Revisiting the Routine: Is Newborn Eye Ointment Necessary for Every Baby?

Revisiting the Routine: Is Newborn Eye Ointment Necessary for Every Baby?

As mothers, we strive to make choices that align with our values and ensure the well-being of our babies. One decision that often arises after birth is whether to administer eye ointment to your newborn—a practice that may feel routine but deserves a closer look, especially for those of us who embrace natural parenting approaches.

What is Newborn Eye Ointment, and Why is it Used?

Newborn eye ointment, typically erythromycin, is applied shortly after birth to prevent an eye infection called ophthalmia neonatorum. This condition can result from bacteria, most commonly Neisseria gonorrhoeae or Chlamydia trachomatis, passed from mother to baby during delivery. The practice has its roots in the late 1800s, when silver nitrate drops were introduced to prevent blindness caused by gonorrhea infections in newborns.Source: Centers for Disease Control and Prevention, 2020(https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm)

Today, erythromycin is the standard antibiotic used, offering protection against a broader range of bacteria. However, it’s worth noting that this practice originated when routine prenatal care and STI screenings were far less common than they are now.

Why Are Some Countries Moving Away from Universal Prophylaxis?

In many countries, including the UK, Norway, Sweden, and Canada, the routine use of newborn eye ointment has been discontinued. These nations have shifted toward risk-based approaches, relying on comprehensive prenatal care to identify and treat infections during pregnancy. This shift reflects advancements in medicine and a more personalized approach to newborn care.Source: Canadian Paediatric Society, 2015(https://cps.ca/en/documents/position/ophthalmia-neonatorum)

In these countries, eye ointment is only used when there is a clear risk, such as when a mother tests positive for gonorrhea or chlamydia, or if her STI status is unknown. This approach acknowledges that for babies born to mothers without these infections, the benefits of prophylactic eye ointment may not outweigh the risks.

What Are the Risks of Newborn Eye Ointment?

While the intention behind newborn eye ointment is to prevent serious infections, it’s not without potential downsides:

1. Irritation and Temporary Blurred Vision: The ointment can cause temporary eye irritation, redness, and blurred vision, which can affect a baby’s ability to bond through eye contact immediately after birth.

2. Antibiotic Resistance: Overuse of antibiotics, even in this form, contributes to the growing issue of antibiotic resistance.Source: World Health Organization, 2021(https://www.who.int/health-topics/antibiotic-resistance)

3. Limited Effectiveness for Chlamydia: Studies suggest that erythromycin may not significantly reduce the risk of conjunctivitis caused by Chlamydia trachomatis, casting doubt on its necessity in all cases.Source: American Academy of Pediatrics, 2019(https://publications.aap.org/pediatrics/article/143/6/e20191132/37944/)

4. Risk of Conjunctivitis (Pink Eye): Ironically, one of the listed side effects of erythromycin eye ointment is the potential to cause chemical conjunctivitis (pink eye) in newborns. This occurs due to the baby's eyes reacting to the medication itself, which may result in redness, swelling, and discharge—similar symptoms to what the ointment is meant to prevent.

   Source: American Academy of Ophthalmology, 2021

   (https://www.aao.org/eye-health/treatments/erythromycin-eye-ointment)

   
   

Alternatives and the Importance of Prenatal Care

For mothers without known STIs, the need for eye ointment is Null. Routine STI screenings during pregnancy allow healthcare providers to treat infections early, reducing risks to both mother and baby. Source: BMJ, 2016(https://www.bmj.com/content/355/bmj.i5796)

By addressing potential infections before birth, mothers can often avoid the need for interventions like eye ointment, ensuring a more natural and uninterrupted bonding experience with their newborn.

Making an Informed Decision

As mothers, we know that every baby, birth, and circumstance is unique. If you’re considering skipping eye ointment for your newborn, talk openly with your healthcare provider. Discuss your prenatal care history, STI screenings, and any potential risks specific to your situation.

A Thoughtful Conclusion

At the heart of natural motherhood is a commitment to thoughtful, informed choices. Questioning long-standing practices like newborn eye ointment is not about rejecting modern medicine but about tailoring care to meet the unique needs of each baby and family. By staying informed and advocating for your baby’s health, you’re nurturing them with love, intention, and care—one decision at a time.

Sincerely, a Meraki Mother.