Brief Answer: better to start Detailed Answer: Hi Thanks for writing to health care magic. Herpes orolabialis does need antiviral. If it has involved only the orolabial region, and the baby is otherwise active as you had mentioned, there is no need to take iv acyclovir which is reserved for severe disseminated herpes. But you need to start oral acyclovir atleast for 5 days . This will prevent a) recurrences and help in fast healing. b) can prevent spread to your second twin. To avoid spread to the other twin, avoid close body contacts. Nurse from different nipples both at the breast or bottle. Hope I answered your query Wishing both your twins good health Regards Dr Arun

---