A prophylactic eye ointment is usually administered in the first hour of life. Generally, either erythromycin or tetracycline (both antibiotics), or the older silver nitrate solution is used.

Why choose this?

The intention of the eye ointment is to prevent newborn blindness (“opthalmia neonatorum”) from infection after birth. Mothers infected with gonorrhea, chlamydia or herpes, can pass these infections on to the baby during a vaginal delivery. Left untreated, they can cause blindness in the newborn. To avoid this, states passed laws throughout the 1900s mandating that all newborns receive silver nitrate to assure that any infections would be caught early and treated. While silver nitrate is still administered in some hospitals, most opt for antibiotics these days. If you know that you have an STD and you deliver vaginally, you can protect your baby's eyesight by requesting the gentler tetracycline drops.

Why opt out?

Delivering your baby by C-Section completely negates the need for treatment. Anything placed in a baby’s eyes interferes with his vision, causing blurring, swelling and irritation. Blurred vision interferes with the newborn's 'sensitive window' (first 2 hours after birth) that is crucial for bonding as well as the establishment of breastfeeding.

Silver nitrate is only effective against gonorrheal infections. Since its irritating effects can actually cause chemical infections, it has been mostly replaced by less damaging antibiotics which carry their own risks. A study showed that babies actually benefit from bacterial exposure in the birth canal which populates the digestive tract and builds up the immune system.

Antibiotics upset the body's delicate bacterial balance. We've all heard of the dangers of the overuse of antibiotics and antibiotic resistance. In the end, if a mother is known to be infection-free, there seems little reason to administer any ointment at all. 

Your options

State law requires mothers be tested for STD infection in the 3rd trimester. If positive, determine if intravenous treatment can eliminate risk of transmission to the baby during birth, and/or choose the eye ointment best suited to your infection. If negative, you may delay administration of the eye drops until after the sensitive 2-hour period, choose the gentlest eye ointment you can, or refuse the ointment completely.

Have others (hospital staff and visitors) wash their hands when touching your baby to minimize exposure to external bacteria.

Note: in some states, hospitals are required by law to administer some type of ointment and may try to threaten parents with Child Protective Services investigations, etc. If you encounter this, research both the laws and penalties in your state, and call your hospital as well as your local Child Protection or Child Safety office. You'll likely find that these are merely intimidation tactics.