Chlamydia Infection, Acquired At Birth (Infant)

Chlamydia is a sexually transmitted infection (STI). Some birthing 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.

In infants, chlamydia most often causes eye infection called conjunctivitis, lung infection called pneumonia, or both. Most newborns are given an antibiotic ointment in their eyes after birth. But this doesn't prevent a chlamydial infection of the eyes.

With 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.

With pneumonia, the child often has a cough. Sometimes the child may also have a low fever or fast breathing.

When found early, chlamydia in an infant can be 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 child. Be sure to give all of the medicine, even if your child no longer has symptoms. Artificial tears may also be prescribed to ease eye discomfort.

General care

  • Wash your hands well with soap and clean, running water before and after caring for your child.

  • If your child has an eye infection:

    • 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 child from rubbing their eyes.

    • Apply a cool compress (such as a damp washcloth) to the eye as needed. Use a different cloth for each eye. 

  • Care for pneumonia:

    • For children age 1 year and older. Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or prop your older child’s body up with pillows. Talk with your healthcare provider about how far to raise your child's head.

    • For a baby younger than 12 months. Never use pillows with, or prop up, or put your baby to sleep on their stomach or side. Babies younger than 1 year should sleep on a flat surface on their back. Don't use car seats, strollers, swings, baby carriers, and baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.

    • Ask the provider if you should use a humidifier or vaporizer in your child’s room to help keep the air moist.

  • Wash your child’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 with your healthcare provider about getting testing and treatment 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)

  • Your child has eyelid redness, swelling, and fluid leaking for more than 2 days after starting treatment.

  • Your child has ongoing signs of eye infection, such as red or swollen eyelids or increased fluid leaking from the eyes.

  • Your child is breathing very fast or having trouble breathing.

  • Your child is wheezing or has a cough that won’t go away.

  • Your child’s lips, fingernails, or skin turns blue. This may be a sign that your child isn't getting enough oxygen.

  • Your child isn't feeding well or isn't gaining weight.

  • Your child seems very ill or has any other symptoms that concern you.

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

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