Conjunctivitis in the newborn: everything you need to know about neonatal conjunctival inflammation

Conjunctivitis in the newborn is quite common. The scientific name for this neonatal conjunctival inflammation is "ophthalmia neonatorum" and it affects babies in their first month of life. It is the most common eye disease in newborns: according to statistics, it affects 1.2 to 12% of infants.

The causes of conjunctivitis in the newborn can be different and, according to the origin of the infection, the inflammation is defined as chemical, bacterial or viral. Neonatal conjunctivitis is often contracted during vaginal birth: it happens when the new mother has a "asymptomatic infection that is passed on to the child. Fortunately, it can be cured without consequences for the baby.

The eyes of newborns who contract the conjunctival infection, which leads to the obstruction of the tear duct, appear swollen, red, with abundant tearing. The discomfort can affect both eyes as well as one eye (it is only in cases of allergic conjunctivitis that both eyes must necessarily be affected).

Let's find out together what are the three different types of neonatal conjunctivitis (bacterial, viral and chemical), also focusing on the indicated therapies and the necessary prevention.

Bacterial conjunctivitis in the newborn: types and treatment

The most common cause of conjunctivitis in the newborn is Chlamydia trachomatis, a widespread bacterium that risks causing infection in the baby at birth. This type of conjunctivitis, in fact, appears between 5 and 24 days after birth and symptoms that characterize it are watery, mucous or purulent secretions from one or both eyes. It is a "conjunctival infection that should be treated as soon as possible because it can heal and, half of the time, is linked to other systemic infections. It will therefore be necessary to provide as soon as possible with the antibiotic administration.

Another bacterium that can be contracted during childbirth is Naisseria gonorrhoeae: if the birth canal is infected, the newborn could become infected in turn during the passage, or in the "uterus itself. This neonatal conjunctivitis called" gonococcal "occurs within 3-4 days after childbirth and brings the symptoms of a very serious conjunctivitis, usually on both eyes: edema of the palpedre, chemosis and purulent secretions. Scarring can lead to very serious consequences and it is therefore essential to treat it promptly, also because it can spread throughout the body to create meningitis and sepsis. Again, antibiotic treatment will be required according to the doctor's instructions.

The bacterial inflammation may be due, finally, to bacteria present in the hospital itself (mainly Gram-negative bacteria): in this case too we will proceed with the administration of antibiotics.

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Neonatal conjunctivitis of viral origin: what it is and how to treat it

Neonatal conjunctivitis can also have a viral origin and be caused by Herpes Simplex Virus (HSV): in these cases it will occur between 6 and 14 days after delivery. The symptoms of this conjunctival inflammation are small blisters on the eyelid and / or dendritic keratitis (inflammatory disease affecting the cornea).

The virus must be isolated quickly so that the infection does not spread to the nervous system. The necessary treatment involves the use of systemic acyclovir for two or three weeks under medical supervision.

Chemical conjunctivitis in newborns: when it occurs and with what therapy to treat it

The most common cause of conjunctivitis in the newborn, however, is of chemical origin: it depends on the administration of eye drops based on silver nitrate, a drug that is regularly administered to newborns to prevent the onset of gonococcal ophthalmia.

Chemical conjunctivitis is characterized by redness of the eyes, purulent and sticky secretions, so much so that the child has a hard time opening his eyes, especially after sleeping. This pathology occurs 7-8 hours after childbirth and should be treated promptly with a simple physiological solution that allows you to clean the eyes. In fact, it usually resolves within a few days without requiring pharmacological remedies.

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How to wash the eyes of the newborn with conjunctiva inflammation

Giving children antibiotic eye drops as prescribed therapy dictates can take a lot of patience. Before pouring the eye drops, however, it will be necessary to carefully wash the baby's eye. It will be good to use a physiological solution and then cleanse the eye by proceeding from the inner to the outer corner, changing the gauze to avoid contact with the infected one.

How to prevent conjunctivitis in the newborn

In order to prevent the onset of conjunctivitis in the newborn it is important to recognize and treat any infections of the future mother already during pregnancy. Many of them, in fact, are asymptomatic carriers of bacteria that could then cause inflammation in the baby: if it is identified through screening for genital infection in women, the first step is done!

It will then be important to proceed with "careful prophylaxis at the birth of the child: within one" hour of the birth, the administration of silver nitrate drops or antibacterial eye drops is required by law. Finally, due attention must be paid - by the doctor - in early diagnosing the onset of the pathology in the child and in treating it without wasting time with the most adequate treatment (generally, coma we have seen, antibiotic eye drops).

For further scientific information on the subject, you can consult the website of the Bambino Gesù Pediatric Hospital.

See also: All the situations experienced by a new mother

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