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Infectious Conjunctivitis in the first two months of life.

Infectious Conjunctivitis (Pink Eye, Sticky Eye)
General information
Conjunctivitis is an inflammation of the thin, clear tissue (conjunctiva) that covers the white of the eye and the inside surface of the eyelid. On the first day or two of life, it can be caused by medication (such as silver nitrate) placed in the eye after birth to prevent infection. Most conjunctivitis occurring during the next few weeks is due to infection caused by bacteria, viruses or germs called chlamydia.
Infection by germs present in the birth canal can occur at the time of delivery. In most cases, the “Pink eye” begins by two to 10 days of age but may occur as late as the second month of life.
Once a baby enters the world, she/he can catch conjunctivitis from infected persons in the same way as any other child: by face–to–face contact; on hands, or in droplets coughed into the air. The time until illness begins depends on the germs involved but is usually two to seven days after exposure.

The Illness
The usual sign of conjunctivitis is redness of the white of the eye, often accompanied by increased tearing or discharge (“Matter”). This discharge can be watery or thick, with mucus and pus running out of the eye. The eyelids are usually pink and slightly swollen. Infection may begin in only one eye but spreads to involve both sides in most infants. The duration of illness varies. Viral infections usually get better in eight to 10 days, most cases of conjunctivitis caused by bacteria or chlamydia improve after two to three days of treatment.

When to call your doctor
Treatment of Pink Eye/Conjunctivitis
Antibiotic treatment for conjunctivitis in newborn infants may be given by injection, by mouth, by eye drops or by ointment, depending on which germ your doctor suspects is causing the infection. When oral antibiotics are prescribed, they should be continued for the full course (often 14 days), even if the eyes appear better after only a few days.
If drops or ointments are to be used, first wipe any mucus or pus off the lids with a tissue or cotton ball dipped in warm water. Then gently pull the eyelids apart, place one drop (or a 1/4 inch ribbon of ointment) into the small pouch that this forms and hold the eye closed for a few seconds. Avoid touching the dropper or tube to the eye. Treat both eyes even if only one side looks infected.
Since tears quickly wash out the eyes, drops should be given with feedings around the clock. Ointment need be given only three times a day. Treatment should be continued for five to seven days. Regular diet and family activities with the baby can continue during this illness.

Contagion
To reduce the spread of infection, anyone handling the baby should wash his/her hands immediately afterwards. All persons treating your baby’s eyes should take particular care to avoid touching their face until they have washed their hands. Family members and visitors should avoid face–to–face contact with your baby until all drainage from the eyes has stopped. The baby’s towels and washcloths should be kept separate and changed daily until treatment is finished. Tissues used to cleanse the eyelids should be discarded immediately.

Return to group activities
Infants may return to day care when drainage from the eye has stopped, usually after one to two days of treatment. Many facilities have written guidelines concerning the return of a child with conjunctivitis. If medication will be given by caretakers outside the home, demonstrate for them the best way to use eye drops or ointment on your baby and emphasize the importance of careful hand washing.

Common concerns
With proper and early treatment, there is little risk that conjunctivitis will permanently harm your baby’s vision. Left over prescription eye drops or ointments should not be used.