Within an hour of birth, newborns are typically given antibiotic eye drops to prevent eye infections. The application of eye antibiotics to newborns, either in solution or ointment form, is now considered the standard of care in most developed countries and is actually mandated by law in many states. The Nebraska Department of Health and Human Services does not mandate these antibiotics, primarily because the practice is widespread throughout Nebraska and is universally recognized by the U.S. medical and legal community as a standard procedure immediately after birth.
The most common antibiotic given is erythromycin, although some institutions may use silver nitrate. The purpose of the antibiotic is to prevent infection of tissues surrounding the eye caused by bacteria that may be present in the birth canal. The bacteria could be ordinary bacteria or bacteria associated with sexually transmitted diseases. The bacteria associated with gonorrhea and chlamydia can cause permanent visual impairment, and can also spread throughout the body to cause other serious problems.
While gonorrhea may not be particularly widespread and is easily detectable, at least 4 million people in the U.S. are thought to have chlamydia infections, and 50-75% of women with chlamydia do not have symptoms of the infection. When you consider the risks of your newborn developing an eye infection from these potent bacteria as well as from the normal bacteria within the birth canal, the benefits of the antibiotics are overwhelming. Indeed, since this practice became widespread (silver nitrate was used for newborns as early as 1881), the number of newborn eye infections has decreased dramatically. In our view, the only downside to the antibiotics is that a small number of newborns may have irritated eyes from the drops or ointment, but this irritation will dissipate within a few days.