What's wrong with eye drops?

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With my last two babies my husband said be sure and tell them NO eye drops (I never mentioned eye drops so I'm sure they got them). I see several other posters say the same thing.

I just wonder what the issue is with eye drops?

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Do you mean the erythro eye ointment? A lot of people choose to delay it, though I haven't had many outright refuse it. The reason they want it delayed is because they feel it makes the infant's vision poorer right after birth when they really want the baby to be able to focus on their face for bonding purposes.

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Specializes in Maternal - Child Health.

Undiagnosed and untreated gonorrhea and/or chlamydia infections in pregnant women can lead to serious eye infections in newborns, causing lifelong visual impairment. Newborn eye prophylaxis in the form of silver nitrate drops or antibiotic ointment is required by law in most, if not all states. However, parents may opt out of this treatment by signing a form stating their objections.

For many years, silver nitrate drops were the treatment of choice for newborn eye care. While effective in preventing infection, they are very irritating, and have been largely replaced by erythromycin ointment. Erythromycin ointment can cause transcient redness around the eyes that many parents mistake for an allergic reaction. This redness goes away within several hours and does not cause any lasting effects.

Many parents will request that eye treatment be delayed to allow baby to have a clear view of Mom and Dad during the first few hours of life to promote bonding. Most nurses will happily accomodate this reasonable request and give the ointment when baby slips into a sleepy period.

If you have any concerns about eye prophylaxis, please ask what type of medication is used in your hospital, and whether the staff will be willing to delay its administration to allow for bonding. If you prefer that no prophylaxis be given at all, your OB may be willing to test you for STD's near your due date to help you make an informed decision as to its necessity.

Best of luck to you!

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If it is proven that mom does not have gonorrhea, chlamydia, or any other STD that could cause eye problems, then why is the treatment necessary in the first place?

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Specializes in Maternal - Child Health.
If it is proven that mom does not have gonorrhea, chlamydia, or any other STD that could cause eye problems, then why is the treatment necessary in the first place?

If a patient is free of STDs, eye prophylaxis is not necessary. But insuring that a patient is free of STDs is not quite as simple as it seems. A patient who cultures negative at her first pre-natal visit may become infected during pregnancy, and since STDs are often asymptommatic, she may have no idea that she is infected. Cultures done on admission to L&D will not show results for a few days, by which time mom and baby will already be home.

Because an undiagnosed infection poses such a great risk to the newborn, and because the treatment is so cheap, easy and safe, it has become mandatory. It is a practical matter of weighing the risks and benefits in terms of individual and public health. That means that some babies will be treated unnecessarily in order to acheive the goal of eradicating visual impairment due to congenital eye infections.

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In Texas they cannot refuse this, it is state law. They can refuse the vitamin K, but not the erythro.

We used to give it in the delivery room (I hated it for bonding), but with our new computer charting - have to have baby sticker to scan when giving med...yada, yada... we now do it at about an hour of age.

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It's not required by law here and the parents can refuse it if they want to. They do not need to sign a waiver just a verbal "I do not want it" is enough. I think it's silly there is a law that a parent cannot override in regards to refusing ointment, especially if they have tested negative. If mom's membranes are intact until right before delivery, there is very little risk of infection passing to the baby.

I personally would have it done but if a parent has researched it and is resonably sure they are infection free, it is not my place to override their decision in regards to their child. I would be a very angry parent if I was told that you did anything to my child without my consent. I never do anything without the consent of the parent unless it is life threatening.

ETA: If anything I am more concerned about those parents refusing vit K over those refusing ointment.

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The ointment doesn't hurt the child. It's a small price to pay to prevent blindness. In an ideal population - sure, let 'em choose. But when half the moms you get drop in with little or no prenatal care and multiple sex partners, I'd rather err on the side of caution rather than let children go blind when a simple, painless and virtually harmless dose of antibiotic ointment can prevent it.

When it comes to vaccines, however, I hate that these nasty things are being forced on the public the way they are. They are not nearly as harmless and their effectiveness is questionable. Inject mercury - a known toxin - into my baby? No way! Now that's a cumpulsory treatment worth fighting.

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I agree it does not hurt the child and I would err on the side of caution but the fact remains it is their child and their decisions need to be respected.

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Maybe some texas nurses can tell me......I am an L&D nurse....not nursery. But I have been told that a mom CAN NOT refuse erythromycin eye drops. There is not waiver of refusal. When a patient is adament about refusing the nurse tells them to call their pedi...talk to him...and get him to call the nurse with an order for no eye drops. All of this is done whild the patient is in labor. They tell them the order must be received w/in 1 hour of delivery or the drops will be given. If the patient says "why can't you call them" the nurse will reply "because I know what he/she is going to say." I totally agree with the nurse as this limits her liability if the baby were to get an infection.....as she was following a doctors orders.

I find this wierd because as we all know patients have the right to refuse meds....

As the L&D nurse I usually will tell the patient "this is not about you...." because of course I am not trying to make the patient fell we are making a moral judgement about her or her spouses sexual history. but I will say "out there in the world....there are lots of pregnant women out there that will contract an STD during there pregnancy....and it is cheaper for you, the insurance agency, and the government to give this antiobiotic than it is to test all pregnant women for numerous STDs at delivery."

Once you explain that it is business...not personal....then bring mom an extra pillow and offer to get dad a cup of coffee....it all blows over...

my advice to all the pregnant moms out there....talk to your pedi BEFORE you show up in labor....'cuz I care way more about keeping my licence than weather your baby gets eye drops or not.

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Specializes in N/A.
Undiagnosed and untreated gonorrhea and/or chlamydia infections in pregnant women can lead to serious eye infections in newborns, causing lifelong visual impairment. Newborn eye prophylaxis in the form of silver nitrate drops or antibiotic ointment is required by law in most, if not all states. However, parents may opt out of this treatment by signing a form stating their objections.

For many years, silver nitrate drops were the treatment of choice for newborn eye care. While effective in preventing infection, they are very irritating, and have been largely replaced by erythromycin ointment. Erythromycin ointment can cause transcient redness around the eyes that many parents mistake for an allergic reaction. This redness goes away within several hours and does not cause any lasting effects.

Many parents will request that eye treatment be delayed to allow baby to have a clear view of Mom and Dad during the first few hours of life to promote bonding. Most nurses will happily accomodate this reasonable request and give the ointment when baby slips into a sleepy period.

If you have any concerns about eye prophylaxis, please ask what type of medication is used in your hospital, and whether the staff will be willing to delay its administration to allow for bonding. If you prefer that no prophylaxis be given at all, your OB may be willing to test you for STD's near your due date to help you make an informed decision as to its necessity.

Best of luck to you!

That was very informative and well written Jolie. I always enjoy reading your posts. I had my wife show me what they use at her hospital here in TX. It is a little tube that says, Erythromycin Ophthalmic Ointment USP. She tells me it is state law in Texas but I can't find the statue to prove it. Can someone find it for me?

By the way I have become completely fascinated by ya'lls profession. I love hearing labor stories from ground zero. And OMG the drama that goes along with it is like the best soap opera ever!

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We use the ointment too.

Jolie - great teaching moments - I love your posts.

I don't think it is a big deal - bonding continues very nicely in my experience. Usually a baby is latched right onto a breast so they don't see that much anyway. ;)

steph

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