Pink eye, officially known as conjunctivitis, is inflammation of the conjunctiva, the thin membrane covering the white part of the eye and the inner surface of the eyelids. This common ocular issue is possible in newborns, even in the first few weeks of life. While pink eye in older children and adults is often a minor annoyance, the condition in an infant under three months old is taken seriously. A newborn’s immature immune system means that even mild infections can progress rapidly or signal a more dangerous underlying cause.
Causes of Newborn Conjunctivitis
The causes of conjunctivitis in infants are distinct from those in older populations. A specific concern is infection acquired during passage through the birth canal. The most serious infectious causes are the bacteria responsible for chlamydia and gonorrhea, which can lead to severe eye damage if not treated promptly. Chlamydial conjunctivitis typically appears five to twelve days after birth, while the more aggressive gonococcal infection often presents much earlier.
Another cause is chemical conjunctivitis, which results from the prophylactic eye drops administered shortly after birth to prevent gonococcal infection. These drops, commonly erythromycin ointment, can cause a mild irritation that mimics pink eye symptoms. This irritation is usually brief, often resolving within 24 to 48 hours.
Beyond birth-related infections, infants can acquire bacterial or viral conjunctivitis through contact with caregivers or the environment. Common bacteria like Staphylococcus or Streptococcus can be transmitted via unwashed hands or contaminated linens. Additionally, a blocked tear duct can cause tears and mucus to back up and lead to secondary infection, creating symptoms similar to conjunctivitis. This issue is often marked by persistent tearing and discharge without the significant redness of a true infection.
Identifying Symptoms in Infants
Parents can observe several signs that indicate the presence of conjunctivitis or a related eye issue. The primary symptom is the noticeable redness or pink coloration of the whites of the eyes and the inner lining of the eyelids. The eyelids themselves may appear puffy or swollen, a sign of inflammation.
The appearance and consistency of any discharge is an important clue to the underlying cause. A thick, yellow or green, pus-like discharge is commonly associated with bacterial infections, like Staphylococcus or gonorrhea. This discharge can be copious enough to cause the infant’s eyelids to stick together, especially after sleep.
In contrast, a thin, watery discharge may point toward a viral infection, chemical irritation, or a blocked tear duct. Infants may also exhibit behavioral signs, such as increased fussiness, reluctance to open the affected eye, or excessive eye rubbing. Any combination of redness, swelling, and discharge in a newborn warrants professional attention.
Treatment and When to See a Doctor
Because of the potential for severe complications, any sign of pink eye in a newborn under three months old requires immediate evaluation by a pediatrician. Unlike older children, a newborn’s eye infection cannot be assumed to be a mild, self-limiting viral case. The medical team must rule out serious infections, particularly gonococcal conjunctivitis, which can lead to corneal damage and vision loss if treatment is delayed.
The diagnostic process involves taking a sample of the eye discharge (a swab) to be tested for specific pathogens like Chlamydia and Gonorrhea. Treatment protocols depend entirely on the identified cause. Bacterial infections are managed with antibiotic eye drops or ointments. Chlamydial infection requires oral antibiotics to eliminate the bacteria from the body and prevent lung infection. Viral or chemical conjunctivitis is managed with supportive care, such as gentle cleaning and warm compresses.
Caregivers play a significant role in preventing the spread of infection through meticulous hygiene practices. Frequent handwashing is necessary before and after touching the baby’s eyes. A clean cloth or cotton ball should be used for each gentle wipe to remove discharge. Parents must also be vigilant for warning signs that necessitate an immediate trip to the emergency room, including a high fever, extreme eyelid swelling, or a sudden change in the baby’s behavior such as lethargy or poor feeding.