Peering over the bassinette where my newborn son was sleeping next to our bed, I prepared myself for the onslaught of blubbery new mom love that usually swept over me when I looked at his peaceful sleeping face.
But instead of being greeted with a picture of his adorableness, I was horrified when I saw that one of his eyes was completely crusted shut with a thick, yellowish discharge. Oh no! I thought. What had I done? Did he have pinkeye? Was something wrong?
As I would soon find out, there are many different reasons that your newborn might have some eye discharge, ranging from the totally normal to the more worrisome symptoms of an infection that needs to be treated.
Nasolacrimal duct obstruction
When my son woke up with his eye crusted shut, I was immediately worried for him. Luckily for us, my uncle happens to be an optometrist who was also nice enough to let me text him pictures of my son's eye to his cell phone so he could let me know if I needed to drag my sore postpartum body into the office to have him evaluated.
And as it turned out, he didn't require a trip out of the house. Our son had a very common condition called nasolacrimal duct obstruction, or in other words, a blocked tear duct.
Essentially, something blocks the tear duct. So instead of flushing out the eye like the tear-eye drainage system is supposed to, the tears — and thus resulting bacteria that those tears normally get rid of — back up and cause the drainage.
Nasolacrimal duct obstruction occurs in over 5 percent of newborns. And the reason that the condition occurs so frequently in newborns actually makes a lot of sense, because it's related to something that happens at birth.
The most common cause is the failure of a membrane at the end of the tear duct. Other causes of the condition might be from a birth defect, such as an absent eyelid, narrow or stenotic system, or a nasal bone that obstructs the tear duct. So even if your baby has the harmless condition, if it appears to be a reoccurring problem, you will need to have them assessed by your care provider to ensure there's not an abnormality causing the blockage.
Symptoms of nasolacrimal duct obstruction
How can you tell if your baby has called nasolacrimal duct obstruction? Some of the symptoms include:
- occurs in the first days or weeks after birth
- red or swollen eyelids
- eyelids that can get stuck together
- yellowish green discharge or watering of the eye
One of the telltale signs that your newborn's eye discharge is from a clogged tear duct and not actually an eye infection is if only one eye is affected. In the case of an infection, like pink eye, the white part of the eyeball will be irritated and both eyes are more likely to be affected as the bacteria spreads.
How to treat nasolacrimal duct obstruction
In most cases, nasolacrimal duct obstruction is self-limiting and will heal on its own without any medication or treatment. In fact, 90 percent of all cases heal spontaneously within the first year of life.
We only had one unfortunate incident when pinkeye really did pass through our entire family after my oldest daughter started preschool (thanks, little kid germs). Aside from that, my son, and two years later, my next baby, experienced on-and-off bouts of clogged ducts.
In every situation, we followed our pediatrician’s recommendations to clean the affected eye with a warm washcloth (no soap, of course!), wiping the discharge away, and gently apply pressure to help unclog the duct.
There's a technique to dislodging the duct clog, called a tear duct massage. Essentially, it means applying gentle pressure directly underneath the inner part of the eye and moving outwards towards the ear. But be careful, because the skin of a newborn is very fragile, so don't do it more than a few times a day and use a soft cloth. I found that muslin swaddling cloths or burp cloths were the gentlest option for my baby's skin.
Other causes of eye infection
Of course, not all cases of newborn eye discharge are a result of a simple clogged duct. There can be serious eye infections that can be passed along to a baby through the birthing process.
This is especially true if your baby didn't receive the erythromycin antibiotic ointment after birth. Have your baby evaluated by a professional to ensure that they won’t need special medication.
In the case of pinkeye (conjunctivitis), the white of the eye and the lower eyelid will become red and irritated and the eye will produce discharge. Pinkeye can be a result of a bacterial infection, which will require special antibiotic eye drops, a virus, which will clear on its own, or even allergies. Don't perform any at-home remedies without speaking to your doctor first.