(905) 527-8919 -- 189 Hughson Street South, Hamilton, ON L8N 2B6 -- info@hamiltonmidwives.ca
(905) 527-8919 -- 189 Hughson Street South, Hamilton, ON L8N 2B6 -- info@hamiltonmidwives.ca
Erythromycin eye ointment and vitamin K injections are two medications recommended to be given to all newborns within the first few hours of life.
The Canadian Health Protection Act requires care providers to put erythromycin ointment (or some suitable alternative) into the eyes of newborn babies to prevent infections of the eye. The infections are caused by several vaginal bacteria, including gonorrhea and chlamydia. The mother may not know she has these infections. The baby comes into contact with the bacteria as it is born. An infection that may develop, especially if untreated, can result in blindness in the newborn.
Erythromycin is an antibiotic ointment that is effective against these organisms. It prevents the infection from occurring. The ointment is usually put into the baby’s eyes an hour to two hours after birth. The baby’s vision will be blurred for a short time after the ointment is put in the eyes. The ointment does not cause stinging or pain. Occasionally, a baby may have redness or minor swelling as a result of the ointment.
Vitamin K is needed for blood to clot properly. Vitamin K is made in the bowel (intestine) by bacteria. Babies have no bacteria in their bowels when they are born, so they are not able to make vitamin K for some time. Occasionally babies do not have enough vitamin K to allow their blood to clot properly.
Babies who have low vitamin K are at risk for spontaneous bleeding. This condition, known as hemorrhagic disease of the newborn, can be very serious because it can cause bleeding into the brain (like having a stroke), into the kidneys, or into the intestine, and can lead to death.
Since the 1960s, vitamin K has been given routinely to newborn babies. In Ontario, it is given by injection (intramuscular) into the baby’s thigh. One dose of 1.0 mg of vitamin K given within one to two hours of birth reduces the risk of bleeding problems to almost zero.
We do not know of any side effects from Vitamin K.
A simple screening blood test that involves taking a small amount of blood from the baby’s heel can indicate whether a baby has PKU or a problem with thyroid function. This test is generally done between 24 hours and 10 days following the birth.
Phenylketonuria (PKU) is a rare condition, (approximately 1 in 16,000) in which a baby is unable to produce enough of an enzyme called phenylalanine hydroxylase. This results in a build-up of a protein commonly found in breast milk and many foods, a protein called phenylalanine. Too much phenylalanine interferes with the central nervous system and the breakdown of proteins. It can cause behavioural problems, seizures and mental retardation.
The blood sample is sent to a laboratory for analysis. The result generally takes two to four weeks.
PKU can be mild to severe. Treatment includes a special diet low in phenylalanine. Breastfeeding is generally possible, depending on the severity of the disease.
As part of the same blood test for PKU, babies can be tested for thyroid function. The blood test measures the amount of thyroid stimulating hormone (TSH). This may indicate a baby has congenital hypothyroidism. The incidence of thyroid problems in babies in Ontario is approximately 1 in 4000.
Hypothyroidism (low thyroid function) is a condition where the thyroid gland does not produce enough thyroid hormone to meet the needs of the body. The properly functioning thyroid gland is essential for normal physical and mental development.
If congenital hypothyroidism is suspected through newborn screening, specialist follow-up is recommended. A second more specific blood test and a thyroid scan can diagnose the cause of hypothyroidism.
The treatment for congenital hypothyroidism is the medication thyroxine. The medication is taken daily and effectively replaces the missing hormone or hormones.
Canadian Task Force of the Periodic Health Examination. Prophylaxis for gonococcal and chlamydial opthalmia neonatorum. CMAJ 1992;147(10):1449-53.
Enoch J. Vitamin k: is it necessary? Midwifery Today 1996 Winter:28-30.
Frye A. Understanding diagnostic tests in the childbearing year. 6th Ed. Portland: Labrys Press, 1997.
Information pamphlet for children with congenital hypothyroidism. Hospital for Sick Children, Toronto.
Newborn screening. (handout). Ontario Ministry of Health and Long-term Care, 1999.
This brochure was produced by:
The Hamilton Midwives
100 – 131 John Street South
Hamilton ON L8N 2C3
Phone (905) 527-8919
E-mail: info@hamiltonmidwives.ca