Neonatal Conjunctivitis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Neonatal Conjunctivitis?
A pediatrician, a doctor for babies and children, usually diagnoses and treats neonatal conjunctivitis. An ophthalmologist, an eye doctor, may also see the baby if the infection is serious. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is neonatal conjunctivitis?
Conjunctivitis is swelling or infection of the membrane that lines the eyelids and covers the white part of the eye. When it happens in a newborn, it is called neonatal conjunctivitis. Other names are newborn conjunctivitis and ophthalmia neonatorum.
The CDC says newborn pink eye can come from infection, irritation, or a blocked tear duct. It can cause serious health problems for newborns if it is not treated.
Symptoms
Infected newborns develop drainage from the eyes within 1 day to 2 weeks after birth. Other signs include:
- Eyelids that become puffy, red, and tender.
- Watery, bloody, or thick pus-like drainage from the eyes.
The type of infection can change the picture. Gonococcal conjunctivitis causes red eyes, thick pus, and swollen eyelids. It can spread to the blood and to the lining of the brain and spinal cord (meningitis). Irritation from eye drops causes a mildly red eye and some swelling for only 24 to 36 hours.
Causes and who gets it
Swollen or inflamed eyes are most often caused by one of three things. These are a blocked tear duct, antibiotic eye drops given right after birth, and infection by bacteria or viruses.
Bacteria that normally live in a woman's vagina may be passed to the baby during childbirth. More serious eye damage may be caused by gonorrhea and chlamydia, which are infections spread by sexual contact. The viruses that cause genital and oral herpes may also lead to severe eye damage. Herpes eye infections are less common than those caused by gonorrhea and chlamydia.
Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. When a mother has active herpes sores at delivery, a cesarean birth (C-section) is recommended to prevent serious illness in the baby.
How doctors diagnose it
The cause is often hard to tell, because the symptoms are very similar for each cause. The health care provider will perform an eye exam on the baby. If the eye does not look normal, other tests may be done.
- A culture of the drainage from the eye, to look for bacteria or viruses.
- A slit-lamp exam, to look for damage to the surface of the eyeball.
Treatment
Treatment depends on the cause. Eye swelling caused by the eye drops given at birth should go away on its own. For a blocked tear duct, gentle warm massage between the eye and nasal area may help. Surgery may be needed if the duct has not cleared by the time the baby is 1 year old.
Antibiotics are often needed for eye infections caused by bacteria. They may be eye drops, ointments, or medicine given by mouth, by vein, or by shot. Chlamydial conjunctivitis is usually treated with antibiotics by mouth. Gonococcal conjunctivitis is treated with antibiotics by vein or shot. Without treatment, the baby could get open sores on the cornea and go blind. The cornea is the clear cover over the colored part of the eye. Special antiviral eye drops or ointments are used for herpes infections of the eye.
Salt water eye drops may be used to remove sticky yellow drainage. Wash your hands before and after touching the infected eyes. Quick diagnosis and treatment often leads to good outcomes.
When to see a doctor
Newborns should be seen by a doctor right away if they have pink eye symptoms. Talk to your provider if you gave birth, or will give birth, where eye drops are not routinely placed in the baby's eyes. An unsupervised birth at home is one example. This is very important if you have or are at risk for a sexually transmitted disease.
Call 911 or go to the emergency room if your baby has trouble breathing or bluish or grey skin. Also go if a fever is followed by a change in mental status or a stiff neck or back.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can look at a newborn's eyes, refer the baby for urgent care, and follow up afterward.
Common questions
Is neonatal conjunctivitis serious?
It can be. The CDC says pink eye can cause serious health problems for newborns if it is not treated. Complications may include blindness and scarring of the cornea. Quick diagnosis and treatment often leads to good outcomes.
Can neonatal conjunctivitis go away on its own?
It depends on the cause. Swelling from the eye drops given at birth should go away on its own. Infections caused by bacteria often need antibiotics.
Do all newborn eye infections come from the mother?
No. A blocked tear duct or irritation from the eye drops given at birth can also cause red, swollen eyes. Infections can pass from the mother to the baby during childbirth, even if she has no symptoms.
Why do newborns get eye drops after birth?
The drops help prevent many eye infections. Most states have laws requiring this treatment. Hospitals now mostly use antibiotic eye drops, typically erythromycin.
Sources
- MedlinePlus - Neonatal conjunctivitis
- Centers for Disease Control and Prevention - Pink Eye in Newborns
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
