Conjunctivitis (Newborn)

Conjunctivitis is an irritation of a thin membrane that covers the white of the eye and the inside of the eyelid. This membrane is called the conjunctiva. Conjunctivitis is often known as “pink eye” or “red eye” because the eye looks pink or red. The eye can also be swollen. A fluid may leak from the eyelid. The eye may itch and burn.

In newborns, conjunctivitis is often caused by a blocked tear duct. It can also be caused by eye drops that are often given at birth. The irritation may be caused by an infection. An infection may have been passed to the baby from the mother at birth. It may be because of a sexually transmitted infection. Or, it may be caused by normal bacteria in the mother’s vagina.

The healthcare provider may do tests for infection. If a bacterial infection is found, your child will be treated with antibiotics.

A blocked tear duct needs no treatment. It often goes away on its own before the child is 1 year old.

Home care

Your child’s healthcare provider may prescribe antibiotic medicine. This is to treat an infection. Follow all instructions when using this medicine.

To give eye medicine to a child

Adult hands putting ointment in infant's eye.

  1. Wash your hands well with soap and clean, running water for at least 20 seconds.

  2. Remove any drainage from your infant's eye with a clean tissue. Wipe from the nose area outward toward the ear to keep the eye as clean as possible. Use a different tissue for each eye.

  3. To remove eye crusts, wet a washcloth with warm water and place it over the eye. Wait about 1 minute. Gently wipe the eye from the nose area outward toward the ear with the washcloth. Do this until the eye is clear. If both eyes need cleaning, use a separate cloth for each eye.

  4. Place your infant on a secure, flat surface and don't leave their side. A rolled-up towel or pillow may be placed under the neck so that the head is tilted back. Gently hold your infant's head.

  5. Using eye drops: Apply drops in the corner of the eye where the eyelid meets the nose. The drops will pool in this area. When your infant blinks, the drops will flow into the eye. Give the exact number of drops prescribed. Be careful not to touch the eye or eyelashes with the dropper.

  6. Using ointment: If both drops and ointment are prescribed, give the drops first. Wait 3 minutes, and then apply the ointment. Doing this will give each medicine time to work. The ointment may be easier to apply while your baby is sleeping. To apply the ointment, start by gently pulling down the lower lid. Place a thin line of ointment along the inside of the lid. Begin at the nose and move outward. Close the lid. Wipe away excess medicine from the nose area outward. This is to keep the eyes as clean as possible.

  7. Place any used washcloths or towels in the laundry so they won't accidentally be used by others.

  8. Wash your hands with soap and clean, running water again for at least 20 seconds. This is to help prevent an infection from spreading.

General care

  • If the problem is a blocked tear duct, massage the tear duct 2 to 3 times a day. To do this, wash your hands for at least 20 seconds before touching your baby. Then use a finger to gently rub the area where the corner of the eye meets the nose.

  • Cut your baby’s fingernails weekly to help prevent eye scratches.

  • Shield your child’s eyes when in direct sunlight so they don’t get irritated.

  • Make sure your child doesn’t rub their eyes.

Follow-up care

Follow up with your child’s healthcare provider. If your child has a serious eye infection, they may need to see a pediatric eye specialist (ophthalmologist).

Special note to parents

To prevent spreading the infection, always wash your hands for at least 20 seconds with soap and clean, running water before and after touching your infant's eyes. Dispose of all tissues. Clean washcloths after each use.

When to get medical advice

Call the provider right away if any of these occur:

  • Your child has a fever (see Fever and children” below)

  • Your baby is fussy or cries and can't be soothed

  • Your child has vision changes, such as trouble seeing

  • Your child shows signs of infection getting worse, such as more warmth, redness, swelling, or fluid leaking from the eye

Call 911

Call 911 if your child has any of these:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or trouble waking up

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

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:

thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years old, 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

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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