Expert Advice

Who Needs Erythromycin and Eye Ointment At Birth?

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What do we know about love? It makes us want to gaze at our beloved, sometimes for hours. Looking into each other’s eyes is the most common way humans bond. Why, then, do babies in the United States get erythromycin or eye ointment at birth that blurs their vision in their first minutes of life when mom and baby want to gaze into each other’s eyes[1]?

More and more parents are questioning the routine administration of eye ointment to all babies. Why is it routine, why is it necessary, why is it done immediately instead of letting mom and baby bond?

Your birth plan can state your desire whether your baby receives eye ointment. Be sure to read our post on the legal issues around routine administration of it. Even if your state requires it, the final version of the birth plan on your hospital bag checklist can still voice your preference.




In the 1800’s a doctor discovered that putting silver nitrate in babies’ eyes helped prevent opthalmia neonatorum (ON), a type of conjunctivitis (pink eye) that caused blindness. It was medical breakthrough at the time, but was painful for babies.

Today, eye ointment in the United States is called erythromycin (ee-RITH-ro-my-sin). It’s an antibiotic that may contribute to antibiotic resistance but only a little research has been done on this[2]. Other countries use Povidone Idodine, an alternative antiseptic that is easier on baby but isn’t available in the US.

ON conjunctivitis comes from the gonorrhea or chlamydia bacteria present in a mother’s vagina who actively has, or carries, one of these diseases when baby is born.

In the 1800’s there were no tests or treatments for these diseases, but today is different. Today, women usually get tested twice for both these infections and can receive treatment to cure them. Although no screening test is 100% accurate, babies rarely get ON today because their mothers rarely have gonorrhea or chlamydia at baby’s birth.




Some parents question why the eye ointment is required or routinely given if mom doesn’t have gonorrhea or chlamydia. The United Kingdom and Australia don’t believe every baby needs eye ointment, but some states in the US believe it is necessary for every baby, despite research to the contrary.

According to the NIH (National Institutes of Health)[3], if a mother doesn’t have gonorrhea or chlamydia when she gives birth, the choice for eye ointment is a personal one. “…Parental choice of a prophylaxis* agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy.”   *prophylaxis=preventative

The United Kingdom and Australia[4] don’t use any eye ointment unless it’s called for. They use a wait-and-see approach. If baby develops ON, they easily treat it. Otherwise, they leave baby’s eyes alone.




The pro side for routine administration of eye ointment is:

  • If mom has undetected gonorrhea or chlamydia, routine administration of eye ointment prevents baby from contracting ON.
  • In areas where the rates of gonorrhea and chlamydia are high, or if mom has sexual partners who may carry the disease, this plays a protective role.

The con side:

  • It’s uncomfortable for baby.
  • Blurring baby’s vision immediately after birth may interrupt bonding and breastfeeding, but no research has been done on this yet.
  • Birthing women rarely have these diseases because they’re usually tested for them more than once during pregnancy.
  • If mom has gonorrhea or chlamydia, she can be treated and cured before baby is born.
  • Routine use of antibiotics may contribute to general antibiotic resistance.

Your choice for eye ointment—or not—can be included in your birth plan. If your state allows a choice, your birth team can either avoid the ointment all together or may be able to give you and baby some bonding time before they put it in. Be sure you know your state law so you can plan your birth accordingly.



To learn more about baby’s first care, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner.  These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

Published: Dec 3, 2015 | By SP Turgon, Certified Labor Doula | Reviewed by: Kim Walls, Natural Products Expert, Elizabeth Bachner, LM, CPM, L.Ac., Midwife | Last reviewed: December, 2015

Kim WallsWho Needs Erythromycin and Eye Ointment At Birth?

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