Updated: Dec 21, 2018
Recently, you may have seen an article circulating in your social media feeds about the efficacy of using Erythromicin ointment in your newborn's eyes.
It seems that it has been a practice under question and scrutiny for several years now in Canada. In some provinces it is actually mandated by law, stating that it must be done, with or without the consent of the parents.
Luckily for us Cape Bretoners, we have the choice!
Today let's learn a bit about the history of the how this came to be standard practice and the risks and benefits of it for our babies!
Let's go way back to the 1800's, when approximately 10% of babies (In Europe) were developing Opthalmia Neonatorum (ON). In 1879, it was discovered by doctor Albert Neisser to be caused by gonorrhea.
By 1880, all infants were being treated with silver nitrate, given in the eyes. While this did work at reducing the cases of ON, it also irritated the eyes and was painful for the babies.
Eventually, erythromicin became the drug of choice to kill bacteria in the eyes to protect the infants from gonorrheal ON, and as Chlamydia cases have risen, from it as well.
In modern times, Chlamydia is now the most common reason (between 2%-40% of cases) for ON, although Gonorrhea leads to more serious risks.
The infant can only contract ON if the birthing person has an untreated infection at birth.
If untreated, between 1 in 2 or 1 in 3 risk developing gonorrheal ON, which has a higher risk of blindness.
During pregnancy, untreated gonorrhea has been linked to miscarriages, stillbirths, premature birth, low birth weight, premature rupturing of the membranes, chrorioamionitis (inflammation of the fetal membranes) and bloodstream infections.
Chlamydia has been linked to preterm labour, premature rupturing of the membranes, low birth weight and lung infections.
Anyone who is sexually active can contract these STI's!
If you are within a known monogamous relationship and have both been tested, you are good.
Otherwise, use latex condoms every time you have sex!
The Benefits to Universal Erythromicin for all Babies
It has been shown to reduce the cases of Gonorrheal ON (Darling and MacDonald, 2010)
It may be helpful for birthing folks who do not have the opportunity for proper screening for Gonorrhea and Chlamydia.
It may protect babies if birthing person's sexual partners have multiple partners, without their consent or knowledge.
It is inexpensive.
The Risks to Erythromicin
It has approximately a 20% failure rate, which is climbing as bacteria develops antibiotic resistance
It causes even more blurred vision for baby, which could impact early bonding experiences.
(EDIT: A midwife has expressed that is not cause for concern due to blurriness of vision naturally in infants and that the effects will be gone once it is absorbed)
It can cause a chemical pink eye.
The Canadian Pediatric Society has recommended a discontinuing of the routine use of eye ointment.
Increased screening and treatment of STI's during pregnancy. This works well for us here in Canada,as we generally have easy access to testing and treatment.
Povidone- Iodine can also be used instead of Erythromicin. It is even more inexpensive and and does not increase the risk of antibiotic resistance.
Countries that NO longer recommend Erythromicin (unless necessary):
At the end of the day and the beginning of your parenting journey, it is our mission to ensure that you have all the information available to make educated and informed decisions for YOUR family.
I'll leave you with a fun fact!
Colostrum has been shown to reduce ON from non-gonorrheal and non chlamydial bacteria!!! Liquid gold!