You’ve just given birth to your precious baby, and your care provider suggests two routine procedures right away, the Vitamin K injection and erythromycin eye ointment. How do you know if this is right for your baby? 

Ophthalmia Neonatorum (ON) is the infection and inflammation of the thin layer of tissue that covers the inner part of the eyelid. In the late 1800s, about 10% of babies were contracting the infection during birth and about 0.3% were going blind from it. In 1879, it was discovered that gonorrhea (from the mother) was to blame for causing the infection in newborns. Since then, doctors have learned that chlamydia can also cause ON. Currently, in the United States, chlamydia is the leading cause of ON. 

Women are routinely screened for sexually transmitted infections during pregnancy and about 0.62% of women are infected with chlamydia and 0.7% with gonorrhea. (CDC, 2022) Oftentimes, there are no symptoms of infection and the mother goes without diagnosis. Because of this, care providers treat every baby with an eye antibiotic immediately after birth. The antibiotic is called Erythromycin and it’s applied in and on baby’s eyes within the first hour of life. 

While ON is typically caused by gonorrhea or chlamydia, up to 30% of infections could be from other forms of bacteria, commonly known as conjunctivitis or pink eye. There are no studies that suggest that these types of infections cause blindness or that erythromycin prophylactically prevents the infection. 

There are risks and benefits to every newborn procedure. 

The benefits of using erythromycin include:

• Reduce the risk of blindness by slowing or preventing ON infection (Darling & McDonald, 2010)

The risks of using erythromycin include:

• May not be 100% effective at preventing any type of ON
  • Erythromycin has had a 20% failure rate of gonorrheal ON (Lund et al. 1987)
  • May not prevent chlamydial or bacterial ON at all (CPS, 2015)
• Blurred vision and interruption of bonding 

You get to decide what is right for your baby regarding eye ointment and all newborn procedures. It’s important to have the information, the background, and the studies available to you. You can choose to forgo this procedure if you don’t feel it is necessary for your family. Like everything, you may opt out of anything at any time.