Refusing Erythromycin Ointment

Ecstatic83 · August 2013

Just curious, are any of you refusing the prophylaxis ointment?

KaramelSutra · August 2013

Why would you?

HBirdie · August 2013

We were thinking about it, but when I discussed it with my midwife, she said there wasn't really any good reason not to do it, there aren't any real risks. Even if you know you don't have any STI's, there are other vaginal infections your child could be exposed to that you aren't aware of, and the ointment will help. So we're not refusing.

Ecstatic83 · August 2013

https://www.keeperofthehome.org/2012/02/1o-decisions-for-parents-of-newborns.html

#3 from the above article... Just one example I happened to see today...

You're probably familiar with the pictures of newborns in those striped hats, eyes smeared with some kind of clear goop. That "eye goop" is usually administered within 1 hour of all births, and is generally either erythromycin or tetracycline (both antibiotics), or the older silver nitrate solution.

Why might you want this?

The intention of the eye ointment is to prevent newborn blindness from infection after birth ("opthalmia neonatorum"). If the mother has gonorrhea, it can be passed on to the baby during a vaginal delivery and can cause blindness if left untreated (chlamydia is similar, as well as herpes). To avoid this, states passed laws throughout the 1900s mandating that all newborns receive silver nitrate, assuring that any infections would be caught & treated. This eye-irritant is still administered in some hospitals, but most now use the gentler antibiotics. If you know that you have an STD and you deliver vaginally, you will want to protect your babies eyes. In this case, you can request the gentler tetracycline drops.

Why might you opt out of this?

For one, having a C-section negates the need for this completely. Anything placed in a baby's eyes interferes with his vision, blurring it and usually causing swelling & irritation. Blurred vision interferes with the "sensitive window" right after birth when baby is alert & awake, so crucial in mother-child bonding as well as the establishment of breast-feeding.

Silver nitrate is only effective against gonorrheal infections, and is such an eye-irritant that it can actuallycause chemical infections (read a good paper here). It has mostly been replaced by less-painful antibiotics, however these antibiotics carry their own risks. As this study showed, babies actually needthe bacterial exposure they receive from their mother's birth canal to correctly populate their digestive tracts and build up their immune systems.

Antibiotics upset the bacterial balance in our bodies, wherever they are administered (we've all heard about the dangers of over-using antibiotics). If a mother is known to be disease-free, there seems little reason to administer any ointment at all. A randomized 1993 trial in Washington State states.

"The results suggest that parental choice of a prophylaxis agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy." (emphasis mine)

Your options: Be tested for STD infection in your 3rd trimester (this is state law anyway). If positive, find out 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. (Note: in my state, KY, hospitals are required by law to administer an ointment of some kind, and some try to threaten parents with Child Protective investigations, etc. However, when I made my own calls to various hospitals as well as our Child Safety office, I found that these were 100% intimidation tactics. Research the penalties & state laws in your own state) Have others wash their hands when touching your baby to minimize exposure to external bacteria.

Ecstatic83 · August 2013

HBirdie said:

We were thinking about it, but when I discussed it with my midwife, she said there wasn't really any good reason not to do it, there aren't any real risks. Even if you know you don't have any STI's, there are other vaginal infections your child could be exposed to that you aren't aware of, and the ointment will help. So we're not refusing.

I'm going to ask at my next appt. I've just always thought it was so sad that they can't open their eyes till it dried. That's what prompted me to look into what it is actually for.

AppleMuffins · August 2013

Yup, in my state it's the law. Baby has to have it.

MamaInMN · August 2013

AppleMuffins said:

Yup, in my state it's the law. Baby has to have it.

I believe it's required here too (MN) but we are refusing it. We don't see the need. I'm sort of in the mindset to expose LO to as little medication as possible and if we know it's unnecessary (I was tested at the beginning of this pregnancy) I just don't see the point.

DonnaMartinGraduates · August 2013

I plan to decline it. I'm havi g a RCS and just don't see the need for it.

CDMay2006 · August 2013

We are refusing it. I have no risk factors, so it is unnecessary.

One option to consider is delaying it until after the first hour. That way you have that optimum bonding time (since it impairs sight temporarily), but also the medicinal effects of the medication.

AppleMuffins · August 2013

CDMay2006 said:
We are refusing it. I have no risk factors, so it is unnecessary.
One option to consider is delaying it until after the first hour. That way you have that optimum bonding time (since it impairs sight temporarily), but also the medicinal effects of the medication.

Yes, we can't refuse it but we can delay it! It was actually recommended to us.

SweetPeaK26 · August 2013

I asked dh about it, his response was basically why wouldn't we do it this time since we did with the other two. It didn't keep either of them from opening their eyes, and it helps get some of the gunk out. Guess he's got a point.

caover · August 2013

We are refusing as well. No risk factors and I am having a RCS. We are also declining Hep B in the hospital

LnR70707 · August 2013

Ecstatic83 said:

HBirdie said:

We were thinking about it, but when I discussed it with my midwife, she said there wasn't really any good reason not to do it, there aren't any real risks. Even if you know you don't have any STI's, there are other vaginal infections your child could be exposed to that you aren't aware of, and the ointment will help. So we're not refusing.

I'm going to ask at my next appt. I've just always thought it was so sad that they can't open their eyes till it dried. That's what prompted me to look into what it is actually for.

Um, what? Do you think they tape them shut or something? DS was a preemie and was looking right at me with open eyes when they handed him back to me.

A37licia · August 2013

Yep, we are refusing and always have. I don't have any STDs, am in a trusting monogamous relationship, don't feel the risk is valid for us for the "what if your DH cheated" angle, and don't believe the birth canal has a host of infections waiting to infect my baby. I am personally very uncomfortable for antibiotics "just in case". We treat as needed in every area of life, including birth. My midwife and I are pretty comfortable with this route with the research we've both done.

There are VERY few states that will not let you refuse it by signing a form, even though it is state law. NY is the ONLY state I have come across so far that will.not.let.you.refuse. All others of which I am aware, parents have the legal right to refuse it.

bexsd · August 2013

We are turning them down. I don't have the risk factors, don't like unnecessary antibiotics, and have heard conjunctivitis is not uncommon in babies who get the ointment. No benefits, possible risks. Why would we get them?

VitaLuna · August 2013

We likely won't be getting it. I haven't talked to the midwife yet, but I can't see that it would be any issue for them to not do it.

EMLYNNLERETTE · August 2013

AppleMuffins said:

CDMay2006 said:
We are refusing it. I have no risk factors, so it is unnecessary.
One option to consider is delaying it until after the first hour. That way you have that optimum bonding time (since it impairs sight temporarily), but also the medicinal effects of the medication.
Yes, we can't refuse it but we can delay it! It was actually recommended to us.

I am in Texas too. You CAN refuse it, but CPS will be called if you deliver in a hospital. I am not allowing it and spoke to my midwife about the consequences. She said that CPS shows up, looks at your house, sees you are a good parent and leaves. Nothing else happens. I'm totally fine with that (although it probably won't happen since we are delivering at home.) My personal feelings are that I know I have been tested and I want to have the bonding right away without interfering with the ointment. It was ok with our OB back in WI not to use it, so I know it is a matter of medical preference where the state has (IMO) wrongfully stepped in.

RunningGal900 · August 2013

I'll be discussing it with my Dr. I have no risk factors so I don't see the need for it, but honestly it was no big deal with DS and didn't interfere with our bonding. However, I recently had to use an eye ointment for my own pink eye because I'm allergic to a lot of different antibiotics, so drops weren't an option, and it really did suck. It hurt, caused weird blurred vision and was very uncomfortable. If there are no risks for DD then I'd rather her not have to have that same experience. But I haven't discussed it with my Dr.

AppleMuffins · August 2013

EMLYNNLERETTE said:

We are refusing it. I have no risk factors, so it is unnecessary.
One option to consider is delaying it until after the first hour. That way you have that optimum bonding time (since it impairs sight temporarily), but also the medicinal effects of the medication.
Yes, we can't refuse it but we can delay it! It was actually recommended to us.
I am in Texas too. You CAN refuse it, but CPS will be called if you deliver in a hospital. I am not allowing it and spoke to my midwife about the consequences. She said that CPS shows up, looks at your house, sees you are a good parent and leaves. Nothing else happens. I'm totally fine with that (although it probably won't happen since we are delivering at home.) My personal feelings are that I know I have been tested and I want to have the bonding right away without interfering with the ointment. It was ok with our OB back in WI not to use it, so I know it is a matter of medical preference where the state has (IMO) wrongfully stepped in.

I'm in NY so it's a bit different. We really can't say no to that or the vitamin K. We can decline the Hep B though.

A37licia · August 2013

@EMLYNNLERETTE I recently checked my facts on that about TX, since I previously thought TX was just like NY. I believe I read a long thread on mothering.com from people in Texas, and the conclusion I came to was that it's a misdemeanor for a nurse or practitioner not to give it, but it's not on the parents. And like you said, CPS can be called, though it's not a guarantee like it appears to be in NY. It sounds like it varies quite a bit from hospital to hospital, and even nurse to nurse. I think I even heard some nurses will give to the parents so she's in the right and the parents opted not to put it on. Anyway, I was curious about that a few weeks ago since I realized I was asserting things about TX but hadn't really looked into it! And here I am in WA state anyway, LOL.

coraggiosa · August 2013

We are refusing. I do not have any STDs nor does DH. We do not really believe in using antibiotics "just in case", as antibiotics have their own risk factors and can cause harm. My doctor and our pediatrician is perfectly fine with it.

Ecstatic83 · August 2013

Thanks for the input. I'm glad I'm not the only one thinking it is unnecessary if there are no risk factors.

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