What to do if a newborn baby has pus and watery eyes: what to rinse, drops

A newborn's eye is festering - this is a very serious symptom that can be caused by an infectious disease of the respiratory tract or other organs, as well as by functional disorders of the visual organ. A lesion of the eye in a child should always be alarming, since not only vision depends on it, but also the child's development in the future, because he learns about the world around him through sight, hearing and smell.

Statistics on the spread of eye suppuration show that more than 12% of all children face this problem in the neonatal period. Among the causes, dacryocystitis is in first place, and adenovirus infection is in second place. This suggests that etiological treatment is very important in this case.

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Causes of purulent formations on the child's eye

Naturally, if a child's eye is festering, then there is an inflammatory process involving bacterial, fungal or viral flora. But the cause is not always directly an infectious agent. Therefore, all causes can be divided into two groups: infectious and non-infectious.

Among bacterial pathogens, any agent can cause inflammation. In this case, we are talking about purulent conjunctivitis. The cause of this process is the ingress of bacteria into the child's eye and active reproduction. In this case, the protective mechanisms cannot ensure the evacuation of the bacterial agent and an inflammatory process occurs. So the eye begins to fester. The pathogen is most often staphylococcus, streptococcus, bacilli. They enter the eye exogenously and cause an inflammatory reaction there. But not all children develop such an infection. Risk factors for the development of such inflammation are a long stay of the child in a hospital, where there is a constant circulation of microorganisms. In addition, children born with a ruptured fetal sac and meconium-containing fluid are prone to the development of bacterial conjunctivitis. The content of meconium in the amniotic fluid irritates the mucous membranes of the eye and can cause a predisposition to further inflammation.

If a newborn's eye is festering, one of the reasons for this may be gonorrhea in the mother. This disease is characterized by damage to the mother's genitals, and when the baby is born, the pathogen is tropic to the mucous membrane of the eye, it is sure to linger there. Soon this leads to the development of inflammation. But this is a very rare cause today, since all mothers are carefully examined before giving birth.

Among viral agents, the cause of festering eyes in newborns is adenovirus. Adenovirus infection is a widespread respiratory disease of children, which in most cases affects the conjunctiva, sclera, and lymphatic system. Adenoviruses reproduce in the epithelium of the respiratory tract, where characteristic intranuclear basophilic DNA-containing inclusions and adenovirus antigen accumulations can be found. The virus is tropic to all mucous membranes, so the inflammation is manifested by a strong exudative component. The cause of infection of newborns can be a sick person who is in contact with the child, or simply a carrier of the virus. Through droplets of saliva and air, the virus gets on tropic cells. Such cells are the epithelium of the nasopharynx or directly the conjunctiva. There, the virus multiplies and can cause inflammation of both regional lymph nodes and intestinal lymphatic plexuses through the lymphatic system. This causes the consistent development of all symptoms.

Why does a newborn's eye fester if there are no infectious causes for this and the child is completely healthy? A common cause of this in newborns is dacryocystitis. The pathogenesis of dacryocystitis is inflammation of the conjunctiva due to obstruction of the nasolacrimal canal.

The eye is protected from the action of microorganisms, sand by the secretion of tears. The tear flows out of the lacrimal sac at the outer edge of the eyelid and, washing the entire eyelid, flows into the nasolacrimal canal. So the tear ends up "in the nose" and all excess particles are removed from the eye. In children, when they are in the womb, the nasolacrimal canal is closed by a plug that has a gelatinous structure. After birth, this plug should be removed by itself. But this does not always happen, and this plug in newborns can remain on one side or on both sides. Then, when the outflow of tears is disrupted, stagnation occurs and conditions are created for the reproduction of microorganisms. This leads to the fact that the eye begins to fester. Thus, there is inflammation here too, but the bacterial agent in this case is a secondary factor.

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Clinic of diseases that are accompanied by suppuration of the eye in a newborn

Symptoms of adenovirus infection in a child may begin several hours or days after contact with a sick person and after infection. The first signs of the disease begin at the site of infection. Then the child's body temperature rises sharply and catarrhal symptoms appear. The child's nose is stuffy, and later acute rhinitis appears. Exudative processes are also observed on the back wall of the pharynx with pronounced granularity and looseness of the pharynx. The lymph nodes enlarge, reacting to the inflammatory process. Therefore, in addition to nasal discharge, the child may have a cough due to inflammation of the back wall of the pharynx. A few hours or on the second day after the first symptoms of the disease, eye damage in the form of conjunctivitis appears. In this case, the newborn's eye waters and fester precisely because of the conjunctival membrane being affected by the virus, which can also cause redness. The process is usually bilateral with alternating damage to first one eye, and then the other. In addition to pronounced local catarrhal phenomena, there are also systemic manifestations. The child has trouble breathing through the nose, so he sleeps poorly and cannot eat normally. The temperature may rise to subfebrile levels and last no more than three days.

One of the rare symptoms of adenovirus infection is intestinal damage. This may manifest itself as a slight bowel disorder that lasts no more than one day and does not cause discomfort to the child.

If a newborn's eye is very swollen and festering on one side, then this is most often a manifestation of dacryocystitis. The nasolacrimal canal plug, as a rule, remains on one side, therefore, manifestations of dacryocystitis are most often unilateral. Symptoms appear gradually and increase every day. The mother notices that the child's eye is festering, especially in the morning. The intensity of this decreases throughout the day, but every day it repeats itself again. The eye may look swollen, red, and often waters.

If the left and then the right eye of a newborn with dacryocystitis fester, then it is possible that a long untreated process leads to infection of first one eye and then the other. In this case, we are talking about a high probability of bacterial inflammation.

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Consequences and complications

The consequences of dacryocystitis are assessed after the first two weeks of the child's life. In most newborns, the nasolacrimal canal plug can dissolve by the end of the second week of life, so no action should be expected during this period.

If we are talking about a newborn's eye festering as a result of an adenovirus infection, then in this case there may be infectious complications. When the infection spreads to neighboring organs, otitis, sinusitis, and sinusitis may develop. Less frequent but more serious complications are pneumonia and pleurisy. Timely diagnosis of the cause of eye festering in a child allows you to prevent the development of any complications.

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Diagnostics

Pathologies are diagnosed immediately at the stage of examination of the baby. If, in addition to suppuration of the eye, there are other symptoms - rhinitis, fever, then most likely we are talking about a viral infection of the upper respiratory tract. In this case, you need to carefully examine the baby. First, you need to auscultate the lungs. At the beginning of the disease, when there are no complications, breathing should be vesicular. Next, you need to move on to examining the back wall of the pharynx. With a thorough examination with a spatula, you can see hyperemia of the back wall or arches, it is possible that the granularity of the back wall in newborns can be expressed insignificantly. The presence of these symptoms and manifestations of conjunctivitis indicates an adenovirus infection. For specific diagnostics of the virus, additional laboratory tests can be carried out. The material for analysis can be a scraping from the conjunctiva or from the back wall of the pharynx. Next, a polymerase chain reaction is carried out to detect the antigen of the virus in the material. The detection of a DNA-containing virus accurately indicates an adenovirus infection. But such examination is carried out very rarely, since the time spent on analysis does not allow to start specific treatment in time. Therefore, in the presence of a combination of clinical manifestations, a diagnosis can be established. Laboratory diagnostics, if necessary, are carried out in the following main directions. Firstly, specific viral particles are detected in the cells of the epithelial layer of the respiratory tract or conjunctiva using specific methods - immunofluorescence and enzyme immunoassay; stool analysis allows to isolate the virus infrequently, only if there are pronounced intestinal disorders. Secondly, identification of viral particles is carried out using a cell culture, on which they are grown with further study.

Thirdly, a diagnostic study of blood serum. For this, blood is examined at the onset of the disease for the level of antibodies against the virus, and then after two weeks the level of antibodies should increase fourfold. This allows for retrograde confirmation of the diagnosis.

Dacryocystitis should be diagnosed only by an ophthalmologist. A pediatrician should establish a preliminary diagnosis and refer the child for consultation with an ophthalmologist. When examining the child, it can be determined that only one eye is festering. When palpating, it can be determined that the inner edge of the eye in the area of the nasolacrimal canal is thickened. There may also be purulent discharge from the nose on the side of the affected eye. In this case, the child may snore and sniffle through the nose.

Instrumental diagnostics may be limited to test probing and washing of the nasolacrimal canal. For this, a physiological solution is taken and injected into the child's nasolacrimal canal in the area of the inner eyelid. In case of dacryocystitis, the liquid does not flow out through the nose.

Differential diagnostics

Differential diagnostics of eye suppuration in a newborn should be carried out with allergic conjunctivitis, diphtheria of the eyelid, bacterial primary conjunctivitis. Allergic conjunctivitis is a bilateral process, which in newborns is a rare single symptom, more often occurs in combination with skin allergic manifestations. Bacterial conjunctivitis forms dense green-yellow purulent plugs on the eyes, without catarrhal manifestations, unlike adenovirus. It leads to an increase in body temperature only due to inflammation of the eyes, even without the presence of other manifestations.

Diphtheria is a complex bacterial disease that is rare in the modern world due to vaccination. A newborn baby still has strong immunity from its mother, so diphtheria should be ruled out last. Films on the eyes with diphtheria form dense conglomerates that are very difficult to remove with hemorrhages.

These are the main diagnostic criteria that allow us to establish a preliminary diagnosis of suppuration of the eyes in a newborn.

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Treatment

When starting treatment for patients with conjunctivitis caused by adenovirus or accompanying any other viral infection, the following principles are used:

1. The child must be provided with round-the-clock supervision and care. A satisfactory appearance and good general health at the onset of the disease do not always correspond to the severity of the disease. Violation of the regime can sharply exacerbate the infectious process, worsen the course of the disease, and also contribute to the "dispersion" of viruses.
2. Full breastfeeding in small portions contributes to successful treatment. After all, mother's milk contains not only nutrients, but also factors of protection against viruses. It is necessary to remember the following circumstance: energy expenditure in children sick with viral infections does not change significantly, but the need for vitamins is much greater than in healthy children. Therefore, the mother should eat well when feeding a sick child.
3. Since conjunctivitis is dangerous not in itself, but due to possible complications, it is necessary to prescribe individualized complex treatment taking into account the premorbid state of the child’s body, preferring the most effective antiviral and pathogenetic agents.
4. Antibiotics and sulfonamides not only do not have antiviral activity, but also suppress the immune system, cause the development of dysbiosis and allergic reactions. Therefore, the use of these drugs is limited to specific clinical indications.
5. Fever in patients should be considered primarily as an important protective reaction of the body, which has developed in the process of evolution. Therefore, the standard prescription of antipyretic drugs can cause harm to the baby, sometimes irreparable. The mother must control the body temperature, but it is necessary to reduce the indicators above 38.5.

The use of interferons is promising in the treatment of newborns with eye suppuration of viral etiology. Interest in interferons has significantly increased at present.

It has been established that both natural and microbially synthesized interferon have significant therapeutic potential and are capable of protecting cells and the human body as a whole from a number of common viral infections.

A feature of interferons is their broad spectrum of immunotropic action. They activate T-lymphocytes, including T-helpers, which stimulate antibody formation, and T-helpers, which stimulate the maturation of natural killers, as well as some subpopulations of B-cells. Thus, under the influence of interferon, non-specific protective immune forces are activated in the cell.

If the main function of the immune system is to control the protein composition of multicellular populations, then in this system interferons play a leading role in controlling the genetic resistance of the organism. Normally, there are three variants of interferon activity of leukocytes: strong (more than 128 IU / ml), medium (32-64 IU / ml) and weak (less than 16 IU / ml) interferon producers. Most healthy newborns have a strong or medium ability to produce it. At the same time, 75% of healthy children do not show serum interferon. But newborns may not yet have a fully formed system of such an immune response, so they can get sick with varying degrees of severity.

Acute viral infections are mostly characterized by the transient development of interferon deficiency.

Short-term use of interferon in the form of inhalations for 2-3 days alleviates the course of any viral infections. At the same time, interferon injections cause too much of a violent reaction of the body and are themselves capable of provoking a flu-like syndrome.

Medicines for eye suppuration should take into account the cause of this process. In adenoviral conjunctivitis, antiviral drugs are among the main ones in eliminating symptoms.

1. The most accessible and cheap is the domestic interferon drug - Laferon. It exhibits a fairly pronounced antiviral and immunomodulatory effect. Clinical observation has shown that inhalation use of Laferon contributes to the rapid disappearance of signs of the disease, a significant reduction in endogenous intoxication and allergization of the body, normalization of immune shifts. At the same time, the duration of fever is reduced by 2.5-3 days, and manifestations of intoxication (in the form of malaise, adynamia, loss of appetite) are reduced by 3-4 days.

Inhalation use of Laferon has a positive effect on the cellular and humoral links of immunity, helping to eliminate the imbalance in the population composition of immunocompetent cells that has arisen as a result of the disease. After inhalation of Laferon, the immunoregulatory index (CD4 / CD8) is normalized, the induction of g- and a-IFninterferon is activated (by 2 and 1.6 times, respectively), and the content of serum immunoglobulin A increases.

The most optimal way to implement the virucidal effect of laferon is its inhalation administration.

The advantages of this are as follows:

• Rapid intensive absorption of laferon due to vascularization of the respiratory tract mucosa;
• Preservation of laferon in the submucosal layer;
• Direct action on the source of infection and the pathogen;
• Delivery of the drug directly to the affected cells of the target organ (this circumstance prevents the dispersion of the drug throughout the body).

Method of administration - inhalation at a dose of 500 thousand IU once a day. This dose of Laferon can be obtained by diluting an ampoule with 1,000,000 IU of Laferon in 5 ml of distilled or boiled water cooled to room temperature. 2.5 ml of this solution contains 500 thousand IU of Laferon. For inhalation of newborns, inhalers with a special mask should be used. Contraindications for endonasal and inhalation methods of Laferon administration have not been established.

2. Proteflazid is a product containing flavonoid glycosides isolated from domestic cereal plants. One drop of the drug contains 2 to 5 μg of these compounds. The mechanism of pharmacological action of Proteflazid is associated with the fact that plant flavonoid glycosides neutralize the action and activity of viral particles. This occurs by disrupting the synthesis of their DNA in epithelial cells. This leads to the cessation of the production of new viral particles. In addition, the glycosides of the drug increase the production of endogenous interferons, increase reactivity to infectious agents, and have a stimulating effect on the immune system, thereby helping to eliminate immunodeficiency. Treatment with proteflazid helps to normalize the CD3 + T-lymphocyte index and the CD4 / CD8 lymphocyte ratio. Thus, proteflazid is also effective and can be widely prescribed to sick children.
3. Rezistol is often used with antiviral agents. This drug has an antiviral and immunomodulatory effect, significantly improves protein metabolism, increases the content of immunoglobulins in the blood serum, and reduces the duration of the main clinical signs of viral conjunctivitis. The method of administration of the drug is in the form of drops. The dosage is 10 drops once a day. Precautions - use in newborns only as prescribed by a doctor. Side effects are rare, since the drug is herbal.
4. The antiviral drug Aflubin has a direct antiviral and interferon-stimulating effect with its low toxicity. The dosage of the drug depends on the period of the disease and can be from three drops three times a day to seven times a day. Side effects can be in the form of allergic reactions.

There are clear indications for the prescription of antibacterial therapy for conjunctivitis. In the case of uncomplicated viral eye inflammation, antibiotics are not used due to the possible increase in the body's allergization, inhibition of the formation of antiviral antibodies, and an increase in the number of complications.

In some cases, antibiotics are prescribed:

• Suspected bacterial conjunctivitis;
• Presence of congenital infections in the child;
• Duration of fever without symptoms from other organs;
• Very weakened patients;

Antibacterial agents should be prescribed strictly individually, taking into account concomitant pathology and possible side effects. Penicillin is not currently the drug of choice. If a bacterial inflammatory process is suspected, systemic antibiotics or local drops can be used. Eye drops for suppuration can only be prescribed by an ophthalmologist.

How to wash a newborn's eyes if the eye is festering? With confidence, at first, until you can see a doctor, you can use Floxal eye drops. These are eye drops based on the antibiotic ofloxacin, which has antibacterial properties and prevents further bacterial infection. The drug can be used for several days, one drop up to three times a day. Precautions - an open bottle can be stored for up to six weeks.

If a newborn's eye is festering due to dacryocystitis, then the most optimal treatment method is surgery. In some newborns, the plug comes out of the canal on its own. When do newborns' eyes stop festering with dacryocystitis? This happens by the end of the second week of the child's life. If the eyes continue to fester before this period, then massage is started. Massage is performed by circular movements in the direction from the outer to the inner eyelid of the child. This procedure must be performed several times. If the plug does not come out, then surgical methods are used.

Surgical treatment begins with systemic anesthesia. After this, the affected eye is washed with an antiseptic. Then a special thin probe is inserted into the inner edge of the eye and along the nasolacrimal canal the probe enters the nasal cavity. All secretions from the eye pass into the nasal cavity and the canal becomes passable. The procedure is completed by repeated instillation of antiseptic.

Physiotherapy is not used in the acute period. The mother can take vitamins for a viral infection in the child, which increases the activity of the enzymatic systems of the baby's body and helps in the fight against infection.

Folk remedies

Very often parents ask themselves the question, what to treat at home if a newborn has a festering eye? Naturally, folk methods of treatment can only be used with the permission of a doctor and at the discretion and responsibility of the parents. But there are some folk remedies that can be used. First of all, herbal treatment is often used to wash the eyes.

1. Chamomile infusion can be prepared as follows: pour boiling water over one sachet of pharmacy chamomile and leave for three minutes. Then strain the infusion and cool to room temperature. Wipe the child's eyes three times a day, starting from the outside and moving to the inside. This should be done with a sterile merle bandage and with caution. If only one eye is festering, both eyes should still be washed.
2. An infusion of cornflower and calendula flowers helps relieve not only irritation, but also has an antibacterial effect. To prepare the solution, take 30 grams of calendula flowers and the same amount of cornflowers and pour one liter of boiled water. Infuse for three hours and wipe your eyes twice a day while using etiological therapy.
3. Aloe has an antibacterial and immunomodulatory effect, so when a child's eyes are festering, using aloe is even recommended for a better treatment effect. To do this, you need to make fresh aloe juice and mix it with warm boiled water in a one-to-one ratio. You need to rinse the eye in the morning and evening for five days.
4. To prepare a medicinal infusion, take several nightshade seeds and three to four marshmallow leaves. Pour boiled water over the mixture and leave for 10-12 hours. Rinse your eyes with this infusion after diluting it in half.

How to treat if a newborn's eye is festering after surgery and this condition is repeated periodically. In this case, you can use homeopathic remedies that can be used for a long time, taking into account the individual characteristics of each baby.

1. Aconite is an organic preparation, which includes processed and diluted aconite infusion, which helps with acute conjunctivitis in children, which is accompanied by a burning sensation in the eyes, redness of the sclera. The drug can be given to a newborn in the form of granules. Dosage - three granules five times a day in the acute period. The granule can be crushed and given with breast milk. Side effects can be in the form of diarrhea, which goes away after several days of regular use of the drug. Precautions - do not use for treatment if the child has allergic reactions to iodine, since the drug is processed with the addition of iodine.
2. Mercury is a single-component homeopathic medicine for the treatment of conjunctivitis, which is used in chronic processes that worsen in the evening. The method of application of the drug is in the form of granules, the dosage for children in the acute period is one granule six times a day, and after the symptoms have decreased, it can be used three times a day. Side effects are burning, sneezing, itching in the nasal cavity.
3. Gepar sulfur is a complex homeopathic medicine used to treat conjunctivitis with severe purulent discharge. It can be used in the acute period of adenovirus infection against the background of etiopathogenetic therapy. The method of application for children is most often in the form of granules. Dosage - 10 granules once a day before meals for five days, with a further break for two days. The course of treatment is about two months. Side effects are very rare, there may be allergic reactions.
4. Pulsatilla and Arsenic are a combination of homeopathic preparations that help normalize local protective mechanisms of the conjunctiva and reduce the severity of allergic reactions there. For a newborn, the dose is one granule of pulsatilla and two granules of arsenic four times a day. Method of application - you can crush the granule and put it on the tongue without washing it down with water. Side effects are very rare, but there may be slight muscle twitching, which indicates the need to reduce the dose. The minimum course of treatment is one month.

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Prevention

Prevention of eye suppuration in a newborn is, first of all, proper care of the baby, breastfeeding and avoidance of sources of infection. All this allows you to provide the baby with good immunity and protect him from infections at such a vulnerable time - in the first month of his life.

Forecast

The prognosis for treating eye suppuration is positive, whether it is caused by a viral infection or dacryocystitis in newborns. In most cases, pathologies are immediately detected and actively treated, so complications occur very rarely.

When a newborn's eye is festering, it certainly requires not only the mother's attention, but also a doctor's consultation. This may be caused by inflammation in the eye itself of viral or bacterial etiology, or the problem may lie in age-related obstruction of the nasolacrimal canal. In any case, adequate treatment and care for the child are needed, then the prognosis is quite favorable.