Erythromycin Ointment for Newborns - Is It Necessary?

Look at almost any photo of a newborn and you will notice something funny about their eyes: they are usually gooey and slightly red. It is so common to see this in newborns, that some people actually think that is just how they come out! The truth is, that gooey stuff on the eyes is actually erythromycin ointment (an antibiotic). It is usually placed in a newborn's eyes within the first hour after birth, when the nurse or midwife is weighing and measuring the baby. It has become so common that many parents simply accept it as readily as they accept cutting the umbilical cord. But is it really necessary? The answer to that is: it depends.

Eye ointments have been used to prevent serious eye infections in babies since the late 1800s. At that time, silver nitrate was used. Unfortunately, silver nitrate - if given an incorrect dose - can cause blindness. Given correctly, it saved the vision of countless babies. Why? While being birthed, a baby's head, face, and eyes have to pass through the mother's birth canal and vagina. If a mother has an active case of gonorrhea or chlamydia, the infection can be passed from a mother's birth canal to her baby's eyes. This, in turn, can cause blindness in the infant.

Eventually, silver nitrate was replaced (for the most part) by erythromycin ointment. It is safer to use and has less side effects than the silver nitrate. However, erythromycin ointment can still sting slightly, causes temporary blurring of vision, and may cause allergic reaction in rare cases. For public health measures, most states and hospitals have made it mandatory that ALL babies receive a prophylactic dose of erythromycin ointment after birth. Better safe than sorry. And yet ...

There is absolutely no need for this eye ointment if you are 100% certain that you and your partner do not have any STDs. This means that a couple needs to be in a mutually monogamous relationship and certain that neither partner has an STD. I stress mutually monogamous. If either partner is having sexual relations outside the partnership, an STD could be unknowingly introduced to the mother - which could then be passed onto their baby. Unfortunately,  chlamydia and gonorrhea can be active without showing any obvious signs or symptoms. Therefore, proper STD testing at the beginning of pregnancy, followed by a mutually monogamous relationship for the duration of that pregnancy, can ensure a mother that she is not infected.

K and I chose not to have erythromycin ointment placed in Little Bear's eyes after birth. We knew I did not have chlamydia or gonorrhea and were not worried about infecting our newborn with an STD (one wonderful benefit of choosing to live monogamously!). We also wanted Little Bear to be able to see Mommy's and Daddy's face clearly during her first few hours of life - with no blurry goop to look through. Because the state of Oregon requires erythromycin ointment to be given to all newborns, I did have to sign a waiver before I left the hospital acknowledging that I did not want this treatment done.

Deciding whether or not you should have erythromycin ointment placed in your newborn's eyes after birth is a decision only your and your partner can make. But remember, it is completely unnecessary if you are certain you do not have chlamydia or gonorrhea at the time of birth. So whether you decide to have it done or not, sit down with your midwife or doctor and clearly let them know ahead of time what your wishes are.