The Eye Ointment Debate: What Every Parent Needs to Know About Erythromycin and Your Right to Choose 👀
Our minds are boggled at how hospital staff will often apply Erythromycin (the antibiotic eye ointment) to newborn babies' eyes without asking for consent first! 😱
Even more concerning? We've noticed that even when it's clearly written on birth plans to NOT apply the eye ointment, staff sometimes "forget" and still do it because it's... "Hospital Policy." 🤷♀️
Even stranger? They'll apply it after a CESAREAN birth when it's not even medically indicated! 🤦♀️
Today we're diving deep into this routine procedure that many parents don't even know they can question. Because when it comes to your baby's care, you have the right to make informed decisions based on facts, not just hospital routines. ✨
What IS Erythromycin Eye Ointment? 💊
Erythromycin is an antibiotic ointment that's routinely applied to newborns' eyes in most hospitals. It's meant to prevent a specific type of eye infection called ophthalmia neonatorum, which can be caused by certain sexually transmitted infections.
The original purpose: This practice began in the late 1800s when gonorrhea was much more common and could cause serious eye infections in newborns, potentially leading to blindness.
What it looks like: A thick, greasy ointment that can temporarily blur your baby's vision and make their eyes appear goopy or irritated.
The Medical Facts: When Is It Actually Needed? 🩺
Here's what the research actually shows about when this ointment is medically necessary:
It's designed to prevent infections from: • Chlamydia • Gonorrhea
Important facts:
It's NOT necessary unless you deliver vaginally AND have chlamydia or gonorrhea
It does NOT prevent other types of eye infections
It's NOT effective against many other bacteria or viruses
The risk it's designed to prevent is actually quite rare in developed countries
The cesarean contradiction: If you deliver via cesarean, your baby doesn't pass through the birth canal where they would be exposed to these specific bacteria, making the ointment completely unnecessary from a medical standpoint.
Why Do Hospitals Apply It So Routinely? 🏥
"Hospital Policy" - we hear this phrase a lot, but let's understand what's really behind it:
State Requirements: Many states have laws requiring eye ointment unless parents specifically refuse it in writing.
Liability Concerns: Hospitals worry about legal issues if a baby develops an eye infection, even if the risk is extremely low.
Routine Practice: It's become so standard that many staff members apply it automatically without thinking about individual circumstances.
Lack of Risk Assessment: Instead of evaluating each family's actual risk factors, it's easier to apply a blanket policy.
The Problems with Automatic Application 😤
Informed Consent Issues:
Parents aren't always told this is happening
The risks and benefits aren't explained
Alternative options aren't discussed
Some parents discover it was done after the fact
Medical Appropriateness:
Applied even when not medically indicated (like after cesareans)
Given to babies whose parents have been tested and are negative for STIs
Used as a "just in case" measure rather than evidence-based medicine
Impact on Bonding:
Can interfere with immediate eye contact between parents and baby
May blur baby's vision during crucial first hours
Can cause temporary eye irritation
Your Rights as Parents 💪
You have the right to:
Be informed about ALL procedures before they're performed on your baby
Ask questions about the medical necessity
Request to see your STI test results
Decline procedures that aren't medically indicated
Have your written preferences respected
Get a second opinion if you're unsure
You do NOT have to:
Accept "hospital policy" as the final word
Allow procedures just because they're routine
Feel guilty for asking questions
Consent to anything you're not comfortable with
Questions to Ask Your Healthcare Team 🤔
Before Birth:
"What is your hospital's policy on eye ointment?"
"Can I decline this procedure?"
"What paperwork do I need to complete if I want to refuse?"
"Will my baby's care team be informed of my preferences?"
If You're Considering Declining:
"What are my recent STI test results?"
"Given my test results and birth method, is this medically necessary?"
"What are the actual risks if we decline?"
"What signs should we watch for if we choose not to use it?"
If Staff Insist It's Required:
"Can you show me the specific law or medical indication?"
"Who can I speak with about this policy?"
"Can I get this decision in writing?"
When You Might Consider the Ointment ✅
Situations where it might be medically indicated:
Positive test results for chlamydia or gonorrhea
Vaginal delivery with unknown STI status
High-risk situations where testing wasn't possible
Your healthcare provider recommends it based on specific risk factors
Remember: Even in these situations, you still have the right to be informed and involved in the decision-making process.
When It's Probably Not Necessary 🚫
Situations where it's likely not medically needed:
Cesarean delivery (baby doesn't pass through birth canal)
Recent negative STI testing results
Monogamous relationship with tested partner
Low-risk situation with no indication of infection
How to Ensure Your Preferences Are Respected 📝
During Pregnancy:
Discuss your preferences with your healthcare provider
Include your wishes in your birth plan
Ask about hospital-specific procedures for declining
Consider whether you need to sign any forms
At the Hospital:
Inform your nurse about your preferences immediately upon arrival
Ask that it be noted prominently in your chart
Remind staff during shift changes
Don't be afraid to speak up if someone tries to apply it without asking
After Birth:
Communicate your preferences to the pediatric team
Ask to be present for all baby procedures
Don't be afraid to say "stop" if something is happening that you didn't consent to
The Bigger Picture: Routine vs. Individualized Care 🎯
This issue highlights a bigger problem in modern healthcare: the tension between routine protocols and individualized, evidence-based care.
Just because something is done routinely doesn't mean it's:
Medically necessary for your specific situation
Based on current evidence
Required by law (even when staff say it is)
In your baby's best interest
Good healthcare involves:
Assessing individual risk factors
Explaining procedures before performing them
Respecting patient preferences
Using evidence-based decision making
Tell Us Your Experience! 💬
Did hospital staff apply eye ointment to your baby? We'd love to hear about your experience:
Were you asked for consent first?
Was it explained why they wanted to do it?
Did they respect your birth plan if you had preferences about it?
How did you feel about the experience?
Your stories help other parents understand what to expect and how to advocate for themselves!
What You Can Do Right Now 📋
If you're currently pregnant:
Research your hospital's policies
Discuss your preferences with your healthcare provider
Include your wishes in your birth plan
Ask about the consent process
If you're planning future pregnancies:
Use your previous experience to inform your decisions
Share your story with other expecting parents
Consider how you might handle things differently
If you're a birth worker:
Help families understand their options
Advocate for informed consent practices
Support parents in communicating their preferences
The Bottom Line 💡
Informed consent should be the standard for ALL medical procedures performed on your baby, including routine ones like eye ointment application.
You have the right to:
Understand what's being done and why
Know when procedures are actually medically necessary vs. routine
Make decisions based on your family's specific circumstances
Have your preferences respected by the medical team
This isn't about being difficult or anti-medical care. It's about ensuring that medical decisions are made thoughtfully, with full information, and with respect for parents' rights to make informed choices about their baby's care.
Whether you choose to use the eye ointment or decline it, what matters most is that the decision is made with full information and genuine consent. 💕
Want to learn more about advocating for your preferences during birth and newborn care? Our HypnoBirthing classes at Happy Birthing AZ include comprehensive information about newborn procedures, informed consent, and how to communicate effectively with your healthcare team. You can also download our comprehensive birth plan template [LINK] to help you organize and communicate your preferences with your care team. Because every family deserves to make informed decisions about their baby's care. 🌵