Pink eye in babies: Causes, signs, and treatment

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As a parent, you already know that babies have weaker immune systems, which can make them more susceptible to common illnesses such as colds, fevers, and other ailments.

One such illness is pink eye, or conjunctivitis. One day, you might notice that your little one’s eyes look slightly red and irritated. Soon after, their eyes become watery, with a bit of discharge gathering in the corners. As it progresses, your baby becomes more uncomfortable and irritated, with the redness intensifying and frequent eye rubbing becoming more common.

With the summer season approaching and a rise in pink eye cases, it’s important to understand what pink eye is, its causes, signs, and symptoms, as well as tips for treatment and when to consult a doctor. Let’s take a deeper dive into the pink eye in babies to ensure your little one receives the best possible care.

What is a pink eye in babies?

First of all, while we commonly refer to it as ‘pink eye,’ it’s actually conjunctivitis.

According to The American Optometric Association, conjunctivitis is the swelling or inflammation of the conjunctiva.”
The conjunctiva is a thin, transparent membrane that covers the white part of the eye (sclera) and lines the inner surface of the eyelids.

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Did you know?

Conjunctivitis is a term derived from Latin roots that help describe its meaning and origin:

  • Conjunctiva comes from the Latin word conjunctiva (from conjungere, meaning “to join together”) In anatomical terms, the conjunctiva refers to the membrane that connects or joins the eyelid to the eyeball.
  • -itis: This Greek suffix, often used in medical terminology to denote inflammation.
Therefore, conjunctivitis literally translates to “inflammation of the conjunctiva,” describing the condition where this membrane becomes inflamed and appears red or pink.

What causes pink eye in babies?

Multiple factors, from bacteria and viruses to atmospheric allergens, can potentially cause pink eye or conjunctivitis in babies.

During infancy, pink eye is either infectious (caused by a virus or bacteria) or due to an irritant, such as smoke. Irritant conjunctivitis is rare in infants, and allergic conjunctivitis (pink eye caused by allergies) is almost unheard of during this period of a child’s life. Viral infections are the most common cause of pink eye in infants.”

Dr. Kristin Cook, MD, a board-certified pediatrician with a thriving medical practice in Southeastern Wisconsin.

Knowing and understanding the causes of causes of conjunctivitis can help you navigate this illness better. Here are some causes of pink eye in babies:

Bacterial conjunctivitis:

  • Common bacteria: Bacteria such as Staphylococcus or Streptococcus can cause bacterial pink eye.

  • Causes: Apart from the bacteria, sometimes, some insects like flies, poor hygiene like touching your baby’s face and eyes with unclean hands, can sometimes cause conjunctivitis.

  • Symptoms: According to a study published in StatPearls Publishing, symptoms of viral conjunctivitis include red eyes, itching, light sensitivity, burning, and watery discharge and also a thick, pus-like discharge and their eyelids are often stuck together when they wake up.

  • Treatment: “Antibiotics are always needed to successfully treat bacterial conjunctivitis,” says Dr. Cook, “This usually is in the form of eye drops administered directly to the eye, or an ointment that is applied to the inside of the lower eyelid.”

  • Tips: Dr. Cooks says that if your infant is prescribed medication for bacterial conjunctivitis, it is very important that you do not allow the tip of the medication bottle or tube to touch their eye. Doing so will contaminate the medication.

    “Parents need to understand that it may be very challenging to successfully administer the antibiotic as prescribed. I have never met an infant who sat quietly and complied while a medication was being put directly into their eye.  Infants do not like this process at all, and they will fight it! tube to touch their eye. Doing so will contaminate the medication,” she says.

Viral conjunctivitis:

  • Common viruses: It’s often caused by viruses associated with the common cold.

  • Causes: Viral conjunctivitis can also develop if your baby is exposed to the coughs or sneezes of someone with an upper respiratory tract infection.

  • Symptoms: Watery discharge, redness, and a sensation of grittiness in the eye. It is highly contagious and can spread rapidly. According to Dr. Cook, infants with viral conjunctivitis often have concurrent cold symptoms, such as nasal congestion, runny nose, and cough.

    A study published in StatPearls Publishing states that the symptoms of viral conjunctivitis include red eyes, itching, light sensitivity, burning, and watery discharge.

  • Treatment: “There is no treatment for viral conjunctivitis, as the symptoms will get better on their own.  Management of this condition is supportive, meaning you do what it takes to help your child feel more comfortable,” says Dr. Cook. She further adds that drainage can be irritating, and it can be scary for a child to wake up and be unable to open their eye.

  • Tips: “I usually advise the families in my medical practice to gently wipe away the drainage with a cotton ball moistened with warm water,” says Dr. Cook.

  • What about using a warm, wet washcloth to gently remove the drainage? “After the first use, that washcloth will contain germs,” says Dr. Cook, “Repeated use of the same washcloth may contribute to the spread of the infection, and single-use washcloths create a ton of laundry.  As a mom who has been there, this creates unnecessary stress and work. Use cotton balls instead.”

Allergic reactions:

  • Allergens: Pollen, dust mites, pet dander, and other environmental allergens can trigger allergic conjunctivitis.

  • Symptoms: Intense itching, redness, and watery discharge. Both eyes are usually affected, and it is not contagious.

Other causes:

  • Blocked tear ducts: Newborns often have blocked tear ducts, which can lead to a buildup of bacteria and subsequent conjunctivitis.

  • Foreign objects: Small particles or foreign bodies in the eye can cause irritation and inflammation.

Newborn conjunctivitis

While babies of all ages can get conjunctivitis, newborn babies can also experience a different, and severe form of conjunctivitis called “Ophthalmia neonatorum.” It’s the type of pink eye that happens in the first 28 days after a baby is born.

“In the neonatal period, meaning during the first 21 days of an infant’s life, the most concerning cause of bacterial pink eye is due to maternal sexually transmitted infections such as gonorrhea or chlamydia,” says Dr. Cook. “It is recommended that all newborns receive a dose of an antibiotic called erythromycin, applied to the eyes within several hours after birth.  This is to prevent a condition called ophthalmia neonatorum, which can lead to blindness.”

  • Cause: It happens when a baby is exposed to chlamydia or gonorrhea during birth.
  • Risk: If not treated right away, it can cause permanent eye damage.
  • Prevention: In the U.S., delivery rooms have been using antibiotic ointment on newborns’ eyes for many years to prevent this condition.

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Did you know?

In the U.S., eye infections from N. gonorrhoeae occur in 0.3 out of every 1,000 live births, while Chlamydia trachomatis infections occur in 8.2 out of every 1,000 cases. About 10,000 babies worldwide go blind each year because of ophthalmia neonatorum.

According to another study published in the StatPearls Publishing, detecting and treating this condition early is very important for a good recovery and all pregnant women should be tested and treated for sexually transmitted infections.

What are the pink eye symptoms in babies?

Here are some symptoms of pink eye in babies:

  • Redness: The white part of your baby’s eye and their inner eyelid appear red or pink.
  • Watery eyes: There’s an increased tearing and watery discharge from your baby’s eyes.
  • Discharge: Yellow, green, or white pus that can crust over, especially after sleep, making it hard for your little one to open their eyes.
  • Swelling: Their eyelids may appear puffy or swollen.
  • Itchiness or irritation: Your little one might rub their eyes frequently due to discomfort.
  • Fussiness: Increased irritability and crying due to eye discomfort.
  • Crustiness: Crustiness around the eye after sleeping or an eye that is sealed shut after sleeping.
  • Sandy or gritty feeling: The eye feels “sandy” or “gritty.”

Is pink eye in babies contagious? 

Yes, pink eye in babies can be contagious, depending on the cause.

If your little one is suffering from viral or bacterial conjunctivitis, then it’s highly contagious. These types of pink eye can spread through direct contact with infected eye discharge, as well as through contaminated objects or surfaces. So make sure that when you clean your baby’s eyes using a wipe or a cloth, all these items are properly disposed of.

Don’t forget to maintain proper hygiene, like washing hands regularly.

Infectious conjunctivitis, meaning pink eye caused by a virus or bacteria, is contagious. Bacterial pink eye is contagious until an infant has received antibiotic treatment for 48 hours, and viral pink eye is contagious until the eye symptoms resolve.”

Dr. Kristin Cook, MD, a board-certified pediatrician with a thriving medical practice in Southeastern Wisconsin.

If your baby has pink eye, it’s advisable to consult a healthcare professional for guidance on how to manage the condition and reduce the risk of spreading it to others.

How to differentiate pink eye from allergies in babies?

When your baby’s eyes start showing signs of discomfort, it can be tricky to know if it’s pink eye or allergies. But don’t worry! Here’s a simple guide to help you distinguish between the two and get the right treatment.

How to treat pink eye in babies?

When your baby has pink eye, you can help by maintaining good hygiene practices at home and ensuring their comfort, but in most cases, it’s important to consult your pediatrician for proper diagnosis and treatment recommendations.

Medication:

  • Antibiotics: If your little one’s conjunctivitis is caused by bacteria, your doctor may prescribe antibiotic eye drops or ointment to clear the infection.
  • Antiviral Drugs: For viral pink eye, antiviral medications may be recommended, although viral conjunctivitis often resolves on its own without treatment.

What you can do at home to help:

  • Warm compresses: Applying a clean, warm washcloth to your baby’s closed eyelids can help soothe discomfort and reduce crusting.
  • Gentle cleaning: Use a clean, damp cloth to gently wipe away any discharge from your baby’s eyes, being careful not to rub or irritate the eyes further.

Hygiene practices to follow:

  • Frequent handwashing: Wash your hands frequently, especially after touching your baby’s eyes or handling any items contaminated with discharge.
  • Avoid sharing items: Do not share towels, washcloths, or pillowcases with your baby to prevent spreading the infection.

When it comes to the prevention of infectious conjunctivitis, many physicians will discuss the importance of not touching your face or eyes. This is great advice for an adult. Yet, infants learn about the world around them through their senses. They are going to touch and taste things. Please understand that you cannot prevent an infant from rubbing their face, eyes, or sticking things into their mouth.It’s going to happen numerous times throughout the day, and that’s okay! Focus on what you can control.”

Dr. Kristin Cook, MD, a board-certified pediatrician with a thriving medical practice in Southeastern Wisconsin.

Always follow your pediatrician’s advice and complete the full course of medication prescribed, even if your baby’s symptoms improve. If you have any concerns or notice worsening symptoms, contact your pediatrician for further guidance.

Conclusion

Dealing with pink eye in your little one can be tough, but you’re not alone in this journey. By maintaining good hygiene practices at home and ensuring your baby’s comfort, you’re already doing so much to help them feel better. 

However, don’t forget the importance of consulting your pediatrician for the right diagnosis and treatment advice. They’re your best ally in navigating through this. Keep following their guidance and shower your baby with the love and care they need. 

Sources:

  1. Conjunctivitis in babies. American Optometric Association. “Conjunctivitis (pink eye)
  2. Viral Conjunctivitis in babies.  StatPearls Publishing. “Viral Conjunctivitis.”

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