Sunday, February 12, 2012

Saying No, Part II

As promised, I wanted to talk more about saying no, specifically when it relates to labor and delivery.  I don't have as MUCH to say about eye ointment as I did about Vitamin K.  But I feel equally strongly about it.

Similar to my last post, I'm not going to include all of my citations here.  But I will let you know that this page at as well as some info at was very helpful.  I'd strongly encourage you to do your own literature based, evidence based reading before you say no to anything yourself.

Eye Ointment
Why do all the pictures of 12 hour old babies always look a little greasy around the eyes?  Because for decades, it's been standard practice in the US (and many other westernized cultures) to use an eye ointment to reduce the risk of or prevent bacterial infections which could, theoretically, lead to infant blindness.  BLINDNESS?!?!  NOT COOL!  Most moms would hear that little information and say, "where do I sign for the eye ointment?"  But I'm sorta a black sheep when it comes to trusting medical professionals... I think it comes with the territory when you work in the medical field and learn how unscientific many of the 'scientific' things we recommend are.  Thus, I wanted to learn a little for myself.  He's what I've learned thus far:

  • gonorrhea and chlamydia can cause blindness in infants when they'd get exposed to the illnesses in the birth canal during delivery.
  • back in the day, the treatment for infants essentially included washing out the eyes with sterile water... you can imagine how useful that was.
  • In more modern times, if a child is infected with gonorrhea or chlamydia in their eyes, we'd treat them with antibiotics, which typically resolves the infection in less than a week.
  • The standard prophylactic for eye infections at birth used to be silver nitrate, but now the standard is Erythromycin... an antibiotic... wait, didn't we say in yesterday's post about vitamin K that antibiotic exposure would limit/reduce the uptake of vitamin K in a newborn?  hm...
  • Even if mom tests negative for gonorrhea and chlamydia (which, btw, I have multiple times in my life), physicians will still administer the prophylactic because sometimes screening tests for STDs are wrong/false negative.
  • Another "scare tactic" is that gonorrhea and chlamydia can lay dormant in a woman for years without symptoms... thus worrying us all that our children could get it in their eyes with no symptoms.  But it doesn't work that way.  If an infant gets an eye infection from gonhorrhea or chlamydia, you'd know immediately by their swollen, puffy, red, eyes and face.  One site even talked about "oozing."  Now what kind of mother would I be if I miss "oozing" from my child's eyes and face and don't take them IMMEDIATELY to the docs office for diagnosis and treatment?
Thus, given that I'm 100% positive that I'm in a monogamous relationship where neither my spouse nor I have either of these STDs, given that I plan to pay close attention to my child's eyes and face immediately following their birth (and probably for the next 18 years after that), and given that I don't believe in prophylactic antibiotics, I plan FIRMLY on declining the eye ointment at birth unless my midwife can make a REALLY good argument otherwise in the moment.  And at the present, my midwife agrees with me!

Stay tuned for part 3, where I discuss Hep B shots... 

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