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Question: My daughter has pink eye. Does she really need antibiotics?

Christine Climer replies: If your daughter is enrolled in school or child care, she probably will not be allowed to attend until all her symptoms are gone or until she’s been on antibiotic drops for at least 24 hours. Bacterial conjunctivitis (pink eye) is quite contagious, so these restrictions are in place to prevent the spread of infection to other children within the group.

If you are able to stay at home with her, you might consider a study published in the June 2005 issue of The Lancet, which calls into question the practice of routine antibiotic administration for pink eye in children. Parents participating in the study were instructed to apply one drop to each of the child’s eyes every 2 hours for the first 24 hours and then four times daily until symptoms had been gone for 48 hours.

Researchers found that by the end of the seventh day, children who had been given antibiotic eye drops had the same cure rate as children given placebo drops containing only distilled water and boric acid. This solution is similar to the saline solutions contact wearers use. Discuss this option with your physician if you are wishing to avoid antibiotic drops.

Many mothers swear that adding a drop of breast milk to the eye eliminates infection; however, I am not aware of any research evaluating this practice. While breast milk may indeed have a beneficial effect due to its anti-bacterial properties, expressed milk can also contain bacteria — even straight from breast to eye. It is usually recommended that only sterile (bacteria-free) drops be put in eyes, to prevent causing further infection.

My personal feeling is that in many cases, the potential benefit of using breast milk directly from the breast outweighs the risk of inadvertent infection. Because I have no scientific evidence proving that this is safe, however, I would suggest that you speak with your health care provider first.

No matter which option you choose, you should be careful to prevent spreading the infection or re-infecting your daughter’s eyes. Change her pillowcase daily, wash her hands and yours frequently and avoid sharing washcloths or towels. Try either warm or cold compresses to relieve discomfort and loosen any crust on the eyelashes.

Your doctor may instruct you to call for help if she is an infant, if she doesn’t seem to be any better after three to four days, if she starts running fever or if the skin around the eye becomes red.

© Christine Climer

NFO Health & Wellness Editor Christine Climer is a registered nurse with experience in pulmonary disease, pediatrics, home health and hospice services. Also trained in early childhood education, she specializes in the promotion of early childhood health. She lives with her husband and three children (including a set of twins) in Texas and enjoys researching health issues and gardening.

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