into the brain and cause permanent damage (kernicterus), including cerebral palsy, hearing loss, and intellectual disability. Kernicterus is almost entirely preventable with appropriate monitoring and treatment. The key is ensuring bilirubin levels are checked per guidelines and treated promptly when elevated.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is has congenital cmv (cytomegalovirus) normal?
Congenital cytomegalovirus (CMV) infection occurs when CMV is passed from mother to baby during pregnancy. It is the most common congenital infection, affecting about 1 in 200 babies. Most babies with congenital CMV (about 90%) have no symptoms at birth and do well. However, about 10% are symptomatic at birth and may have hearing loss, vision problems, developmental delays, or other complications. CMV is also the leading non-genetic cause of hearing loss in children. Early identification and antiviral treatment can improve outcomes for symptomatic babies.
When should I call the doctor about has congenital cmv (cytomegalovirus)?
Your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work Your baby has seizures or sudden developmental regression — seek emergency medical evaluation
When is has congenital cmv (cytomegalovirus) normal?
Your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well Your baby is receiving antiviral treatment and is tolerating it well with regular monitoring Your baby's hearing tests have been normal so far and you are continuing regular follow-up
What causes has congenital cmv (cytomegalovirus)?
Congenital cytomegalovirus (CMV) infection occurs when CMV is passed from mother to baby during pregnancy. It is the most common congenital infection, affecting about 1 in 200 babies. Most babies with congenital CMV (about 90%) have no symptoms at birth and do well. However, about 10% are symptomatic at birth and may have hearing loss, vision problems, developmental delays, or other complications. CMV is also the leading non-genetic cause of hearing loss in children. Early identification and antiviral treatment can improve outcomes for symptomatic babies. Common explanations include: Your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well. Your baby is receiving antiviral treatment and is tolerating it well with regular monitoring.
What should I mention to my pediatrician about has congenital cmv (cytomegalovirus)?
You should mention has congenital cmv (cytomegalovirus) at your next visit if: Your baby seems to not respond to sounds or voices as expected. Your baby is not babbling by 6 months or has concerns about speech development. Your baby had congenital CMV and is not meeting developmental milestones.
Is has congenital cmv (cytomegalovirus) normal at 0-1 month (diagnosis)?
Congenital CMV must be diagnosed within the first 3 weeks of life (by testing urine or saliva) to distinguish it from CMV acquired after birth. Symptomatic babies may have petechiae (tiny red spots), jaundice, small head size, enlarged liver or spleen, or abnormal brain imaging. If your baby is diagnosed with symptomatic congenital CMV, antiviral treatment (valganciclovir) started within the first month of life has been shown to improve hearing and developmental outcomes.
Is has congenital cmv (cytomegalovirus) normal at 1-6 months?
For symptomatic babies, antiviral treatment typically continues for 6 months. Blood counts and liver function are monitored during treatment, as the medication can cause side effects. Hearing tests should be performed at diagnosis and repeated regularly, because CMV-related hearing loss can fluctuate or worsen over time — even in babies who initially pass their newborn hearing screen.
Should I go to the ER for has congenital cmv (cytomegalovirus)?
Seek emergency care if your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work, or if your baby has seizures or sudden developmental regression — seek emergency medical evaluation. When in doubt, call your pediatrician's after-hours line for guidance.
Does has congenital cmv (cytomegalovirus) go away on its own?
In many cases, has congenital cmv (cytomegalovirus) resolves on its own, especially when your baby was diagnosed with congenital CMV but had no symptoms at birth and is developing normally — most asymptomatic babies do well. By 1 year+, children with congenital CMV should have hearing monitored through at least age 6, as late-onset hearing loss can occur. Those with hearing loss benefit from early intervention services, hearing aids, or cochlear implants. Many children with congenital CMV, even those who were symptomatic, develop well with appropriate support. Speech therapy and educational support may be needed for children with hearing-related language delays.
CDCNIHAAP

References

  1. [1]Centers for Disease Control and Prevention. Congenital CMV Infection. CDC
  2. [2]National Library of Medicine. Congenital Cytomegalovirus: Public Health Action Towards Awareness, Prevention, and Treatment. JAMA Pediatrics, 2023. NIH
  3. [3]American Academy of Pediatrics. Congenital Cytomegalovirus. Red Book, 2021. AAP

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss My Baby Has Congenital CMV (Cytomegalovirus).

Things to mention

  • Describe when you first noticed has congenital cmv (cytomegalovirus) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems to not respond to sounds or voices as expected.
  • Mention if your baby is not babbling by 6 months or has concerns about speech development.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Your baby seems to not respond to sounds or voices as expected
  • Your baby is not babbling by 6 months or has concerns about speech development
  • Your baby had congenital CMV and is not meeting developmental milestones

Urgent signs to report immediately

  • Your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work
  • Your baby has seizures or sudden developmental regression — seek emergency medical evaluation

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

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Bottom line

Most cases of has congenital cmv (cytomegalovirus) are normal. Talk to your pediatrician if your baby on antiviral treatment develops a high fever, unusual bruising, or looks pale — these may be medication side effects requiring immediate blood work.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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My Baby Has Auditory Neuropathy — What Does This Mean?

Auditory neuropathy spectrum disorder (ANSD) is a hearing condition where the inner ear (cochlea) detects sound normally, but the signal is not transmitted properly to the brain via the auditory nerve. This means your baby may pass one type of hearing test (OAE) but fail another (ABR). ANSD affects about 10-15% of children diagnosed with permanent hearing loss. The hearing ability of children with ANSD is highly variable — some hear almost normally, others have severe hearing loss, and hearing can fluctuate. Early intervention with hearing aids or cochlear implants, combined with speech therapy, gives the best outcomes.

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