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 |
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
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