Does Your Newborn Need Eye Ointment At Birth?

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Erythromycin is an antibiotic used on newborns at birth to prevent blindness. This blindness s caused from infection with 1 of 2 sexually transmitted infections, chlamydia and gonorrhea.  Both infections can progress rapidly in newborns’ eyes, damaging the clear part over the pupils (corneas) and causing irreversible harm. Men and women can harbor chlamydia and gonorrhea infections without any symptoms. Obstetricians test most women for these infections during their pregnancies and treat them if their tests come back positive, but mothers can still pick up those diseases after their tests come back, so to be safe every newborn is treated.  The use of the eye ointment for newborns is referred to as eye prophylaxis.  It will make baby’s vision temporarily blurry, but it doesn’t hurt. This eye ointment for newborns isn’t washed off — it eventually just wears away on its own.  Waiting an hour or two before the treatment will allow for some visual family bonding.  

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Benefits:

  • Erythromycin can reduce the risk of chlamydial and gonorrheal infection (Darling and McDonald 2010).
  • Erythromycin prophylaxis may be helpful if the mother was not screened for chlamydia/gonorrhea, screening results were not correct, or if there is a sexual partner who may be re-infecting her (Medves 2002).
  • Erythromycin prophylaxis may be especially helpful in geographic regions where rates of chlamydia and gonorrhea are very high (Medves 2002).


Risks:

  • Widespread use may contribute to the development of antibiotic resistant bacteria (Hedbert et al. 1990).
  • It’s possible that care providers may not be watchful for infection because they assume the infant was “already treated,” but prophylaxis does not work all the time (Lund et al., 1987).
  • Drug shortages happen occasionally. In 2009, there was an erythromycin shortage in the U.S. and providers began using alternative medicines that had never been tested in newborns. One of those medications– gentamicin– was later found to have severe adverse effects in newborns (CDC, 2010).


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