Eye ointment -- a hill to die on, or go along to get along? UPDATE - Page 2

[nia82]

Unless you live in NY state were it is absolutely mandatory, I'd absolutely refuse it. And yes, unnecessary antibiotics are potentially harmful (resistant bacteria strains for one!). And I have heard from NY state that they will not let you wipe the ointment off either, they are super stringent about this, the only way around it there is an unassisted birth.

The ointment originally addressed gonorrhea only, but chlamydia may cause eye infections as well. I have heard read online how some obgyns try to tell women that the vagina is a dirty horrible place hence the ointment is necessary... *eyeroll*

I just signed a waiver for both my births, easy peasy, in CA and CO.

[womenswisdom]

Originally Posted by carriebft 

I wasn't aware that eye ointment helps prevent infection in the first couple weeks from other bacteria not related to STDs. My daughter did get an infection in both eyes and we declined the ointment. I think i would continue to decline though because she got the same stuff they would have put on her at birth and i controlled the goop with breastmilk as well. she was fine after one day of use. It seems like a bit much to get it on all my kids though just because of that issue. when it comes to abx, i would rather treat as it happens in this case.

I have heard other people say they have been told this, but I can't imagine how it could possibly be true.  It's not true for any other bacterial infection you can think of, but somehow one dose of antibiotic ointment is supposed to protect babies from acquiring a bacterial infection for some length of time (more than a couple hours) after administration?  I can't see how that would even be possible.

[weliveintheforest]

the nurses at your actual birth might be much more easy-going about you declining than the nurse doing a tour.  

It doesn't seem to be a big deal to decline it where I live so it's hard for me to imagine... dh and I would fight it out of principal but I think as long as your baby has had the time to look at you and nurse, it wouldn't be a big deal to give it.  I doubt it is harmful aside from blurring the vision.

[motherhendoula]

My first was born in a Free Standing Birth Ctr and i was a little off put by the Vitamin K and the goop - it was all so new to me.  I ws told that i could NOT decline - however, my midwife put the goop on my daughters eyebrows!  I guess that was a 'win win' situation!

[liliaceae]

I would still decline it. I wouldn't give my newborn unnecessary medication just to make the nurse feel better. And even if the baby did get an eye infection later, you could still treat it with antibiotic ointment. It's not like the baby would instantly go blind from the infection.

[Dot-to-Dot]

My understanding is that the ointment isn't JUST to protect babies from their mothers who may have an STD, but to protect them from all kinds of bacteria (of which there are LOTS in the hospital) which may potentially cause an eye infection...and that infants can very, very quickly have permanent damage to their eye if the infection were to go too long before treated.  So, I wouldn't turn it into a battle with the argument in mind that, "I don't have an STD so leave me alone!" because from the nurse's perspective, I think it's about more than that.

However, if you don't want it done, all you have to do is have your doctor initial each bullet point in your birth plan.  If anyone questions you about your decision, you just hand them a copy of the birth plan with the doctor's little initials right by "No eye ointment for baby" and if they persist you tell them to just talk to the doctor about it.  Like someone else said earlier, no decent nurse should say anything beyond informing you of risks/benefits and that should be it.

I went into labor still undecided about the ointment and then forgot.  She got the ointment and didn't really open her eyes for days.  Maybe even a couple of weeks!  It was an all natural birth but she was not alert like they said she'd be, ha!  Anyway, lots of people are saying how you can easily just wipe it out of her eyes.  I'm sure you could wipe the excess of the surroundings of her eyes...but to wipe something off that went onto her eyeballs?  I'm pretty sure I wouldn't have been able to do that to my newborn.  And it probably isn't a good idea to go jabbing your germy finger in her eye anyway.  Maybe I don't fully understand the comments or the ointment, but I don't think it's the hill to die on....although, I highly doubt they'll harp on you about it if you just refer them to your approving doctor who signs off on the birth plan ahead of time.

[CookAMH]

Personally, this is one I would stand firm on if I were in a hospital. Thankfully we didn't get grief at ours with DS, but I feel strongly about using abx when they are not needed, especially in my brand new baby.

Unless your in NY state, as far as I know, it is QUITE simple to sign the refusal form. Who cares if they have to type it up.

[CookAMH]

Originally Posted by Dot-to-Dot 

My understanding is that the ointment isn't JUST to protect babies from their mothers who may have an STD, but to protect them from all kinds of bacteria (of which there are LOTS in the hospital) which may potentially cause an eye infection...and that infants can very, very quickly have permanent damage to their eye if the infection were to go too long before treated. 

This is often touted by hospital staff (often to persuade acceptance) but it is not true.  It IS only for chlamydia and gonorrhea.

[by-the-lake]

 DDDC- Yes, keeping baby in room, ensuring by request or visualization that staff are hand washing correctly, will ensure the baby doesn't get those supposed 'bugs' people may be concerned about. Lacrimal duct plugs are fairly common in babies, and can be confused with eye infections. If you are concerned, breast milk can be used as it has proven antimicrobial properties. Just a thought. Normal birth, in absence of chlamydia and gonorrhea infection, is no cause for random eye infections.

[hjdmom24]

My thought is that if they know you were against it at first and then they were able to persuade you to do it anyways..what other things may they (try to) pressure you to do? I think it is important to consider other opinions but ultimately it is YOUR child and this will only be the first of many battles you will have to fight for them..I say it's good practice :)

[Dot-to-Dot]

Originally Posted by CookAMH 

This is often touted by hospital staff (often to persuade acceptance) but it is not true.  It IS only for chlamydia and gonorrhea.

Yeah, I wouldn't doubt it!  Which is why I was firmly "no" with the ointment.  But, then I heard about a midwife who says the only way she WOULD give her own baby the ointment would be if they were forced to transfer and the baby was born in the germy hospital.  Otherwise, she'd of course never consider it for a baby born at home.  She wasn't hospital staff and I assumed she knew more than I do about newborns.  And of course, whether you transfer or not doesn't magically change your STD status.  This made me wonder...because in my experience, the hospitals really are pretty germy.  However, By-the-lake makes a good point about rooming in to keep baby away from a good amount of germs.
 

[msmiranda]

Wow, I didn't expect to get so many responses -- thanks all!  It is great to hear others' views on the issue.  I am still on the fence.  On the one hand it's not as though giving the ointment is equivalent to circumcision or feeding a bottle of formula or something like that that has permanent consequences.  But on the other hand, I don't like my right to decline being questioned, and I can see it becoming a slippery slope. 

We are going to go ahead and get the Vitamin K and agree to the baby's blood sugar being tested after birth (bc I have GD), neither of which I am super thrilled about, but we are declining the bath, Hep B shot, and possibly the metabolic screen depending on whether my ped will insist on doing it a second time a few days later.  That combined with all the birth stuff I'm declining will give me plenty of practice in saying "no thank you" and signing waivers.  I was just thinking it might be better to save my assertive energy for the more important stuff and let a few smaller things go.  I'm going to mention it to my OB tomorrow and see whether declining is truly as rare as that nurse said ... my OB didn't bat an eye at anything on my birth plan, including declining all 3rd stage active-management stuff, and said they see women who have the same preferences I expressed "all the time" and are used to accommodating them.  I can't imagine that, it now being 2011, none of those women has ever declined the eye ointment. 

So we'll see.  If I felt strongly about it, I would definitely insist on declining.  Strangely(?), I feel more strongly about declining the bath than the eye ointment ... though if we decide to go along, I will absolutely insist on delaying it until at least an hour after the birth.  And wipe off the area around the eyes as soon as they leave us alone. :) 

[Marissamom]

you may end up wanting the bath. DD was covered in blood and mec. we did wait until she was a couple hours old, but there was no way she wasn't getting everything washed off her. 

[msmiranda]

Originally Posted by Marissamom 

you may end up wanting the bath. DD was covered in blood and mec. we did wait until she was a couple hours old, but there was no way she wasn't getting everything washed off her. 

Well, if there were a lot of blood and meconium, I might reconsider.  That has not happened with my other two.  My inclination to decline the bath is to minimize separation (since they only do baths in the nursery, of course DH would go with him but then I would be alone) and to help the baby maintain his body temperature.  It just seems crazy to do something to him that will make him cold when they already have such a hard time maintaining a good temp for the first 24-48 hours.  Plus I wouldn't be able to be there for his first bath, and that just bugs the crap out  of me.  I'm a control freak that way.

[by-the-lake]

Originally Posted by msmiranda 

Well, if there were a lot of blood and meconium, I might reconsider.  That has not happened with my other two.  My inclination to decline the bath is to minimize separation (since they only do baths in the nursery, of course DH would go with him but then I would be alone) and to help the baby maintain his body temperature.  It just seems crazy to do something to him that will make him cold when they already have such a hard time maintaining a good temp for the first 24-48 hours.  Plus I wouldn't be able to be there for his first bath, and that just bugs the crap out  of me.  I'm a control freak that way.

Good for you. Establishing good bonding and breastfeeding takes precedence over the first bath. Studies show improved breastfeeding because of the odor of amniotic fluid. In the event of blood or meconium, a baby can be wiped down pretty well without a full blown bath. I did not have my last DS bathed until we got home, and will do the same this time  around.
 

[Marissamom]

Originally Posted by by-the-lake 

Good for you. Establishing good bonding and breastfeeding takes precedence over the first bath. Studies show improved breastfeeding because of the odor of amniotic fluid. In the event of blood or meconium, a baby can be wiped down pretty well without a full blown bath. I did not have my last DS bathed until we got home, and will do the same this time  around.
 

yeah, I thought we weren't going to do a bath, and there were able to get a lot of the blood and mec off her with a rub-down, but in the pictures of when she was just born you can still see mec all over her face. If I have a cleaner baby this time around, he won't be bathed in the first couple of days. (and no matter what a bath will wait until after the first feeding and some bonding time)

[msmiranda]

So when I asked my OB yesterday, she was like, "people decline the eye ointment all the time, it's not a big deal."  And when I told her some of the other stuff the tour guide had said, she was like, I wonder if I can find out who that was.  I said I didn't want to get her in trouble, but my OB said, "but she's giving out wrong information!" 

I think what happened is that this nurse used to work on the L&D unit some years ago (maybe 5?  maybe even more?) and back then, maybe no one ever did decline the eye ointment, so that was genuinely her experience.  In the past several years I think there's been a real explosion in awareness of choices in maternity care and more women wanting to exercise more control over their care and the care of their babies.  Since this hospital is known in the area as being NCB friendly, it stands to reason that some of those mamas (and maybe some non-NCB mamas too) have declined eye ointment.  Which is why what she said didn't ring true to me, and I was right.  She was speaking from her experience, but her experience was outdated. 

I told my OB that they probably  just don't expect someone to come in for the tour asking questions as detailed as the ones I had.  Which is kinda annoying because now I'm questioning all the other info I got that night ...

[Turquesa]

Originally Posted by motherhendoula 

My first was born in a Free Standing Birth Ctr and i was a little off put by the Vitamin K and the goop - it was all so new to me.  I ws told that i could NOT decline - however, my midwife put the goop on my daughters eyebrows!  I guess that was a 'win win' situation!

What an awesome way to get around NY's draconian law.  Your MW rocks! 

OP, I'm really glad it worked out for you!

[Magali]

Originally Posted by CookAMH 

This is often touted by hospital staff (often to persuade acceptance) but it is not true.  It IS only for chlamydia and gonorrhea.

This. 100%.
 

[mrsberman]

When I told my MW I was declining the ointment because I don't have chlamydia or gonorrhea she tried telling me the antibiotic isn't just for that. It helps protect again E. coli infections as well. I just shrugged my shoulders and said I still don't want it, but I was really confused because I have never heard of the ointment/drops protecting against anything but the two STDs. She did have a very glazed over look in her eyes and wouldn't make eye contact with me when she told me this. I don't know if she was telling me something that she was forced to say vs something she actually believed. I decided not to argue and ask for references on this one because she assured me that it's a personal choice to decline and it won't be a problem at the hospital.