Erythromycin Ophthalmic Ointment: Is It Needed For Newborns?

Erythromycin Ophthalmic Ointment: There he is, your darling baby who you have been anxiously waiting to meet for the past several months.

You envelop him in your arms and give him a cuddle, promising to always be there for him…

…and then a nurse whisks him away for a series of medical treatments.

While he won’t be gone long, he will be returned to you with shiny, glossed over eyelids.

This is due to eye drops or ointment which healthcare professionals often administer to newborns.

But many parents still question this erythromycin ophthalmic ointment: Is it needed for newborns?

Are Babies Born With Pink Eye?

Here’s where it all began: in the 1800s nearly 10% of all newborns born in European hospitals developed something known as ophthalmia neonatorum (let’s keep it short and refer to this as “ON” from now on).

This “type” of pink eye is more serious than your standard bacterial eye infection and it develops during the first four weeks of life.

It was known to cause blindness in 3% of those infants who were infected.

Near the turn of the 19th century, Dr. Carl Crede had an “ah-ha!” moment and realized that only infants with mums who were infected with gonorrhea (spoiler alert: we now know that chlamydia can cause it too) were infecting their babies with ON.

Since antibiotics didn’t exist at the time, Dr. Crede put silver nitrate in the eyes of all newborns born in his hospital.

In his hospital, the instances of  ON went from 30 to 35 cases per year to 1.

Silver nitrate was effective but it was not exactly comfortable.

Not only is it irritating, but it can cause a lot of other nasty side effects such as:

• Intense pain
• Chemical pink eye (conjunctivitis caused by getting chemicals, liquids, smoke or even fumes in the eye)
• Temporary vision impairment

Also, it turns out that it is not effective in treating ON caused by chlamydia, the leading cause of this infectious disease in North America.  This is why erythromycin ophthalmic ointment is now used in the United States and Canada.

Way To Spoil Our “First Moments” Photoshoot!

As if you haven’t been snapping hundreds of pictures already, but in case you happen to have not taken any pictures of your freshly born babe, make sure you do so before he receives the eye drops.

These eye drops will blur his vision and may be uncomfortable, so he may keep his peepers shut tight for a while.

Do They Actually Work?

Yes… kinda.  The erythromycin eye drops are most effective, but a 2012 study in Canada shows that N gonorrhoeae are extremely resistant to the eye drops.

23% of the time, these eye drops will do nada to prevent ON.

Treating chlamydia-caused ON with eye drops is also not recommended because the eye drops cannot reliably prevent neonatal conjunctivitis.

The best way to treat ON in infants is to make sure that mama receives the medical care she needs to make sure these viruses do not exist at the time of delivery.

Your medical provider should have tested you for both diseases a long while ago, but keep in mind that if you have had more than one sexual partner (or if you suspect your partner has or was unfaithful during your pregnancy) you should be retested and treated.

You never know what you may have picked up during these nine months.

What’s The Big Deal?

So these eye drops can reduce the risk of both gonorrhea and chlamydial ON and they may be helpful in regions where the rates of these two diseases are high.

Buuuut…

• The ointment irritates the eye and causes blurred vision, which may interfere with those first precious parent/baby bonding moments
• Because it is an antibiotic it may add to the growing issue of antibiotic-resistant bacteria
• The eye drops have an estimated 20% fail rate

I’ve Heard I Can Refuse The Eyedrops

So here’s the deal: here in North America, we have experienced a drastic decline in both gonorrhea and chlamydia which, of course, reduces the risk of a newborn getting ON.

One study showed that in the USA, the rate of ON was 8.5 per 100,000 births.

In Canada, it was 6 per 100,000 births due to chlamydia and 0.5 per 100,000 for gonorrhea.

In fact, the risk of ON is so low that other high-income countries such as Norway, Sweden, Denmark, Australia, and the United Kingdom have long abandoned this practice.

Canadian doctors are even are calling for this practice to be stopped.

 

But that does not mean that you may be able to refuse them.

Over 30 states in the USA have laws requiring medical professionals to use eye drops to protect infants against ON regardless of whether or not a mother has chlamydia or gonorrhea and regardless of whether your baby was delivered vaginally or by c-section.

In most states, you can forgo the erythromycin ophthalmic ointment upon written consent.

But in others, such as New York, refusing them may result in a call to Child Protective Services (and they say we live in the “land of the free”…).

The Down Low On Erythromycin Ophthalmic Ointment

The eye drops are not even close to being 100% effective and most healthcare professionals can catch ON before it becomes a serious health issue.

But then come the “What ifs”.

The best way to protect your new kiddo from developing ON is:

1. Get screened for sexually transmitted infections during your pregnancy and treat it
2. Stay in a mutually faithful relationship with a partner who is uninfected
3. Keep a watchful eye over your newborn and be on high alert for any eye infections

Have something to say about these eye drops or have a question?  Comment below!

 

References:

http://womenshealth.gov/pregnancy/childbirth-beyond/baby-first-hours.html
http://www.cps.ca/en/documents/position/ophthalmia-neonatorum
http://www.cps.ca/en/documents/position/ophthalmia-neonatorum#ref30
http://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/
http://www.cbc.ca/news/health/newborn-eye-treatment-doesn-t-work-say-pediatricians-who-want-law-repealed-1.3000350