Birth trauma Eye Ointment Erythromycin
Newborn Procedures: Eye Ointment May Not Be Necessary
Thursday, July 02, 2009 by: Jen Patterson
(NewsTarget) A myriad of procedures is done to newborn
babies usually immediately after birth. These include a shot of vitamin
K, a hepatitis vaccine, a test for PKU, administration of eye ointment and
The eye ointment is administered to prevent conjunctivitis resulting from a gonorrheal or Chlamydial infection in the mother. This type of conjunctivitis can lead to blindness. Some women are asymptomatic for gonorrhea and since false positives are possible, prenatal screening of the mother is thought insufficient as a diagnostic tool.
The ointments used are usually silver nitrate or an antibiotic such as erythromycin or povidone-iodine. Silver nitrate reduces the incidence of conjunctivitis in newborns, but it can cause irritation. Ironically, this irritation itself sometimes leads to conjunctivitis in the infant!
In 1992 a study of 4,544 babies, born between 1989 and 1991 received one of five treatments so that the efficacy of the ointments could be tested. Three groups were given antibiotic eye drops: either erythromycin, two doses of erythromycin or tetracycline. A fourth group received silver nitrate drops and a fifth serving as a control group received no drops. Surprisingly, no significant differences were found in the incidence of newborn conjunctivitis among these groups. The drops of antibiotic and silver nitrate made no difference whatsoever. A small 2007 study of 138 infants confirmed these results: no significant difference was found in infection rate for babies receiving saline drops, erythromycin drops or no drops.
A 1995 study including 3117 infants tested an additional antibiotic called povidone-iodine or betadine. This antibiotic did reduce the incidence of newborn conjunctivitis relative to erythromycin or silver nitrate. However, this study did not include a control group against which to measure the effects of these treatments! Nevertheless, povidone-iodine does appear to have an effect. A fourth study, performed in 2007 examined the effects of povidone-iodine, erythromycin and no treatment on a total of 330 infants. Those receiving povidone-iodine had fewer eye infections than those receiving erythromycin or neither.
Additionally, the infection is rather ugly and impossible to be missed by barely competent parents; there is still plenty of time for treatment when the eye infection starts to look so obvious and antibiotics clear it up.
The indiscriminate use of antibiotics in newborns has the potential to increase the rates of diaper rash, thrush, digestive problems and antibiotic resistance in some. Anecdotally, some mothers claim that their babies who received eye ointment didn't gaze at them or their surroundings as soon as their babies who did not receive eye ointment did.
Results of studies like those described above are not always available to the public. Parents are generally not counseled on the efficacy or indications for newborn procedures; instead, hospital staff routinely undertakes their administration unless explicitly asked otherwise. In some cases parents have no choice or are led to believe they have no choice.
Matinzadeh etal. 2007. Efficacy of topical ophthalmic prophylaxis in prevention of ophthalmia neonatorum. Tropical Doctor 37: 47-9.
Ali, Z. etal. 2007. Prophylaxis of ophthalmia neonatorum comparison of betadine, erythromycin and no prophylaxis. J Trop Pediatr. 2007 Dec;53(6):388-92. Epub 2007 Nov 30.
Isenberg, S.J. etal. 1995. A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. The New England Journal of Medicine 332: 562-566.
Chen JY. 1992. Prophylaxis of ophthalmia neonatorum: comparison of silver
nitrate, tetracycline, erythromycin and no prophylaxis. Pediatr Infect Dis J 11:1026-30.
About the author
Jen Patterson is a mom, doula, and evolutionary biologist. She is co-teaching nutrition classes for fertility enhancement.