Pink eye (Conjunctivitis)

Caring for your baby’s ‘sticky’ and ‘watery’ eyes

Your baby’s eyes are kept moist and healthy by tears that wash over the surface of their eyes constantly. Tears are produced in the lacrimal glands and there is one lacrimal gland above each eye. Your baby’s tears are then carried away from the eye by a tear duct, which is a very fine tube. When babies are born, their tear ducts are sometimes not fully developed and patent (clear). Studies have shown that approximately one in five babies are born with tear ducts that are not fully developed and either one or both eyes may be affected in this way. In the majority of cases however, the tear ducts will develop slowly over a few weeks, without any need for intervention or there being any problems. For some babies however, this process can take several months to complete.

It is also possible for a baby’s tear ducts to become blocked by amniotic fluid or debris deposited around the time of their birth eg vernix and skin cells. See also our article, ‘Your newborn baby’s skin’. Many parents do not realise that their newborn baby is unable to shed tears in the initial weeks following their birth – this is perfectly normal. Because babies do not produce tears, it is very difficult for any debris that has collected to be washed away. You may therefore, need to wipe away any eye discharge that has accumulated and this will be explained later in this article.

 

Watery and sticky eyes

Newborn babies frequently develop watery or sticky eyes after their birth. You may notice a collection of clear, white or yellow-coloured discharge at the inner corner of your baby’s eyes (closest to their nose). This discharge is often particularly noticeable during the first 48 hours after your baby’s birth. Where this discharge collects over a period of time, especially overnight, it can dry out forming a crust on your baby’s eyelid(s) and/or eyelashes. This can sometimes cause your baby’s eyelids and eyelashes to become partially glued together, which can be particularly noticeable first thing in the morning. However, the surface of your baby’s eyes – the ‘sclera’ should still continue to look white and healthy despite the presence of any discharge. Your midwife and health visitor will describe this condition as ‘sticky eyes’. In most cases sticky eyes are perfectly harmless and there is no infection present. Occasionally, you may notice that your baby’s eyes do begin to look slightly pink, which is a sign of mild inflammation; however, this usually resolves without requiring any treatment.

Watery eyes usually resolve on their own, but your baby’s eyes can become watery again if they develop a head cold and their tear ducts become blocked again. Very rarely, watery eyes can indicate there might be other eye problems, so should you have any concerns, it is important that you contact your GP for their advice. If your baby’s tear duct is still blocked by the time they are 12 months’ of age, your GP may advise that your baby is referred to an eye specialist for a minor operation that opens up their tear duct.

Bébé - Soin des yeux

 

Cleaning your baby’s eyes

If your baby develops sticky eyes, these should be cleaned regularly to prevent a build up of discharge. Where discharge builds up, it is possible for infection to then develop either in the tear duct or the conjunctiva (conjunctivitis). Ideally, you should aim to clean your baby’s eyes every four hours, although you may need to do this more often if their eyes are particularly sticky. If you are still in hospital, the ward staff will show you how to clean your baby’s eyes using sterile salt water – Normal Saline (Sodium Chloride) and cotton wool balls. If you are back at home your community midwife or health visitor can help you with this. You can use ‘cooled’ boiled tap water for cleaning your baby’s eyes; however, using boiled water can cause their eyes to become irritated, so it may be worth asking your midwife, health visitor or GP for some ampoules (plastic pods) of sterile saline.

 

How to clean your baby’s eyes

a). Hand hygiene is very important to prevent infection being introduced into your baby’s eyes. Always wash your hands thoroughly with soap and water before and after bathing each eye

b). Dampen a clean cotton wool ball with sterile saline/cooled boiled water and in one gentle movement, clean along the lash line from the inner corner of your baby’s eye across to the outer corner. Discard the used cotton wool after use

c). This action may need to be repeated more than once in order to remove all the discharge present. Ensure you use a clean cotton wool ball each time

d). Dry your baby’s eye using a clean cotton wool ball – in one gentle action move in the same direction from the inner corner of the baby’s eye outwards

e). Clean your baby’s other eye in the same way. It is very important that you never use the same cotton wool ball for both eyes, because this can spread any infection that might be present

f). Where the eye discharge has dried and become crusted, your baby’s eyelids or lashes may be partially stuck together. Where this is the case, it is important that you don’t try to force their eyelids/lashes apart with your fingertips. Instead, you should always bathe their eyes open using the above technique.

 

Is there anything else that helps?

Where your baby’s tear duct(s) is blocked, massaging it every few hours can help remove the blockage and open up the tear duct. You can do this by gently applying light pressure to the skin over the tear duct between the inner corner of your baby’s eye(s) and their nose. Massage down the side of the nose, moving from the top to the bottom.

Conjunctivitis

While your baby’s tear duct(s) is developing, they can be more prone to picking up infection and developing conjunctivitis. This is where the eyes become inflamed (pink and sore) and the delicate skin around them can become swollen. Conjunctivitis tends to cause a more profuse ‘yellow’ coloured discharge and you may notice that your baby keeps rubbing their eyes because they feel itchy. Where this happens, the infection can be easily introduced from one eye into the other.

While conjunctivitis is a very mild infection, it is nevertheless, extremely contagious and very easy to pick up. It tends to be seen more often in toddlers and school age children. If you think your baby may have developed conjunctivitis, they will need to be seen by your GP. They may advise that your baby is started on antibiotic eye drops or ointment. In order to make sure that your baby has the right antibiotics to fight off the infection, an eye swab will be taken. This enables a sample of the discharge to be examined in a laboratory.

Hand hygiene is very important when bathing your baby’s eyes and instilling eye drops/ointment, because conjunctivitis is so highly contagious. It is therefore best to use a separate hand towel to prevent the infection being picked up by other family members.

If your baby appears to be in pain or is reluctant to open their eyes, or the discharge is a greenish colour and won’t clear up – always contact your GP for their immediate advice.

Elston J (1985). Sticky eyes in infancy. Maternal and Child Health 10(8):248, 250-251.

Fok TF, Wong W, Cheng AFB (1995). Use of eyepatches in phototherapy: effects on conjunctival bacterial pathogens and conjunctivitis. Pediatric Infectious Disease Journal 14(12):1091-1094.

Harris MJ (1996). Infections in the first months of life. Journal of Paediatrics, Obstetrics and Gynaecology 22(2):13-15.

Matejcek A, Goldman RD (2013). Treatment and prevention of ophthalmia neonatorum. Canadian Family Physician 59(11).

Moten J, McGuiness B (2000). Is your midwifery practice evidence based? Here’s milk in your eye: an exploration of the use of colostrum for the treatment of ophthalmia neonatorum. Open Line 8(2):6-7.

Newell SJ, Miller P, Morgan I et al (1997). Management of the newborn baby: midwifery and paediatric perspectives. In: Henderson C, Jones K eds. Essential midwifery. London: Mosby. 229-264.

Verd S (2007). Switch from antibiotic eye drops to instillation of mother’s milk drops as a treatment of infant epiphora. Journal of Tropical Pediatrics 53(1):68-69.

Zuppa AA, D’Andrea V, Catenazzi P et al (2011). Ophthalmia neonatorum: what kind of prophylaxis? Journal of Maternal-Fetal and Neonatal Medicine 24(6):769-773.

Useful websites

http://www.nhs.uk/Conditions/Watering-eye/Pages/Treatment.aspx [Accessed 23 January 2014]

http://www.patient.co.uk/health/tear-duct-blockage-in-babies [Accessed 23 January 2014]

2017-05-26T16:29:16+00:00