Birth is a flurry of activity: Once a baby takes its first breath (and everyone finally stops holding theirs), most doctors automatically swab on newborn eye ointment before mother and baby meet.
It’s a quick and painless procedure, but we find it’s always worth pausing to evaluate why we do routine newborn interventions, and whether they’re beneficial.
Every mother and baby unit has a unique history and needs. At The Retreat, we’re passionate about your right to informed consent for each and every element of your birth and newborn care, including your choice about eye ointment for newborns.
The story behind routine eye ointment for newborns
Today we’re used to seeing smeary, shiny-eyed newborns, but prophylactic (preventative) eye ointment was a real medical breakthrough back in the late 1800s. Back then, European babies had a 1 in 10 chance of developing an eye infection called ophthalmia neonatorum (ON), which led to blindness in 3% of cases.
German doctors found that mothers with the sexually transmitted infection gonorrhea had a higher rate of blind babies. When they began applying silver nitrate to all newborns’ eyes as a preventative measure, the number of ON cases dropped dramatically.Today silver nitrate isn’t used because it causes eye irritation, but antibiotic eye ointment for newborns is extremely common, and even mandated by law in many states.
Speaking of antibiotics, back in the early days of silver nitrate use, preventative application was far more effective than waiting for symptoms of infection to appear. But modern antibiotics are extremely good at treating ON even after an infection is present.
Another big change is that gonorrhea isn’t the leading cause of ON anymore. Now chlamydia is more likely to cause a newborn eye infection.
Perspectives: Does your baby need eye ointment?
There’s a great article that goes over the many studies done on infants regarding ON and newborn eye ointment in detail, but we’ll summarise some of the key things you may want to consider.
The current U.S. standard is a .5% erythromycin antibiotic solution applied in the first hour after birth. The leading cause of ON infections in newborns is maternal chlamydia, which may not respond to erythromycin as well as the former culprit, gonorrhea. And there are other causes of ON that don’t respond to erythromycin because they’ve become resistant to it, including many strains of Staphylococcus aureus, Streptococcus pneumonia, and group A and B streptococci.
Some practitioners worry that ointment can blur a newborn’s vision and hinder early bonding, or create a false pink-eye appearance that leads to unnecessary antibiotics.
Given public health changes, the advent of antibiotics, and the growing problem of antibiotic resistance, treating babies across the board with preventative newborn eye ointment may not be as time-sensitive or effective as it was in the past.
But, with all that said, erythromycin ointment has fairly mild risks for your baby. And it’s inexpensive and readily available as an extra measure of protection for babies of women who have tested positive (or aren’t sure of their status) for ON risk factors like chlamydia.
Alternatives to erythromycin
For parents who don’t choose routine erythromycin eye ointment for newborns, here are the ways they can address ON:
- The wait-and-see approach of observing a newborn for signs of eye infection is a strong option. The UK has switched to this method over preventative ointment. Parents who choose to skip the ointment should know the signs of infection and communicate with their care provider if they suspect a problem so antibiotics can be introduced.
- Povidone iodine may actually be more effective, less irritating, and cheaper than erythromycin — and it can address a wider variety of ON sources than antibiotics.
- Colostrum applied to the eyes has been found to be effective in preventing ON from non-sexually-transmitted bacteria. This is a risk-free preventative measure that may be a good alternative for women who have tested negative for gonorrhea and chlamydia.
The Retreat Birth Center in El Paso is on your team
However you choose to address your sweet baby’s eye health, we’re happy to support you and help you along your journey into parenthood.
This post is part of a series on your many choices in newborn care. Please browse through our other articles and learn more about your role as the primary decision maker for your growing family. We’re here to empower you to make informed decisions that resonate with your values.
Here’s a sampling of our other newborn care posts:
Water Birth 101
Why You Should Have Skin to Skin Time With Baby
What Is Delayed Cord Clamping?
Why You Should Wait to Bathe Your Newborn
Info on Infant Circumcision
If you’d like to learn more about newborn care choices, check out our event calendar here.
And we’d love to talk with you in person and give you a one-hour tour of our beautiful birthing facilities! Give us a call or send a message so we can set up a time to meet with you.
To schedule your free tour and consultation, please call (915) 308-5000 or click here.