Conjunctivitis in Babies

When to get help

Under 30 days old: get an urgent appointment. The NHS lists a baby less than 30 days old with red, sticky eyes under urgent advice, alongside pain in the eyes, sensitivity to light, changes in vision and very red eyes. Newborn conjunctivitis can be caused by organisms that need prompt treatment, which is why the age line is drawn so sharply.

Ask for an urgent GP appointment or call NHS 111 in the UK — and note the NHS instruction to call rather than use 111 online for a child under 5. In Ireland use your GP or the out-of-hours service, in the US or Canada your paediatrician, in Australia healthdirect on 1800 022 222, in New Zealand Healthline on 0800 611 116.

See a GP non-urgently if your older baby has red, sticky eyes, or if symptoms have not cleared within seven days.

Call emergency services — 999, 112, 911, 000 or 111 by country — if red eyes come with the general baby red flags: a non-blanching rash, difficulty breathing, a first seizure, blue, grey or mottled skin, or a baby who is floppy or cannot be roused. Those point away from conjunctivitis and towards something systemic.

What conjunctivitis looks like

Also known as red eye or pink eye, it usually affects both eyes and makes them red, burning or gritty, watery, itchy, and producing pus that sticks to the lashes. The NHS notes it usually gets better in a couple of weeks without treatment.

The sticky variety is the one people notice in babies: lashes gummed together after a nap, and a crust that has to be softened before the eye will open.

Infectious or not

The NHS gives a workable rule of thumb. Conjunctivitis that produces sticky pus is contagious. If eyes are red and feel gritty, it is also usually contagious. Conjunctivitis caused by allergies makes eyes red and watery but is not contagious. In a baby, allergic conjunctivitis is less common than in older children, and a sticky discharge points to infection.

How to clean the eyes

The NHS method is deliberately simple. Boil water and let it cool. Gently wipe the eyelashes with a clean cotton wool pad to clean off crusts, using one fresh piece for each eye. Wipe from the inner corner outwards, and never reuse a pad between eyes — that is how one infected eye becomes two.

A cold flannel held on the eyes for a few minutes can soothe them. Wash your own hands before and after.

Treatment, and who can prescribe

A pharmacist can advise on conjunctivitis and suggest eyedrops or antihistamines. But the NHS states one thing clearly for this age group: if you need treatment for a child under 2 years old, you will need a prescription from a GP. Over-the-counter drops sold for adults are not a shortcut for a baby.

If it is a bacterial infection, antibiotics may be prescribed. They will not work for viral conjunctivitis or for an allergy, which is why most cases are managed with cleaning and time.

Stopping it spreading

• Wash hands regularly with warm soapy water — yours and your baby's.
• Wash pillowcases and face cloths in hot water and detergent.
• Cover the mouth and nose when sneezing and bin used tissues.
• Do not share towels or pillows.
• Do not rub the eyes, and try to stop your baby rubbing theirs.

Nursery and childcare

The NHS says you do not need to stay away from work or school unless you or your child are feeling very unwell. UKHSA guidance for education and childcare settings takes the same view for conjunctivitis. Many settings still ask for children to be kept home, which is not what the national guidance says — if that comes up, it is worth pointing to.

Signs of something more serious

The NHS lists these as reasons for urgent advice because they can indicate a more serious eye problem rather than simple conjunctivitis:

• pain in the eyes;
• sensitivity to light;
• changes in vision, such as wavy lines or flashing;
• very red eyes, in one eye or both.

In a baby, pain and light sensitivity have to be inferred: persistent screwing up of one eye, turning away from light, or crying when the eye is touched. Swelling or redness of the eyelid and surrounding skin, rather than the eye surface itself, is a different problem again and needs same-day assessment.

Contact with someone who has it

Infectious conjunctivitis spreads readily within a household, largely on hands and shared fabric. If an older sibling or an adult has sticky eyes, the practical steps are the ones above applied preventively: separate towels and flannels for everyone, hot washes for pillowcases, and hand washing before handling the baby or preparing feeds. It is worth being deliberate about this rather than relying on general tidiness, because a baby's eyes get touched far more often than an adult's.

If you wear contact lenses and develop symptoms, the NHS advises not wearing them until your eyes are better, and seeing a GP if you also have spots on your eyelids, since that can indicate an allergy to the lenses. Handling a baby's face with hands that have just adjusted an infected lens is an easy transmission route to close off.

Blocked tear ducts, which this is not

A watery eye with occasional stickiness in a young baby, without redness of the white of the eye, is often a blocked tear duct rather than conjunctivitis. It is common, usually resolves on its own during the first year, and does not need antibiotics. The distinguishing feature is the white of the eye: conjunctivitis makes it red, a blocked duct usually does not. If you are not sure, that is a reasonable thing to ask about at a routine review — but a red eye in a baby under 30 days is not something to wait and see about.