HOW TO TAKE CARE OF A NEWBORN WITH EYE DISCHARGE

I had a short consultation with a new mom and the encounter left me to ponder again and again the word of our Lord Jesus Christ as contained in John 9:1-3. It reads, “As He passed by, He saw a man blind from birth. And His disciples asked Him, ‘Rabbi, who sinned, this man or his parents, that he would be born blind?’” Jesus answered, “It was neither that this man sinned, nor his parents.”

The encounter goes thus…

Patient: Good morning doctor

Doctor: Good morning ma, how may I help you?

Patient: My newborn is seven days old, and his eye leaks out yellowish discharge, it dries up when he sleeps and then he can’t open his eye when he wakes up. It gives me concern.

Doctor: Have you administered any medicine or substance in the eyes?

Patient: I have been advised to put breast milk in his eyes, but I just put a little, the eyes are not just opening. I have tried putting eye drops but could not because the eyes refuse to open.

Doctor: Is that all ma? Have you used any herbal concoction?

Patient: Not at all, but I have been putting the local eye pencil to remove the impurities from my baby’s eyes.

Doctor: How was your delivery? Where did you deliver your baby?

Patient: Delivery was uneventful; I delivered at a Primary Health Care centre.

Doctor: Has your baby been immunised?

Patient: No, I will have him immunised and circumcised after the eighth day. Doctor, my baby is okay; all I want from you is to help open my baby’s eyes.

Doctor: I will need to admit your baby for proper care, treatment and investigations. The eye discharge can lead to blindness, meaning your baby may not be able to see for life. We need to take immediate action.

Patient: No way, my baby will see once the eyes are open. Tomorrow is the naming ceremony. Kindly help open the eyes. We will be back tomorrow for the admission after the naming ceremony.

The baby was received from the mother and an infusion (drip) called ‘normal saline’ was used to irrigate the eyes. The eyes opened and the mother was ecstatic. She paid her bill for the treatment and investigations but never came back for the investigations.

She was called on phone a day after the naming ceremony. She thanked us for opening her baby‘s eyes and said her baby was now very okay.

If this child turns blind and the question of who sinned is thrown open to the public, it is clear that our answers will be the mother, since many of her acts and actions were not just right.

Ophthalmia neonatorum

Neonatal conjunctivitis or ophthalmia neonatorum is a form of conjunctivitis contracted by newborns during delivery. The baby’s eyes are contaminated during passage through the birth canal from a mother infected with Neisseria gonorrhoeae , Chlamydia trachomatis or Herpes simplex virus.

If left untreated, it can rapidly progress to blindness and should be considered an ophthalmic emergency. Early referral to an ophthalmologist is essential.

Purulent discharge, watery discharge and blood-stained discharge are highly specific for Chlamydia. Herpes simplex conjunctivitis usually causes a non-purulent and serosanguineous discharge. A greenish discharge is more characteristic of pseudomonas aeruginosa infection, while gonorrhoea infection causes the neonate to have red, swollen eyes with purulent discharge.

Early treatment and urgent referral to a specialist centre are essential. Ensure that mother is tested for gonorrhoea, treated and contact traced. Ophthalmic ointment containing 0.5 per cent erythromycin is typically applied to the newborn’s eyes within an hour of birth as prophylaxis against gonococcal ophthalmia.

Sticky eyes: Sticky eyes occur when the extremely fine tear duct that leads from the inner corner of the baby’s eyes (near the nose) is blocked by fluid and debris (such as amniotic fluid). Newborns have difficulty flushing their own eye out, as they do not produce tears in the early weeks.

The sticky eye(s) should be bathed frequently with sterile salt water and clean cotton balls. Some parents will use cooled boiled water in the absence of sterile salt water. The tear duct (lying under the skin between the inner eye and nose) can also be gently massaged towards the baby’s nose, to help clear the duct. If sticky eyes are not bathed regularly, the stagnant, sticky secretions can occasionally lead to an infection of the tear duct or conjunctivitis.

Puffy eyes: Both upper and lower eyelids are oedematous (swollen) so that the conjunctivas are not visible. There are no extra secretions. This is usually bilateral and no treatment is required.

The eyelids may be oedematous and moist, but there is no stickiness and no crusting of the lids. This is usually bilateral and simple sterile eye irrigation with saline infusion is required.

Nasolacrimal duct obstruction: Nasolacrimal duct obstruction is caused by an imperforate membrane at the end of the nasolacrimal duct. It causes persistent tearing, crusting or matting of the eyelids, and spilling of tears without conjunctivitis. It may indicate nasolacrimal duct obstruction, which is usually unilateral.

Mucopurulent material discharge may occur and indicate need for ophthalmic antibiotics.

Conservative management is recommended in the first year of life, as the majority of cases will resolve spontaneously or with massage.

Prevention

Parents or care providers should wash their hands frequently to prevent transmission of neonatal conjunctivitis. Some years ago, all new born eyes are routinely bathed with silver nitrate solution to prevent this infection, but it was found that it causes chemical conjunctivitis. The eye drops that may be used routinely now is erythromycin eye ointment

HOW TO MANAGE RED EYE IN A NEW BORN

I have decided to write today’s piece titled “How to take care of a red eye in a newborn’’ in response to a question from another reader.

Her question: My newborn son has red spots in the white parts of his eyes. Is this the same as opthalmia neonatarum mentioned in your last article? Will they ever go away? I have also used breast milk in both eyes but all to no avail.

These red spots are called subconjunctival haemorrhages. They are common in newborns and typically result from the normal trauma of birth. As newborns are squeezed through the birth canal blood vessels (on the eyes and elsewhere) can rupture.

Subconjunctival haemorrhages are bruises of the eye. As with any bruising in newborns, they increase the risk of jaundice.

Subconjunctival haemorrhage is a frequent finding in normal newborns. This condition is also called red eye. It is different from opthalmia neonatarum, which is an infection of the eye and presents with eye discharges

Symptoms

The red area may be large or small but is always confined to the limits of the sclera. It is asymptomatic, does not affect vision, and spontaneously resolves in several days. This infant may have significant facial bruising as well as the eye finding.

Subconjunctival haemorrhage is a bright red patch appearing in the white of the eye.

Also in older children, a subconjunctival haemorrhage occurs when a small blood vessel breaks open and bleeds near the surface of the white of the eye (conjunctiva). It may happen without injury and is often first noticed when one wakes up.

Sudden increases in pressure, such as violent sneezing or coughing can cause a subconjunctival haemorrhage in children. In such children, the doctor must make sure the cough is appropriately treated and the face will appear clear gradually.

Treatment

Subconjunctival haemorrhage resolves on its own over two to four weeks in the newborn. It requires no treatment, just as there is no need for eye drops.

General prevention

The tiny, delicate eyes of a newborn baby need proper care because it is important to keep them clean and healthy.

Using a soft a cotton ball (wool) and plain water, one can carefully cleanse the baby’s eyes. Dampen the cotton ball with a little bit of lukewarm water. With the baby’s eyes closed, gently wipe the eyes from the inside to the outside corners. Use a new cotton ball for each eye.

There is the need to teach pregnant women the importance of treating sexually transmitted infections, such as herpes simplex, gonorrhea, and chlamydia in order to decrease the incidence of neonatal conjunctivitis.

Conclusion

There are over 10 eye conditions in newborns. Some are self-limiting while others need paediatricians and ophthalmologists’ attention.

10 WAYS TO PREVENT CANDIDA INFECTIONS

CANDIDIASIS

Candida is a type of yeast that naturally lives inside the body, but when there is an overgrowth of the yeast it can have a negative impact on the body's immune system and cause various infections.

Symptoms of Candida are fatigue, gas and bloating, recurring yeast infections, abdominal pain, oral thrush, fungus, dizziness, depression and acne.

There is a variety of factors that can lead to a Candida overgrowth, but in general it is caused by a weakened immune system, which cannot regulate the growth of Candida in the body. The immune system can be weakened by stress, illness and various medications.

Many modern foods that have been processed or contain refined ingredients that are commonly found in junk food encourage 

10  WAYS TO PREVENT CANDIDA INFECTIONS

1.    Avoid foods that amplify Candida growth, such as sugar, dairy, yeast, caffeine, alcohol, nicotine and wheat.

2.    Avoid foods high in sugar, dairy, yeast, wheat and caffeine. These types of ingredients are believed to promote fungal overgrowth

3.    Eat yogurt: Many experts also recommend eating lots of yogurt that contains Lactobacillus acidophilus, a "good" bacteria believed to keep Candida albicans in check.

4.    Ingest probiotics, which can be found in some yogurts or supplements, which fight against Candida growth.

5.    Make vegetables that are high in fiber and low in starch the basis of your diet. Vegetables such as cabbage prevents Candida overgrowth.

6.    Onions, garlic and ginger root are also effective anti-fungal foods.

7.    Eat high-protein foods such as fish that has not been treated with antibiotics, organic chicken and turkey, eggs and nuts.

8.    Practice good oral hygiene: This includes brushing regularly, flossing, using an antiseptic mouthwash (e.g., Listerine), and reducing/eliminating the use of tobacco

9.    Vaginal yeast infections: To help reduce the risk of vaginal infections, wear loose, natural-fiber clothing and undergarments with a cotton crotch. Also, stay away from deodorant tampons and feminine deodorant sprays.

10.Reducing stress and having  plenty of rest

CANDIDA INFECTION OF VAGINA

 

CANDIDA INFECTION OF PENIS

 CANDIDA INFECTION OF THE MOUTH