Ditch The Eye Goop: Why This Unnecessary Law May Be Repealed

reneeshawIf you’re anything like me, your first pregnancy may have been typical in terms of common interventions. Ultrasounds? Of course! Doesn’t everybody get those? Antibiotics for GBS? I heard that was safest… Pitocin and an epidural? I kinda want to avoid them, but it’s another thing so many women just do… The newborn eye goop? Why would I question it?

By my second pregnancy, I had learned to look more critically at a lot of the things I did automatically, as advised, the first time around.

I pretty much did everything differently (and had a healthier, easier pregnancy and birth because of it) — including the newborn eye goop.

What is the newborn eye goop?

The eye treatment is antibiotic eye ointment meant to prevent neonatal ophthalmia, which is essentially conjunctivitis (pink eye) contracted during birth, if the mother has gonorrhea or chlamydia.

The practice of treating each and every newborn with eye ointment dates back to the late 1800s, when doctors began putting silver nitrate in babies’ eyes. At the time, about 10% of babies in Europe developed ophthalmia, with 3% experiencing blindness. Silver nitrate helped keep babies from going blind due to corneal infection from gonorrhea. It also caused chemical conjunctivitis in over half of the babies treated.

Since the advent of antibiotics, erythromycin ophthalmic ointment has been used instead of silver nitrate.

Preventing blindness in babies is good, right? So why would anyone want to avoid the eye goop?

Well, I don’t have an STD. I don’t have chlamydia or gonorrhea. Because both my husband and I have been tested for STDs, and because we are monogamous, there is no chance that my babies will contract neonatal ophthalmia that might lead to blindness.

When we look at the facts, the chance of a baby contracting neonatal ophthalmia is very rare, and the chance of it leading to blindness is even more rare.

This begs the question: why are 100% of babies born in hospitals subjected to this routine treatment when the chance of blindness is so rare?

Antibiotic eye ointment is currently recommended by multiple health organizations in the United States, including the American Academy of Pediatrics and the American Association of Family Physicians.

In Canada, the eye ointment is required by law in Ontario, Quebec, British Columbia, Alberta, and Prince Edward Island.

The Canadian Pediatric Society, however, has come out recommending a repeal of this law. They state that neonatal ophthalmia is so rare that they stopped tracking incidents of it in 2000.

It is also now recognized that the treatment is “of questionable efficacy,” because around 25% of cases of neonatal ophthalmia do not respond to the antibiotic ointment.

The issue is similar to that of administering antibiotics to every mother who tests positive for Group B Strep. GBS is dangerous and can kill your child, right? So why would anyone be against routine antibiotics?

When the issue is broken down and the facts are assessed, the risk of GBS killing a baby is very small, while routine antibiotics actually pose a larger, more likely health risk to both mother and child. With both GBS and ophthalmia, baby can be monitored and treated after birth, rather than treating every mother and child regardless of their health status.

As more and more parents become fully informed about their pregnancy, birth, and child-rearing options, including various interventions that are commonly foisted upon us with little evidence-based information attached, it is clear that this practice of antibiotic eye ointment needs to end.

It is the antithesis of evidence-based care for all babies to be treated regardless of the STD status of their mother, and it is a positive step for the Canadian Pediatric Society to speak out against this routine treatment.

When will the United States catch up?

Image via Renee Shaw Photography


8 thoughts on “Ditch The Eye Goop: Why This Unnecessary Law May Be Repealed”

  1. Pink eye is not just from std. Did you know common cold sores cause pink eye too even if at the current time you don’t have one it’s always in your body. Also the amount of antibiotics in the ointment is so minimal it’s less then first aid cream. If you don’t want your baby to have it that’s fine but don’t condem people who do. Every time I read one of these midwife things it’s always saying how horrible having your baby in a hospital is…..well some people would like a different birth story but don’t need to be shamed because they didn’t have their baby in a forest with a waterfall for a calming sound track

    1. Cold sores and the more common pink eye you reference are both viral, and thus would not be impacted by the antibiotic ointment. The particular type that’s being treated for with prophylactic antibiotics is specifically related to the bacterial infections mentioned in the article. Nowhere in it did the author shame people who chose the ointment, or simply didn’t make a choice and the ointment was used on their children as part of standing orders wherever they gave birth.

      That said, I think we should occasionally reexamine any standard medical treatment. We are encouraged to look over medical bills for incorrect or duplicate charges, but we should also be vigilant against unnecessary charges. If the routine STD panels which are already done during pregnancy indicate the ointment is unneeded, why use it? Its simple enough to change the standard order to be for infants whose mothers have not been tested in the last year. Its one thing if it were something we couldn’t (or didn’t) routinely test for, but we do.

      How would you feel if the doctors said “You aren’t ill, but here, take these antibiotics anyway.” You’d likely refuse, and for good reason.

    1. Under the British Columbia Health Act Communicable Disease Regulation (2013)5, a physician, midwife, or other quali ed person assisting at the birth of a baby must, within one hour of the birth, treat the eyes of the baby with a prophylactic solution…

      The British Columbia Health Act Communicable Disease Regulation (2013) states that eye prophylaxis may be declined� Information provided antenatally by the physician or midwife prior to obtaining written request from the parents (or the mother, where both parents are not available), must include the following:5
      1� Why the treatment is recommended�
      2� What advantages should be anticipated from the treatment�
      3� What problems may arise if the treatment is not given�
      4� What side effects may arise from the treatment�
      5� Understand the need to monitor their newborn’s eyes for discharge during the rst 4 weeks of life and knows who to contact�
      A sample informed refusal to treat form can be found in Appendix A�

      http://www.perinatalservicesbc.ca/Documents/Guidelines-Standards/Newborn/NewbornEyeProphylaxis.pdf

  2. This is very strange, I am a Midwife and mother of 4 in the UK were all women have at least part of their care provided by midwives and we do not even offer this let alone legislate for it. We have no problems as a consequence.

  3. I had my baby in a birthing centre in Quebec, and no drops mandated either; we were given the choice and chose to decline after doing some research!

  4. All women are screened for gonorrhea and other STDs in pregnancy. The problem is that doctors do not know who you slept with the night before, so doctors have lobbied all of the state legislatures to require, first silver nitrate, and now antibiotics to all babies born in their jurisdiction.

    Has the rate of STDs and blindness caused by this practice dropped? If not, what is the benefit of this intervention?

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