What to Know About Conjunctivitis (Pinkeye) in Newborns

Medically Reviewed by Dan Brennan, MD on June 07, 2022
4 min read

Newborn babies are susceptible to many conditions due to their vulnerable state, including a number of newborn eye infections. Conjunctivitis, also known as pink eye, is one of these infections that commonly affects young children.

Conjunctivitis is an eye infection that typically affects young children. It consists of the inflammation of the white part of your eye and inner eyelids, called the conjunctiva. Although its reddish-pink appearance looks painful, pinkeye is a minor infection that isn’t usually serious. 

If your newborn shows symptoms of neonatal conjunctivitis, though, you should get in touch with your healthcare provider. Some cases of conjunctivitis go away on their own, but many need to be treated.

The main sign of pinkeye is when the eye turns a red or pink shade. Other than the telltale change in color, you should look out for:

  • Signs of eye discomfort, like your baby frequently rubbing their eyes
  • Discharge from the affected eye
  • Swollen eyelids
  • Sensitivity to light

It can be difficult to confirm eye infections in newborns on your own, but a trip to your baby’s healthcare provider will tell you for sure if your baby has conjunctivitis.

There are a number of potential causes for pink eye in newborns, including blocked tear ducts, irritation from topical antimicrobials administered after birth, or something passed from mother to child during birth. Even a mother without symptoms can have active bacteria or viruses that can be given to their newborn children.

The cause of pink eye depends on the type of conjunctivitis your newborn has. Consider the following kinds of conjunctivitis and their causes:

  • Inclusion conjunctivitis. This is also known as chlamydia conjunctivitis because it is caused by chlamydia trachomatis. If a mother has untreated chlamydia, she may pass dangerous bacteria to her baby during delivery. The newborn’s symptoms will appear 5–12 days after birth or earlier if the amniotic sac is broken during childbirth. This kind of conjunctivitis is particularly dangerous because it can affect other parts of the body, like the lungs or the area where the nose and mouth connect.
  • Gonococcal conjunctivitis. This is often caused by a mother that has untreated gonorrhea. Symptoms of gonococcal conjunctivitis appear 2–5 days after birth and can be life-threatening if untreated. It can evolve into a serious infection of the bloodstream, known as bacteremia, and the lining of the spinal cord and brain, a condition known as meningitis.
  • Chemical conjunctivitis. When a newborn receives eye drops to prevent bacterial infection, it can irritate their eyes. This can be diagnosed as chemical conjunctivitis and isn’t serious – symptoms shouldn’t last for more than a few days.
  • Other kinds of conjunctivitis. Other viruses and bacteria can bring on conjunctivitis in newborns. Many bacteria that are normally found in a mother’s vagina, even non-sexually transmitted bacteria, can result in conjunctivitis and serious eye damage.
  • Blocked tear duct. It’s normal for newborns to develop pinkeye as a result of a blocked tear duct. Tear ducts exist to keep eyes moist and then drain the moisture through the duct located in the corner of the eye. If your baby has a blocked tear duct, that lays the groundwork for irritation and conjunctivitis. Blocked tear ducts should resolve themselves, but if your child’s tear duct is still blocked after a year, they might need surgical intervention to clear it up.

If you suspect that your newborn has pinkeye, see your healthcare provider immediately. They should be able to tell you what’s causing it and ways you can treat it. There are a number of severe eye conditions that are easily mistaken for pink eye in newborns.

For all kinds of conjunctivitis, warm and cool compresses are soothing. Warm compresses help clear fluid and crusting, while cool compresses help soothe swelling and puffiness. Ask your healthcare provider if you should rinse your child’s eyes with saline solution. 

If the pinkeye is bacteria-caused, your newborn might need an antibiotic. Other neonatal conjunctivitis treatment includes a warm, gentle tear duct massage for blocked tear ducts.

Other, less serious forms of pinkeye will go away on their own without any treatment or with anti-allergy medicine. You might also be able to relieve symptoms with acetaminophen or ibuprofen, but you should check with a healthcare provider before administering anything to your child.

When caused by bacteria or virus, conjunctivitis is contagious. Bacteria-induced pinkeye is no longer contagious, though, 24 hours after antibiotics were administered or once there’s no longer eye discharge. Virus-induced pinky is no longer contagious once symptoms have completely disappeared. 

Allergy or irritation-related conjunctivitis is not contagious.

Many states require that healthcare providers give eye drops or ointment to prevent neonatal conjunctivitis. This usually happens within a few hours of delivery. Typically this comes in the form of antibiotic eye drops.

Always wash your hands before touching your newborn’s face or eye area. Don’t share eye drops, tissues, washcloths, or anything similar with your baby. Be especially careful if someone else you come in close contact with already has conjunctivitis. 

If you are pregnant, speak with your healthcare provider about screening for and treating sexually transmitted infections. Even if you don’t have any symptoms, get a prenatal screening to confirm there is no dangerous bacteria in your birth canal.

If your child’s conjunctivitis doesn’t improve after a few days of treatment or a week without treatment, reach out to your healthcare provider. Keep a close watch on the baby’s symptoms – increased redness, swelling, and tenderness around the eye or in the eyelids is a sign that the infection is spreading past the eyes and will require more intense treatment.