My Baby Has Fifth Disease (Slapped Cheek)
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, CDC, Mayo Clinic guidelines
Last reviewed:
Baby skin is sensitive and changes frequently. If you are noticing has fifth disease (slapped cheek), here is what you need to know.
The short answer
Fifth disease (also called "slapped cheek") is a common, mild childhood illness caused by parvovirus B19. Its hallmark is bright red cheeks that look as though your child has been slapped, followed by a lacy, pinkish rash on the body and limbs. By the time the rash appears, your child is no longer contagious and is generally feeling well.
Key takeaways
- Fifth disease (also called "slapped cheek") is a common, mild childhood illness caused by parvovirus B19. Its hallmark is bright red cheeks that look as though your child has been slapped, followed by a lacy, pinkish rash on the body and limbs. By the time the rash appears, your child is no longer contagious and is generally feeling well.
- Usually normal when: Bright red rash on both cheeks (the "slapped cheek" look) in an otherwise well child
- Call your doctor if: Your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions
- Varies by age — see the age-by-age breakdown below
“Eczema is very common in babies and children. About 1 in 10 children will develop eczema, typically starting in the first few months of life.”
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What Parents Should Know
According to AAP, CDC, Mayo Clinic guidelines, fifth disease (also called "slapped cheek") is a common, mild childhood illness caused by parvovirus B19. Its hallmark is bright red cheeks that look as though your child has been slapped, followed by a lacy, pinkish rash on the body and limbs. By the time the rash appears, your child is no longer contagious and is generally feeling well. At 0-6 months, fifth disease is uncommon in babies under 6 months because they may still have some protection from maternal antibodies. If a very young infant develops the characteristic bright red cheeks and lacy body rash, it is worth seeing your pediatrician to confirm the diagnosis and rule out other causes of facial redness such as eczema or an allergic reaction. Fifth disease is generally mild and self-limiting even in young infants. It is generally considered normal when bright red rash on both cheeks (the "slapped cheek" look) in an otherwise well child. However, you should contact your pediatrician promptly if your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions.
Normal vs. Concerning
By Age
What to expect by age
0-6 months
Fifth disease is uncommon in babies under 6 months because they may still have some protection from maternal antibodies. If a very young infant develops the characteristic bright red cheeks and lacy body rash, it is worth seeing your pediatrician to confirm the diagnosis and rule out other causes of facial redness such as eczema or an allergic reaction. Fifth disease is generally mild and self-limiting even in young infants.
6-12 months
Babies in this age range can catch fifth disease, especially if they are in daycare. The illness often begins with mild cold symptoms, low-grade fever, and fussiness for a week before the rash appears. The bright red "slapped cheek" rash on both cheeks is the classic first sign parents notice. A few days later, a lacy or net-like pink rash may appear on the arms, legs, and trunk. The rash can come and go for several weeks, often reappearing after warm baths or sun exposure.
1-2 years
This is a common age to contract fifth disease. Toddlers may have very mild cold-like symptoms before the rash, or the rash may be the only sign of illness. The body rash can look alarming with its lace-like pattern, but it is not itchy for most children and does not require treatment. Your child is contagious before the rash appears but is no longer contagious once the rash shows up, so they can return to daycare.
2-3 years
Older toddlers with fifth disease may have joint aches alongside the rash, though this is more common in older children and adults. The rash can fluctuate for up to 3 weeks, fading and then reappearing with heat, sun exposure, or physical activity. This waxing and waning pattern is completely normal and does not mean the infection is getting worse. No specific treatment is needed; just keep your child comfortable.
What to Tell Your Pediatrician
- Describe when you first noticed has fifth disease (slapped cheek) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child seems more unwell than expected, with persistent joint pain or swelling.
- Mention if your child has a known blood disorder such as sickle cell disease or spherocytosis, as parvovirus B19 can cause a temporary drop in red blood cell production.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Bright red rash on both cheeks (the "slapped cheek" look) in an otherwise well child
- A lacy, pink, net-like rash on the trunk, arms, and legs that comes and goes over days to weeks
- Mild cold symptoms or low-grade fever before the rash appeared
- The rash reappearing after a warm bath, time in the sun, or physical activity
- Your child seems more unwell than expected, with persistent joint pain or swelling
- Your child has a known blood disorder such as sickle cell disease or spherocytosis, as parvovirus B19 can cause a temporary drop in red blood cell production
- You are pregnant and your child has been diagnosed with fifth disease, as parvovirus B19 can pose risks during pregnancy
- Your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions
- Your child has a weakened immune system due to medical treatment or illness and develops signs of fifth disease
What You Can Do at Home
- Keep track of when you notice has fifth disease (slapped cheek) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that bright red rash on both cheeks (the "slapped cheek" look) in an otherwise well child — this is generally within the range of normal.
- At 0-6 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Use fragrance-free, hypoallergenic products on your baby's skin. Avoid over-bathing — 2-3 baths per week is usually sufficient.
- While monitoring at home, seek immediate care if your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions.
Related Resources
Rash Decision Tree
Identify common rashes and determine when to seek care.
Baby Skin Conditions Guide
Visual guide to common baby skin conditions, rashes, and when to see a doctor.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
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 fifth disease (slapped cheek) normal?
When should I call the doctor about has fifth disease (slapped cheek)?
When is has fifth disease (slapped cheek) normal?
What causes has fifth disease (slapped cheek)?
What should I mention to my pediatrician about has fifth disease (slapped cheek)?
Is has fifth disease (slapped cheek) normal at 0-6 months?
Is has fifth disease (slapped cheek) normal at 6-12 months?
Should I go to the ER for has fifth disease (slapped cheek)?
Does has fifth disease (slapped cheek) go away on its own?
References
- [1]American Academy of Pediatrics. Fifth Disease (Parvovirus B19). HealthyChildren.org. AAP
- [2]Centers for Disease Control and Prevention. Parvovirus B19 and Fifth Disease. CDC
- [3]Mayo Clinic. Parvovirus Infection. Symptoms & Causes. Mayo Clinic
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss My Baby Has Fifth Disease (Slapped Cheek).
Things to mention
- Describe when you first noticed has fifth disease (slapped cheek) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child seems more unwell than expected, with persistent joint pain or swelling.
- Mention if your child has a known blood disorder such as sickle cell disease or spherocytosis, as parvovirus B19 can cause a temporary drop in red blood cell production.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your child seems more unwell than expected, with persistent joint pain or swelling
- Your child has a known blood disorder such as sickle cell disease or spherocytosis, as parvovirus B19 can cause a temporary drop in red blood cell production
- You are pregnant and your child has been diagnosed with fifth disease, as parvovirus B19 can pose risks during pregnancy
Urgent signs to report immediately
- Your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions
- Your child has a weakened immune system due to medical treatment or illness and develops signs of fifth disease
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
Related Resources
Bottom line
Most cases of has fifth disease (slapped cheek) are normal. Talk to your pediatrician if your child appears very pale, extremely fatigued, or is having difficulty breathing, which could indicate severe anemia, especially in children with underlying blood conditions.
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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