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According to Utah Law, we are required to administer an antibiotic to your baby’s eyes. Utah Administrative Code section R386-702-8 entitled Special Measure for the Control of Ophthalmia Neonatorum states: “Every physician or midwife practicing obstetrics or midwifery shall, upon the birth of a child, instill or cause to be instilled in each eye of such newborn one percent silver nitrate... or tetracycline ophthalmic preparations or erythromycin preparations as these are the only antibiotics of currently proven efficacy in preventing development of ophthalmia neonatorum... A maximum delay of three hours shall be allowed between the time of birth and the administration of an approved prophylactic agent.”
Why is this required?
When a pregnant woman has the sexually transmitted diseases chlamydia or gonorrhea, the baby can pick up the infection in his or her eyes during the birth process. These infections can be very serious and may cause blindness. Women (and men) who have these diseases may not have any symptoms and may not know they are infected.
What if I am not at risk for gonorrhea or chlamydia?
Even though the code does not state that parents can refuse the ointment, parents have the right to refuse any medical procedure for their child.
What are the benefits of eye ointment?
The ointment will usually prevent gonorrhea and chlamydia infections in a newborn’s eyes, and thereby prevent the blindness which may result. It will also prevent other incidental eye infections which do not cause blindness.
What are the risks of eye ointment?
There are three kinds of treatment, erythromycin, tetracycline, and silver nitrate. Erythromycin and tetracycline are not painful to the baby, but do blur the vision temporarily. Blurred vision can interfere with bonding. Silver nitrate irritates the newborn’s eyes and burns the cornea slightly. We do not use silver nitrate.
Allergic reaction to eye ointment is possible, but extremely rare. If it occurs, the ointment can be washed out. The most frequent adverse reactions are minor irritation, redness, and hypersensitivity.
If you want your baby to have the eye ointment:
We will ask you to sign an authorization and your midwife will administer erythromycin ointment to the baby within 3 hours of birth.
If you do not want your baby to have the eye ointment:
We will ask you to sign a waiver and we will not administer ointment to your baby. You should watch for symptoms of infection, and treat if they develop. The most common symptoms are lots of mucous discharge from the eyes and swelling and redness of the eyelids. Newborns may also develop minor eye infections from contact with siblings or others. These are not related to sexually transmitted infections and are easily treated. Notify us if this occurs.