Typical hospital protocol is to instill a petroleum-based antibiotic ointment into baby’s eyes

immediately postpartum. This is done because gonorrhea or chlamydia can cause blindness or

infection if contracted by the baby. Other bacterial infections may cause the baby eye irritation,

but do not cause blindness.

Silver nitrate drops used to be the medication used to prevent blindness from gonorrhea. Silver

nitrate may cause chemical conjunctivitis (an eye infection) and causes a chemical inflammation

of the eyelids and burns the corneal surface slightly as it penetrates to kill bacteria. This may

result in swelling, redness, and plugged tear ducts. Fortunately silver nitrate has since fallen out

of favor and erythromycin, a petroleum-based antibiotic ointment, is the most common

medication used today as it causes much less irritation, but may still cause burning, redness,

blurred vision (which can interfere with bonding) and plugged tear ducts. Irritation may be more

severe in those with hypersensitivity. Erythromycin is effective against certain strains of

staphylococcus, streptococcus, pneumonia, influenza, syphilis, gonorrhea, and chlamydia,

prevent gonorrheal blindness in an active neonatal infection.

A cheap, available medicinal alternative is a 2.5% solution of povidone-iodine (¼ teaspoon

Betadine plus ¾ teaspoon water), which is more effective against chlamydia and has the same

effectiveness as erythromycin against gonorrhea. It should be noted that there is some risk of

A non-medicinal alternative is to rinse the newborn’s eyes with sterile water immediately after

birth and watch closely for signs of infection, treating only if infection is suspected. You may

also place a few drops of breastmilk directly from the breast into each eye, being careful not to

touch the breast to the infected eye. You may do this daily for a week. Another alternative is to

clean the eyes with chamomile tea with a tiny pinch of powdered goldenseal added.

Kansas law states that “any physician or any person authorized by law to act as an obstetrician

shall immediately upon the birth of an infant instill into the eyes of such newly born infant a

prophylactic solution approved by the secretary of health and environment. [The parent] shall

not be required to employ such prophylactic if objection is made by written statement to the

attending obstetrician within three days from the birth of said child. That said written statement

shall be attached to the birth certificate.” As I am not a physician nor authorized to act as an

obstetrician, I am not legally required to administer the ointment. As the parent, you are not

required to have it if you object. Signing this document serves as your written statement of

objection. Please note that if you do not have an infection and simply desire to abide by the law

and have the eye ointment, you may wish to wait 2 to 4 hours before visiting your pediatrician to

have it administered. In cases of prolonged prelabor rupture of membranes treat the eyes as soon

as possible.

*

Shellfish allergies do not predispose you to iodine allergy.

As an unlicensed, non-interventive midwife, I am not authorized to carry medications, nor do I

believe the benefits of eye prophylaxis outweigh the risks and side effects for monogamous,

healthy couples birthing a healthy child. Therefore if you desire eye ointment, you will either

have to hire a licensed midwife or take the child to a pediatrician immediately postpartum.

ULW, p441, 480-481

www.kansasstatutes.lesterama.org/Chapter_65/Article_1/#65-153b

Bates 663; Frye2, p772

Varney, p565