How do I become exempt from my child getting Erythromycin in their
eyes when born?  It is an antibiotic ointment they put in after the
baby is born.  They say it is state law.  I say it is crap.  I am from Michigan.

Hi,

Eye infections in newborns like neonatal conjunctivitis can be
extremely dangerous - they are the most common cause of infant
blindness. Erythromycin and other antibiotic ointments are intended to
prevent your baby's eyes from becoming infected by the many nasties
which lurk in hospitals, as well as from infection in the birth canal.

I'd like to deal first with the differing view regarding the
effectiveness of this drug, and then look at the legal issues.

There's an interesting study here claiming that erythromycin is
ineffective in preventing eye infection in newborns:

Dr Jay Gordon: Neonatal Eye Care
http://www.drjaygordon.com/pediatricks/eyecare.htm

Other studies are cited here:

The Gathering Place: Neonatal Ocular Prophylaxis (this site is *not*
written by medical professionals as far as I can tell).
http://www.angelfire.com/biz3/gatheringplace/eyeointment.html

Dr Gordon admits that his is a "minority view", although it is,
nevertheless, a view which I have come across repeatedly in my
research. However, other studies have indicated that the antibiotic is
indeed effective.

The Neonatal Formulary, which is endorsed by the British Medical
Journal, cites a study which shows that the drug is effective in
treating chlamydia conjunctivitis and ophthalmia neonatorum:

The NeoNatal Fomulary: Erythromycin
http://www.bmjpg.co.uk/books/neonatalformulary/chapters/erytcomment.htm

A simpler guide to the drug and its uses is here:

MEDLINEplus Drug Information
http://www.nlm.nih.gov/medlineplus/druginfo/erythromycinophthalmic202220.html

Although there are some voices disagreeing with the drugs
effectiveness, therefore, the medical community is generally in
agreement that this is an effective prophylactic (i.e. preventative)
drug. I have found no references to harmful side-effects of ocular
erythromycin, although four children are known to have died as a
result of the drug being administered intravenously (see the NeoNatal
Formulary, above). It can also lead to resistance to antibiotics in
later life. It's *generally* recognised as safe, then - something
which can not be said for silver nitrate, the ointment which was
generally used before erythromycin and could have far more painful
effects.

Now for the legal issue. Many states oblige hospitals to use eyedrops
by law in order to prevent infection. There's no easy way to get
around this, but if you are concerned about this you should talk to
your midwife about ways around the issue.

Here's an ingenious solution to the problem:

"Is there any proof that this bacteria causes infection in a newborn's
eyes?  I kept asking for proof, for medical references, and finally
she broke down and admitted that the real reason Dr.s and midwives
tell you it's for other reasons than STD's is because *they* can get
in trouble for not administering it, not because there is truly a
medical need.  So I suggested if it would soothe her conscience, she
could let *us* administer the drops.  And we would miss.

You might try this with your own health care professional."

Taken from Pregnancy.About.com: Newborn Eye Ointment
http://pregnancy.about.com/gi/dynamic/offsite.htm?site=http://www.best.com/%7Efalcao/archives/eyeointm.html

Give it a go!

Hope this helps,

grimace

---

Request for Answer Clarification by audy5000g-ga on 01 Jun 2002 07:50 PDT

I understand why the procedure is done.  I just want to see this
so-called law and no how to get around it.  Do I need an exemption
form?  By the way thanks for being so prompt and knowledgeable.

---

Clarification of Answer by grimace-ga on 01 Jun 2002 08:14 PDT

I've been unable to find the actual text of the Michigan state law
regarding erythromycin treatment - it doesn't seem to be online, and
as I'm in the Uk, I have no easy way of laying my hands on it.

I would imagine, however, that it would be phrased more or less like
the Oregon law - thus:

Any person attending the birth of an infant (e.g., licensed
physicians, persons acting under the direction of a licensed
physician, midwives) shall evaluate whether the newborn is at risk for
chlamydial or gonococcal ophthalmia neonatorum. If so, they shall
ensure that the newborn receives erythromycin or tetracycline
ophthalmic ointment or a comparable prophylactic treatment into each
eye within two hours after delivery.

(from Oregon Administrative Rules
http://www.ohd.hr.state.or.us/acd/oars/div19.htm )

Neither have I been able to find concrete rulings about exemption from
this ruling. It *is* possible to gain exemption from infant
immunisation on religious or philosophical grounds in most states, and
there may well be a similar 'loophole' with regard to this rule.
However, I'm afraid this is as far as my research has been able to
take me. Apologies.

Again, I would stress the importance of consulting your midwife on
this one.

Good luck,

grimace

Researcher was awesome, but like me could only find out so much info
via the internet.  Either way it was helpful, and I will keep
searching until I find the info I need.

audy5000g-ga, I'm curious as to why you feel erythromycin preventative
eyedrops aren't such a good idea. There's no criticism there, I'm just
curious. Thanks.

To answer your question, I do not believe that many of the procedures
done in the hospital are necessary.  The reason the whole eye
treatment started was to prevent blindness in babies who were born to
STD mothers.  But like many procedures in hospitals, they do not
consider you an individual but as a group.  It is cheaper and easier
just to administer these things to everyone instead of taking the time
to treat you as an individual.
Well I don't feel my baby needs to have that discomfort in his or her
eyes for the sake of procedure.  I am having a C-Section and I have no
STD's.  I also disagree with how the antibiotic is grown.  It is made
from bacteria or protozoa that lives in cultures or animal
inoculation.  It has alcohol and citric acid in it.  No thanks!  It is
unnecessary and painful.  I just want to know how to get around it
legally.

Audy,

I was of your same opinion regarding the usefulness of certain
hospital procedures on healthy newborns. For that reason I went with a
midwife assisted home-birth (Maryland.)  This was almost 20 years ago,
but as I recall the midwives provided me with all of the forms I
needed to exempt my baby from the eye drops and several other
“standard” preventive procedures normally administered to babies and
moms. You might try calling around to midwives or home-birth
organizations in Michigan and see if they can assist you. They seem to
have the inside scoop on how to get past some of these procedures.

Some places to start: 

Karen Kamyszek, Midwife  (22 yrs exp)
RR1 Box 300   Hancock, Michigan 49930
906-483-0074
http://www.maxpages.com/midwifekaren


American College of Nurse Midwives
http://www.acnm.org/about/chapters.cfm

Michigan  Chapters

Linda R. Stobinski-Johnson, CNM   ljohnson@midwifes.org 
Temperance (313) 847-7979 

Beth Hanson, CNM Western Michigan Chapter (616) 624-5271 

Robin Jordan, CNM
robjord@freeway.net Northern Michigan Chapter (616) 348-2701 

Good Luck!

-K~

I love this lack of knowledge that I am finding amongst patients.

Quite frankly, I'm not going to put my license at risk by not giving
an antibiotic because some patient "doesn't have chlamydia" or "isn't
screwing around".  We've all heard that one before.

I guarantee that, if the baby becomes blind, all of a sudden the
self-assured opinion that "e-mycin lotion in the eyes is crap" turns
into "Well, they should have told me this could happen....".

Lawyers follow; "Well, the mother isn't a nurse and her opinion is an
uninformed one.  You should have educated her before her child became
blind!!!!"

Of course, you have to educate within 2 hours.  To someone who has
just delivered.  Yeah, right!

Loss of licnence/career, loss of sight, big settlement, etc, etc.

I'm finding this same nonsense with vaccinations too.

I wont even waste my time with the comment above, but It did remind me
that I posted this question 3 years ago.  I thought I would post my
form that I made up for the hopital. Just incase others need it.

INFORMED CONSENT OF ERYTHROMYCIN ADMINISTRATION

We completely understand all the risks associated with having or not
having the Erythromycin administered into our infant?s eyes.  We
understand that it is state law, but we also understand that we can
absolutely refuse the treatment.  If the treatment is done regardless
of our request, it is called battery.

As the mother I do not have Chlamydia or Gonorrhea, so there is no
medical reason to pressure us into having this treatment done.  Even
if I were tested positive for the above, the baby could be treated
only if an infection developed.

Bottom line is this is our baby and we have the right to determine
what is or is not done.


Father's Name:                           Mother's Name:

Date:

I had no problems with the nurses or doctors (And I had a lot of
refusals).  In fact the neonatal surgeon commended me on my studies
and said more patients should be as informed as I was.  I am pregnant
again and hope that this time is smooth sailing as well.  You just
never know who you are going to have to deal with.  Could be a big
headed physician or nurse who believes they know all things, or could
be and understanding hospital staff that choose to trust a mother and
father who have done their research and only want whats best for their
children.