Chlamydial Conjunctivitis, Acquired At Birth (Newborn)

Adult hand wiping infant's eyelid with cloth.

Chlamydia is a sexually transmitted infection (STI). Some birth parents may not know that they have this infection. If a pregnant person has undiagnosed chlamydia, they can pass it to their child during birth. This is called chlamydia infection acquired at birth. Symptoms can appear in a newborn in the first few weeks after birth.

Chlamydia often causes an eye infection called conjunctivitis. The clear covering of the eye and inner lining of the eyelids become red and irritated. The eyelids will be swollen. The eyes will have a watery discharge. This discharge may be white, yellow, or green. Most newborns are given an antibiotic ointment in their eyes after birth. But this doesn't prevent chlamydial conjunctivitis.

Chlamydial conjunctivitis is treated with antibiotics taken by mouth (oral). In most cases, symptoms go away a few days after the medicine is started.

Home care

Medicines

An antibiotic will likely be prescribed to treat the infection. Follow all instructions for giving the medicine to your baby. Be sure to give all of the medicine, even if your baby no longer has symptoms. Artificial tears may also be prescribed to ease eye discomfort.

General care

  • Wash your hands well with soap and warm water before and after caring for your child.

  • Use warm water or artificial tears to rinse the eye every few hours or so while the child is awake. Gently wipe crusts or discharge away from the eyes. Use a wet swab or warm, damp washcloth. When cleaning the eye, wipe from the nose to the outer eye. Use a different cloth for each eye.

  • Try to prevent your baby from rubbing their eyes.

  • To help soothe eye inflammation, you may apply a cool washcloth on the eye. Use a different cloth for each eye.

  • Wash your baby’s sheets and clothes separately from the family’s laundry. This will help prevent spread of the infection.

Follow-up care

Follow up with your child’s healthcare provider as advised.

Special note to parents

Talk your healthcare provider about getting tested and treated for your own chlamydia infection.

When to get medical advice

Call your child's healthcare provider right away if your child:

  • Has a fever (see "Fever and children" below)

  • Has eyelid redness, swelling, and discharge for more than 2 days after starting treatment.

  • Has ongoing signs of infection, such as eyelid redness or swelling,  or more fluid leaking from the eyes.

  • Is breathing very fast or having trouble breathing.

  • Has a cough that won’t go away.

  • Isn't feeding well or not gaining weight.

  • Seems very ill.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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