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  • How Serious is Pink Eye In Babies?

    Reviewed By Laura B Enyedi, MD
    Published Mar. 17, 2023

    Pink eye (also known as conjunctivitis) is a common eye condition that can occur at any age. Though babies can develop runny, goopy eyes for a number of reasons, pink eye isn’t very common – only about 2% of babies develop pink eye during their first month of life.

    When it does occur, pink eye is often due to infections acquired during childbirth. In older babies, conjunctivitis is often caused by cold viruses or bacteria that live on the skin or irritants in the eye.  Most cases of pink eye in babies are self-limited or easily treated, but in rare instances the infection can spread and be life threatening.

    Here’s what you need to know about pink eye in infants and when to seek medical care.

    What causes eye discharge in babies?

    It’s important to know that discharge does not always signal pink eye. Watery or goopy eyes in infants can also arise from:

    • Chemical irritants, usually prophylactic medicines administered shortly after birth including erythromycin and gentamicin drops
    • Blocked tear duct, which often goes away on its own by 12 months of age but may require surgery if it lingers on
    • Epiblepharon, when the lower lid and lashes roll inward and irritate the eye
    • Eye trauma such as a corneal abrasion following delivery, the baby scratching themself or getting injured by a sibling, toy or other object
    • Congenital glaucoma, a rare eye condition that is often accompanied by a cloudy or enlarged cornea

    Your pediatrician should be able to identify these alternate causes of eye secretions and refer you to a pediatric ophthalmologist if needed.

    Causes of pink eye in infants

    There are three common causes of pink eye: viral infections, bacterial infections or exposure to something that aggravates the eye such as smoke or lotion.

    Bacterial pink eye in babies

    Bacteria are often the origin of pink eye in the first 48 hours of life. Conjunctivitis caused by bacteria usually creates a high volume, thick discharge from the eye.  Staphylococcus—a common skin bacteria—is typically the culprit. Gonorrhea is another potential source of infection, although it is uncommon in the U.S. because babies are treated with preventive antibiotics in the newborn nursery. Occasionally these medications can cause mild irritation and pink eye for a couple days.

    Chlamydia, a sexually transmitted infection, can be spread from mothers to babies during delivery and is the most common cause of pink eye in infants younger than 20 days old.

    Viral pink eye in babies

    Herpes simplex virus acquired from the birth canal or from cold sores can also cause pink eye. This often starts in both eyes then can clear up and return in just one eye, sometimes with blisters of the skin near the eye. Herpes infections in infants can become very severe and may even require hospitalization.

    Most commonly, the same types of viruses that cause colds in young children also cause viral pink eye. A virus produces a more watery eye discharge compared to bacterial pink eye.

    Allergic pink eye in babies

    Children and adults can develop allergic pink eye, which is a reaction to pollen, animals or something else in the environment. But this type of pink eye is rare in babies younger than 12 months.

    Does your baby have pink eye? Watch for these symptoms

    Pink eye is an inflammation of the conjunctiva, the clear membrane that covers the white of the eye and inside of the eyelids. Conjunctivitis can affect one or both eyes and often is easily spread from person to person by contact with tears. Call or email your doctor if you notice any of these symptoms:

    • Excessive tearing
    • Yellow or green discharge from the eye
    • Redness or swelling of the white part of the eye
    • Crusting in and/or around the eyes

    Pink eye treatments for infants

    With or without treatment, all types of pink eye should resolve within 14 days. If symptoms persist beyond that, be sure to follow up with your doctor.

    Bacterial pink eye

    Topical antibiotics are typically prescribed for bacterial pink eye to help clear up discharge and reduce how contagious the eyes are.

    Viral pink eye

    There is no treatment for viral pink eye; the body fights the infection on its own. Chlamydial conjunctivitis often needs treatment with oral antibiotics to prevent severe associated lung disease.

    Common mistakes when baby has pink eye

    Well-meaning parents and caregivers may accidentally worsen pink eye or cause it to spread to other people. To avoid the spread of infection:

    • Don’t put breast milk in the baby’s eye. It is not a substitute for antibiotics, and contains other bacteria that can be harmful
    • Do carefully wash your hands before and after handling the baby to protect yourself and others from contagion. Always wash hands before and after you eat, when you go to the bathroom and after you sneeze or cough
    • Do not share towels or bedding with your baby until pink eye clears up
    • Do sanitize objects that are commonly touched by the baby, such as tables, cots, cuddle blankets, and toys

    When to seek urgent medical care

    Don’t hesitate to take your baby to the pediatrician or ER immediately if you notice any of these signs:

    • Trauma or injury to the eye
    • Trouble keeping the eyes open
    • Severe light sensitivity
    • Blisters of skin around the eye