Delaying Eye Drops & Vitamin K Injection

nolanova85 · November 2014

Hi Ladies -

I'm working on my birth plan. I know, I know...birth plan, schmirth plan. But I'll feel better having something in writing, even if it all gets thrown to the wayside!

Anyway, my OBs office gave a sample plan, which is relatively in line with what DH and I envision. I'm editing it slightly before sending to my Bradley instructor, who has offered to review it and offer input. One of the bullet points says the following: "I would prefer to wait up to one hour for the baby to receive eye drops and a vitamin k shot."

I have googled and can't find anything about why this would be something to ask for. Delayed cord clamping? Sure. But does anyone know why this is something I might want / not want? I suppose it's one of those things that might not really matter anyway, I just don't want to put something in my plan - or leave something out - without fully understanding what it means and why I'm asking for it.

FWIW, I can totally ask my OB at my next appt on Nov 12th, but would love any insight that any of you experienced mamas or even FTMs may have.

Thanks!

RayRay007 · November 2014

I'm guessing it's so that you have time to hold your baby before they're taken away to do this? I'm assuming that it's probably common practice to take baby to a nursery or something to do these things. There is no nursery in my hospital (except for NICU) so these things are done in the birthing room or recovery room shortly after birth. My recovery room nurse wanted to take dd over to an isolette to do these things but I asked that she do them while I held dd and she agreed but it was clear it had never occurred to her before. Perhaps that's what you can ask for in your birth plan- that it be done in arms.

SkateyC · November 2014

The idea is that it gives you that first hour with LO with fewer interruptions. So less poking/proding baby immediately after birth, more uninterrupted bonding time in that first hour. There's no evidence to say those things HAVE to be done immediately, as long as they're done within 4-6 hrs - it's just convenience for staff to do them right away.
The antibiotic eye ointment tends to make their vision blurrier too (it's already fairly blurry), so some like to wait while baby is still alert & looking around, and put it in a little later.

vrae0606 · November 2014

I dont have any insight as I am a FTM. But this is something I've been wanting to research myself. I hadn't heard about the eye drops but I have heard about delaying vitamin k & hepatitis b shot. My co-worker opted to delay it with her 2nd child but I can't remember exactly why she did that. Interested to see what others post about this.

taylojade57 · November 2014

I'm not letting LO the eye drops at all. I'm not good at words, but it is beneficial to stop infection if the mother could have gonorrhea or chlamydia. Neither my husband nor I have either, so it is pointless to me. There is also evidence that it can mess with their vision, which can interfere with bonding.

I'm on mobile, so I'm not sure if the link will work, but this is one of the (many) sources I used to make my decision.

https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

ETA: But look into laws in your state. My OB is on board with it, but in the state of NY (I believe) eye drops are mandatory (even if there is no history of the std's) and they will go as far as calling cps if you refuse the eye drops...

BankerBSN · November 2014

taylojade57 said:
I'm not letting LO the eye drops at all. I'm not good at words, but it is beneficial to stop infection if the mother could have gonorrhea or chlamydia. Neither my husband nor I have either, so it is pointless to me. There is also evidence that it can mess with their vision, which can interfere with bonding.

I'm on mobile, so I'm not sure if the link will work, but this is one of the (many) sources I used to make my decision.

https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

ETA: But look into laws in your state. My OB is on board with it, but in the state of NY (I believe) eye drops are mandatory (even if there is no history of the std's) and they will go as far as calling cps if you refuse the eye drops...

The eye drops? Vitamin K is far more important than the eye drops. And the drops only treat gonorrhea.

Some hospitals in Chicago will contact DCFS if you refuse Vit K but not the eye ointment. It is not a law though...

taylojade57 · November 2014

BankerBSN said:

taylojade57 said:
I'm not letting LO the eye drops at all. I'm not good at words, but it is beneficial to stop infection if the mother could have gonorrhea or chlamydia. Neither my husband nor I have either, so it is pointless to me. There is also evidence that it can mess with their vision, which can interfere with bonding.

I'm on mobile, so I'm not sure if the link will work, but this is one of the (many) sources I used to make my decision.

https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

ETA: But look into laws in your state. My OB is on board with it, but in the state of NY (I believe) eye drops are mandatory (even if there is no history of the std's) and they will go as far as calling cps if you refuse the eye drops...

The eye drops? Vitamin K is far more important than the eye drops. And the drops only treat gonorrhea.

Some hospitals in Chicago will contact DCFS if you refuse Vit K but not the eye ointment. It is not a law though...

Vitamin K is more important to get of not to get? I haven't researched that one enough to make a decision yet. I would love some information on it though, if you have any on hand!

BankerBSN · November 2014

taylojade57 said:

BankerBSN said:

taylojade57 said:
I'm not letting LO the eye drops at all. I'm not good at words, but it is beneficial to stop infection if the mother could have gonorrhea or chlamydia. Neither my husband nor I have either, so it is pointless to me. There is also evidence that it can mess with their vision, which can interfere with bonding.

I'm on mobile, so I'm not sure if the link will work, but this is one of the (many) sources I used to make my decision.

https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

ETA: But look into laws in your state. My OB is on board with it, but in the state of NY (I believe) eye drops are mandatory (even if there is no history of the std's) and they will go as far as calling cps if you refuse the eye drops...

The eye drops? Vitamin K is far more important than the eye drops. And the drops only treat gonorrhea.

Some hospitals in Chicago will contact DCFS if you refuse Vit K but not the eye ointment. It is not a law though...

Vitamin K is more important to get of not to get? I haven't researched that one enough to make a decision yet. I would love some information on it though, if you have any on hand!

More important for your baby to get. I don't have info on hand to give out, but I am sure Google has something on it.

2JEL · November 2014

I'm planning to give my child the critical vaccines and Vit K (just had my TDAP today for the second time in a few years), but am skeptical of the massive amounts of preventative medicine pushed on kids in the first couple years of life.

I find it disheartening to read that the majority of states legally require hospitals to "administer the eye ointment in every newborn, regardless of the mother’s chlamydia or gonorrhea status" -- to prevent something that is unlikely to happen and can be treated if it does. The article sort of suggests that there are other possible causes of ON than STDs and then dismisses them, does anybody know what they might be? Surely 30+ states aren't requiring unnecessary medical intervention just so that moms with STDs don't get singled out and feel bad?

ColeyCannoli · November 2014

taylojade57 said:

I'm not letting LO the eye drops at all. I'm not good at words, but it is beneficial to stop infection if the mother could have gonorrhea or chlamydia. Neither my husband nor I have either, so it is pointless to me. There is also evidence that it can mess with their vision, which can interfere with bonding. I'm on mobile, so I'm not sure if the link will work, but this is one of the (many) sources I used to make my decision. https://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/ ETA: But look into laws in your state. My OB is on board with it, but in the state of NY (I believe) eye drops are mandatory (even if there is no history of the std's) and they will go as far as calling cps if you refuse the eye drops...
The eye drops? Vitamin K is far more important than the eye drops. And the drops only treat gonorrhea. Some hospitals in Chicago will contact DCFS if you refuse Vit K but not the eye ointment. It is not a law though...
Vitamin K is more important to get of not to get? I haven't researched that one enough to make a decision yet. I would love some information on it though, if you have any on hand!

Vit K shot is necessary if you are circumcising or baby has any bruising from birth and can prevent a bleeding disorder. Vitamin K is necessary to activate clotting factors in the blood. It can prevent jaundice and excessive bleeding. If you really don't want the shot, your doctor can give you Vit K drops but you have to them to baby at very specific intervals (which I hear can be difficult to remember with everything else going on).

I'm just a student and FTM, so many grains of salt here. Definitely ask you doctor/midwife for more info.

https://newborns.stanford.edu/VitaminK.html

drpayne · November 2014

We skip the eye ointment. We also skip hep b (for a couple years). The vitamin k is one we won't skip. One midwife said she saw a brain hemorrhage once and it was enough to make her recommend it to everyone.

marriedinaugust · November 2014

We will be skipping the eye drops altogether. And postponing all shots/procedures for a couple hours for family bonding and breastfeeding.

ColeyCannoli · November 2014

2JEL said:

I'm planning to give my child the critical vaccines and Vit K (just had my TDAP today for the second time in a few years), but am skeptical of the massive amounts of preventative medicine pushed on kids in the first couple years of life.

I find it disheartening to read that the majority of states legally require hospitals to "administer the eye ointment in every newborn, regardless of the mother’s chlamydia or gonorrhea status" -- to prevent something that is unlikely to happen and can be treated if it does. The article sort of suggests that there are other possible causes of ON than STDs and then dismisses them, does anybody know what they might be? Surely 30+ states aren't requiring unnecessary medical intervention just so that moms with STDs don't get singled out and feel bad?

I think it's less that mom's with STDs would feel bad and more that they don't have time to check every woman that walks into the ER in labor. There are sadly a lot of women who either don't get the basic blood work and prenatal checks while pregnant or would lie about their chances of carrying an STD when they went in to give birth. No hospital wants to be sued (and no doctor/nurse wants to be responsible) for a baby going blind. As for what else causes it, I don't know. I hope someone else can shed some light on that.

Estherlovesbaby · November 2014

This is where my hospital frustrates me. In Germany They will only give the baby vitamin K drops which do not compare to the amount in the shot so she will have to wait to get the shot until she sees her normal doctor at about a week old.

haleyusf · November 2014

You can give baby Vit K drops instead of the shot; I bought a bottle from a midwife supply site and you dose baby 3 times over the first month and it's as effective as the shot. My take on that was we are delaying all shots at birth (starting them up and spacing them out starting at 2 months).

As for the eye ointment, PP mentioned that it causes blurry vision which can interfere with bonding/breastfeeding. Some states do require it by law, but many will waive the requirement if you agree to use breastmilk instead of the ointment.

nolanova85 · November 2014

Hey all - thanks for the input! Good to know about the eye drops. Both DH and I are STD free, so we may forego those all together. Plus, we hope to breastfeed.

We've always planned to do the Vitamin K - it was just a matter of when. Evidence Based Birth did have a good article referencing studies that show how beneficial it is. But I think I will keep the request to delay it for one hour in my birth plan, for the reasons @SkateyC mentions.

nolanova85 · November 2014

haleyusf said:

You can give baby Vit K drops instead of the shot; I bought a bottle from a midwife supply site and you dose baby 3 times over the first month and it's as effective as the shot.

I will ask my OB this - I like the idea of the drops, but we do plan to circumcise, so I'm wondering if that would be a bigger reason to go for the shot?

soulcupcake · November 2014

We'll skip erythromycin, just as I did with two of my other kids. Yes to Vitamin K. I have the option of oral or injection. We'll just do the injection.

https://evidencebasedbirth.com/evidence-for-the-vitamin-k-shot-in-newborns/

jjgypsy · November 2014

Our baby will not be getting the eye ointment. My research shows it does blur vision & it can be painful to baby's eyes. Like others have said it's only for std's, which I've never had & I'm having a c-section. I do have to sign a waiver at the hospital because it is their policy to give it otherwise.

Vitamin-K shots in my opinion, based again on my research, are very important for baby so he will be getting that. I have written in my birth plan to have all non-emergency care delayed for one hour so we have that important bonding time.

Beansjjo · November 2014

does anyone know if this is an option to opt on on in canada ? looked on some government sites and nothing is helping me find out lol. Ill be asking at my next appointment forsure, jw if anyone knows .

drpayne · November 2014

Babies don't really have the ability to absorb vitamin k, which is why the injection is more effective.

byrne15 · November 2014

With my kids, they did it so quickly after birth that I didn't even notice it happening. I had a scheduled C-section with ds#2 and I was holding him within 3-4 minutes of his birth.

passionfruit1234 · November 2014

i have requested a delay of at least 2hrs before anything like vitamin K. The midwife said that should be fine.

I read Ina May's guide to breastfeeding and it suggested that anything like painful needles can affect the baby's ability to breastfeed and that the first 2hrs is extremely important for bonding. That is why i requested it.

BabyBeastie · November 2014

We are only allowing the Vit K shot which is meant to control any internal bleeding baby may develop due to the physical pressure of birth on that tiny, squishy body. We are not going to allow the eye ointment because neither me nor hubs have any STDs so there's no point for our kid as there's nothing there to protect against. We also are not going to allow the HepB vaccine since my test was negative and I don't anticipate my newborn shooting up or sharing body fluids with anyone besides when we nurse. Again, nothing there to protect against so our kid doesn't need that vaccine immediately. It can wait.

nwsnowbunny · November 2014

Just an fyi: erythromycin eye ointment isn't "just for std's", it is an antibiotic eye ointment that protects against the myriad of bacteria that can likely get in your babie's eyes while being born (your butt is right there!). The big deal about the std's is that they can cause blindness which is much worse than an eye infection.

Not to say I think you all should change your plan, just putting the info out there. We treat some nasty eye infections with erythromycin ointment at work

Personally I think I'd wait at least an hour for the ointment since its not something they would need immediately. My hospital makes you have one hour of skin to skin though, so I'd be waiting anyways

sarals24 · November 2014

What exactly is the downside of giving your baby eyedrops? Seems like the pros definitely outweigh the cons here. I mean, how long does it even take, ten seconds? It's not like your kid is taken away for an hour.

nwsnowbunny · November 2014

The common reason people wait is so it doesn't interrupt the critical early bonding time, ointment makes your vision blurry so it may be hard for your baby to see you, see nipple, etc.

2JEL · November 2014

misskilljoy said:

nwsnowbunny said:

The common reason people wait is so it doesn't interrupt the critical early bonding time, ointment makes your vision blurry so it may be hard for your baby to see you, see nipple, etc.

This is basically the ONLY reason I've seen anyone use for refusing them. My country (maybe just my province) doesn't even let you refuse them. Midwives will bend the rules sometimes during home births, but in any kind of centre they are required by law to give them.

I know that I want to delay drops just in case they interfere with bonding.

There's also the objection (common in most other situations involving antibiotics) that giving antibiotics unnecessarily can disrupt the natural bacterial ecosystem of the body and help develop superbugs in a population over time. Most of the doctors I know have given them to their kids anyway-- I have a "less is more" approach to medicine but will be getting Vit K and I will defer to my pediatrician on the drops if she feels strongly about it.

drpayne · November 2014

sarals24 said:
What exactly is the downside of giving your baby eyedrops? Seems like the pros definitely outweigh the cons here. I mean, how long does it even take, ten seconds? It's not like your kid is taken away for an hour.

Many people just don't think they're necessary. That's why we don't do them. I doubt they'd hurt anything. Just don't see the point.

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