Does My Newborn Really Need Antibiotic Eye Ointment After Birth?
A common procedure performed in maternity wards is the application of erythromycin ointment on a newborn's eyes shortly after delivery. If you are hoping for an unmedicated and low-intervention birth, you might be wondering why this ointment is given and if your newborn really needs it. As a parent, you can decline medical procedures on behalf of your child, but you should risks and benefits before making the decision.
What is erythromycin for?
This antibiotic is used to fight bacteria that is present in the birth canal. These bacteria put your infant at risk for developing a condition called ophthalmia neonatorum (ON), which is medical way of saying that the bacteria cause a severe eye infection similar to pink eye. In some cases, the infections spread rapidly and permanently damage the cornea, leading to blindness.
What are the risk factors for developing ON?
You baby is usually only at risk for ON if you have a sexually transmitted infection. The most STIs that lead to infant blindness are chlamydia and gonorrhea. You will have been tested for both of these disease when you became pregnant. If it is possible for you to have contracted an infection during your pregnancy, you need to let your care provider know so you can discuss treatment options. If you do have an STI, forgoing the ointment is inadvisable. If you have not been screened for these diseases, you should err on the side of caution and accept the ointment.
Some physicians will recommend always opting for the treatment, just in case, as other bacteria strains can lead to infection. However, these incidences are rare, and there is almost no risk of infection if a sexually transmitted infection is not present.
If your baby is born via c-section, the risk of developing any infection from vaginal bacteria is almost non-existent. Providing state laws allow it, you can safely choose to forgo erythromycin after delivery. Because the ointment is not 100% effective in preventing infection, low risk for infections would not support the use of a virtually unnecessary treatment.
What treatments are available for ON?
You might wonder if you can't just wait to see if there is an eye infection present before seeking treatment. It is true that babies can be treated for ON that develops from bacterial infections. However, because the infections can cause damage so quickly, it is easier to use ointment as a preventative (prophylactic) treatment. Severe causes of ON require hospitalization and blindness may not always be preventable.
What are the risks of the ointment?
Newborn infants have limited ability to see. They hardly register light and do not see colors very well. However, infants may experience increased eye irritation, which can affect bonding with the mother. If you are concerned about the ointment affecting your ability to create a bond with your child and their ability to breastfeed properly, you can ask to delay ointment for a few hours after birth. You can also improve bonding by asking for non-invasive birth procedures, breast feeding support, and immediate skin-to-skin contact after birth.
Just be aware that many states are required by law to use prophylaxis on newborns, however, depending on the state, you may be able to opt out with informed consent.
Modern antibiotic eye ointments have come a long way in preventing newborn blindness. They are not as dangerous or as painful as earlier treatments for this condition. If you are declining because you baby might feel some stinging, just remember that preventing vision damage is a much higher opportunity cost.
Learn more about your options by consulting resources like Envision Eyecare.
