Pink Eye in Babies and Toddlers
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Uh-oh…your kiddo is sporting a red, gunky eye (or two). Is it pink eye? And if it is, what does that mean? Here’s what to know about how to spot, treat, and prevent conjunctivitis.
What is pink eye?
Pink eye (aka conjunctivitis) is an icky, sticky (usually) contagious eye infection that can be caused by bacteria or a virus (but is viral most often). Essentially, it happens when the membrane surrounding one or both eyes becomes inflamed. Most of the time, it’s a mild condition that either goes away on its own or is easily treated. (Awesome!) Sometimes, however, pink eye can be more serious, especially if the infection strikes a newborn. (This is called neonatal conjunctivitis or ophthalmia neonatorum.)
What causes pink eye?
In wee babies and bigger kids, pink eye can be caused by infections, blocked tear ducts, or eye irritation. When infection is the culprit for newborns, conjunctivitis can be dangerous. Because of this, any newborn exhibiting pink eye symptoms should be seen by a doctor ASAP.
Pink Eye Caused by Infection
The same viruses that cause the common cold, such as adenovirus can also cause pink eye in babies and toddlers. Bacteria can be to blame, too, particularly group A Streptococcus (the bacteria behind strep throat). With newborns, infection can occur during birth when babies are exposed to bacteria or a virus present in the vagina as they pass through the birth canal. If you have a sexually transmitted infection (STI), it increases the risk of your baby contracting pink eye.
Pink Eye Caused by Blocked Ducts
Tear ducts are teeny tubes located on the inner lining of the upper and lower eyelid that are responsible for draining tears from the eyes. Occasionally they can become blocked. In fact, about 10% of babies are born with blocked tear ducts, thanks in large part to being born with narrow ducts. (In older kids, polyps, cysts, or eye injuries are generally the cause.) Regardless, once a duct is clogged, the eye can become irritated, leading to pink eye.
Pink Eye Caused by Irritation
Here’s some irony for you: All newborn babies get either an antibiotic ointment or eye drops immediately after birth to help prevent any eye infection. At times, however, this precaution actually causes mild conjunctivitis. Fortunately, this irritation usually goes away on its own in a day or two. Irritant conjunctivitis can occur in older babies and toddlers, too. For these kiddos, pink eye can happen because of allergic reactions or when tykes rub their eyes too much.
Pink Eye in Babies vs Pink Eye in Toddlers Symptoms
The most telltale sign of pink eye for babies or toddlers is, well, pink eyes. Here, the white part of the eye turns reddish or pink. With newborns, the discoloration starts a few days to four weeks after birth.
Pink Eye Symptoms
Other signs (for big and little kids) might include:
- Swollen eyelids
- Clear or yellow discharge from the eye that may appear stringy
- Crusty eyes or eyelids that stick together
- Itchy, watery, and/or painful eyes
- Frequent blinking
- Sensitivity to bright light
Viral vs. Bacterial Pink eye
A healthcare professional will be able to diagnose whether your child’s pink eye was caused by a virus, bacteria, or allergies, but there are some clues that may tip you off about which type of conjunctivitis you’re dealing with.
Viral conjunctivitis tends to accompany colds and upper respiratory symptoms (think: runny nose, sneezing, cough), and the eye discharge is on the watery side. Usually it affects just one eye. Bacterial pink eye, on the other hand, usually causes thick, goopy, yellow or green discharge. The eyes might even become crusted over in the mornings. It can affect one or both eyes and often goes hand-in-hand with ear infections and occurs shortly after birth.
When should you see a doctor about pink eye?
If your newborn has any signs of pink eye, call your doctor right away. Infections among new babies are more serious than those in bigger kids. For older babies and toddlers, pink eye will usually go away on its own in a few days, but it’s still a good idea to let your provider know anytime you see changes to your child's eyes. Plus, if a bacterial infection is behind your tot’s pink eye, antibiotics may be in order. (Your provider will be able to diagnose a bacterial infection after an exam.)
How long is pink eye contagious?
Pink eye is only contagious if caused by bacteria or a virus—pink eye from allergies is not contagious. Pink eye from viruses and bacteria, however, are very contagious. In fact, pink eye caused by a virus is contagious before symptoms even appear. And pink eye that stems from bacteria can quickly spread as soon as symptoms show up. Your child (or anyone) can spread pink eye to others when their eye secretions or droplets from sneezing or coughing encounter another.
As long as your kiddo has symptoms, they’re contagious, so it's best to have your child engage in lots and lots of handwashing, implore them to avoid touching near the eyes, and of course, try to keep them away from other children and adults. (That means no school or daycare while contagious!) However, if your child has been on antibiotic drops or ointment for 24 hours, they are no longer contagious, so, school and daycare are back in play. (Woot!)
How is pink eye treated in babies and toddlers?
The treatment for pink eye depends on the cause. For instance, pink eye from irritation is super-short-lived and goes away in one or two days—no treatment necessary! If pink eye is from allergies, your child’s doc will likely recommend allergy testing. However, if your child’s pink eye stems from a bacterial infection, your provider will prescribe an antibiotic eye drop or ointment. For newborns, antibiotics may also be offered orally, intravenously, or by way of a shot. (Again, it takes just 24 hours to squash the contagion.) If a virus is behind your tyke’s pink eye, antibiotics won't work. Instead, you’ll need to wait it out, knowing that these types of infections usually go away on their own in a few weeks.
When a blocked tear duct causes pink eye in a newborn, your child’s physician will only prescribe antibiotics if said blockage causes an infection. In most cases, you’ll be asked to gently massage between your baby’s eye and nasal area with a warm compress several times a day. (This is sometimes called milking, and your doc will show you how to do it.)
The good news? Most blocked tear ducts heal by a child’s first birthday. But if the blockage is still there by the time your baby is a year old, your provider might recommend a procedure that’ll enlarge the tear duct opening with a small probe. (If this doesn’t work, surgery may be the next step.)
No matter that cause of your kiddo’s pink eye, you can help relieve some of the symptoms, helping your child feel better. For example, a warm compress on the eyes can help loosen crusting, while and cool compresses can help soothe puffiness around the eyes.
Bottom line: Pink eye is an unfortunate (and expected) part of parenting, but the good news is, it’s usually mild and oftentimes doesn’t need any treatment! The best way to prevent pink eye is by washing hands often and cleaning your kiddo’s toys regularly to avoid spreading it to others.
More on Your Baby’s Health:
- How to Spot Vision Problems in Babies
- RSV in Babies
- What to Know About Enterovirus
- Pediatrician-Approved Cold-Fighters
- What to Know About Croup
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REFERENCES
- NIH National Eye Institute: Pink Eye
- Centers for Disease Control and Prevention: Adenoviruses
- Centers for Disease Control and Prevention: Strep Throat All You Need to Know
- National Institute of Health National Eye Institute: Pink Eye in Newborns
- Seattle Children’s Hospital: Blocked Tear Duct
- Asthma and Allergy Foundation of America” Eye Allergies (Allergic Conjunctivitis)
- American Academy of Pediatrics: Eye Infections
- Centers for Disease Control and Prevention: Conjunctivitis (Pink Eye)
- American Academy of Pediatrics: Pinkeye (Conjunctivities)
- Cedars Sinai: Blocked Tear Duct (Dacryostenosis) in Children
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