Swollen Eyes In Newborns: What's Normal And What's Not?

It is normal for newborns to have some degree of eyelid swelling, which usually subsides within the first few days of life. This puffiness may cause difficulty in opening one or both eyes, but a gentle examination can easily evaluate the eyes. Swelling can also be caused by crying, rubbing, or increased blood flow to the area, resulting in fluid retention. However, it is important to monitor for any infections or other conditions that may affect the eyes, such as conjunctivitis, blocked tear ducts, or allergies, which may require medical attention.

Swelling caused by crying or rubbing their eyes

It is normal for newborns to have swollen eyes, and this swelling usually goes down over the first few days. However, if your baby has been crying or rubbing their eyes, this can also cause swelling. Crying increases blood flow to the area, leading to fluid retention, and the eye tissue swells easily. Similarly, when babies cry, the body produces tears to clean the eyes, and during sleep, these tears accumulate in the tissue around the eyes, causing swelling. This type of swelling typically goes away soon after your baby wakes up.

It is important to ensure that there are no underlying infections or other conditions affecting your baby's eyes. If you notice any redness, discharge, or other symptoms, it is best to consult your healthcare provider for an accurate diagnosis and treatment. In the meantime, a cool compress can help reduce swelling and provide relief.

To prevent eye irritation and swelling, avoid taking your baby to dusty places, and if exposure to dust is unavoidable, ensure that your baby's eyes and nose are properly protected. Additionally, establishing a consistent sleep schedule can help reduce eye swelling caused by fatigue and crying.

Conjunctivitis (pinkeye)

It is normal for newborns to have some degree of eyelid swelling after birth, which usually goes away in a few days. However, if the swelling is accompanied by other symptoms, it may be conjunctivitis (pinkeye).

Conjunctivitis is an inflammation of the conjunctiva, the membrane that lines the eyelids and covers the whites of the eyes. It is often caused by a bacterial or viral infection, or sometimes by a reaction to eye drops. It is highly contagious and can affect one or both eyes.

There are several types of conjunctivitis that can affect newborns:

• Chemical conjunctivitis: This is a rare reaction to eye drops given to newborns to prevent bacterial infections. It usually starts a few hours after the drops are administered, causing red and inflamed eyes. It typically clears up on its own within 2 to 4 days and often doesn't require treatment.
• Gonococcal conjunctivitis: This type is caused by the bacteria Neisseria gonorrhoeae, which can be transmitted to the baby during vaginal birth from an infected mother. It usually appears 2 to 5 days after birth, causing severe redness, swelling, and thick fluid leakage from the eyelids. Treatment often involves intravenous antibiotics.
• Inclusion conjunctivitis: This is the most common type of bacterial conjunctivitis in newborns, caused by Chlamydia trachomatis. Symptoms typically start 5 to 14 days after birth and include red eyes, swollen eyelids, and fluid leakage. Oral antibiotics are often used for treatment.
• Conjunctivitis caused by other bacteria: After the first week of life, other types of bacteria can cause conjunctivitis. Symptoms include red and swollen eyes with some drainage. Treatment depends on the specific bacteria but often involves antibiotic drops or ointments, warm compresses, and proper hygiene.

If you suspect your baby has conjunctivitis, it is important to seek medical attention for an accurate diagnosis and appropriate treatment.

Blocked tear duct

It is normal for newborns to have some degree of eyelid swelling after birth, which usually goes away in the first few days. One common cause of swollen eyes in newborns is a blocked tear duct.

A blocked tear duct is a result of a tear-duct system that is not fully developed. Tears are made in glands under the eyelids and drain through the tear ducts, but when a tear duct is blocked, the tears cannot drain. Blocked tear ducts are common, with about 1 in 20 babies being born with a blockage in one or both tear ducts.

Babies with blocked tear ducts usually show symptoms between birth and 12 weeks of age, with symptoms including:

• More tearing than usual, even when the baby is not crying
• Dried crusting on the eyelashes
• Mild redness or irritation of the eyes or eyelids from rubbing

In some cases, the problem may not become apparent until the tear duct gets infected. An infection can occur when germs grow inside the blocked duct, and signs of an infected tear duct include yellow or green mucus draining from the eye.

A blocked tear duct usually gets better on its own without treatment by the time a child is one year old. However, if the blockage persists, a doctor may recommend seeing an ophthalmologist (eye doctor) to perform an eye exam and, if needed, clear the blockage. Treatment options may include surgery, such as probing the blocked duct with a thin metal instrument or placing tiny tubes to stretch the tear duct.

Insect bites

The symptoms of an insect bite include:

• Pain where the bite occurred
• A small, swollen lump on the skin, which may be red and difficult to see on darker skin tones
• A mark on the skin where the bite occurred

In some cases, insect bites can result in mild allergic reactions, causing itchiness and raised skin around the bite. If the bite becomes infected, the area may become more swollen and painful.

Mosquito bites typically cause itchy, red bumps that look like hives. They are usually harmless, but they can carry diseases in certain parts of the world, such as malaria and yellow fever.

To treat insect bites, you can:

• Apply a cold compress or cool cloth to the bite to reduce pain and swelling
• Use calamine lotion or hydrocortisone cream to relieve itching
• Prevent your child from scratching the bite to avoid infection
• Take antihistamines to relieve itching
• Use painkillers such as paracetamol or ibuprofen if the bite is painful

If you experience any of the following symptoms after an insect bite, seek urgent medical attention:

• Difficulty breathing or swallowing
• A large area around the bite becomes red and swollen
• High temperature and swollen glands
• Severe pain that does not improve with medication
• Signs of infection, such as a scab that looks infected or increasing redness and swelling

Allergies

It is normal for newborns to have some degree of eyelid swelling, which usually resolves over the first few days of life. However, if you suspect that your baby's swollen eyes are caused by allergies, there are several things to consider.

To treat allergic conjunctivitis, you can use cool compresses and lubricating eye drops (artificial tears). Over-the-counter anti-allergy eye drops can also be used, and if your child cannot tolerate eye drops, oral anti-allergy medications are available. If non-prescription treatments are ineffective, consult your doctor for stronger anti-allergy eye drops.

To prevent eye allergies, it is best to avoid exposure to allergens. Frequent hand washing can help remove allergens, and wearing glasses or goggles outdoors can be beneficial if your child is allergic to pollen or other environmental allergens.

Allergic conjunctivitis usually does not cause long-lasting damage, but frequent eye rubbing and eye infections can impact vision. Therefore, it is important to consult an eye doctor if you are concerned about your child's eye health.

In addition to allergic conjunctivitis, other types of allergies can also cause swollen eyes in newborns. These include food allergens, insect bites or stings, medication allergies, and latex allergies. Food allergens, such as cow's milk protein allergy, are particularly common and can cause swelling in the deeper layers of the skin around the eyes and lips. Insect bites near the eye can cause swelling, and contact dermatitis, an allergic reaction to irritants that come into contact with the skin, can also lead to swollen eyes.

If you suspect that your baby's swollen eyes are related to allergies, it is important to identify the specific allergen and take steps to avoid exposure. Mildly swollen eyelids can be treated with gentle cleaning using a warm, wet cloth, and cool compresses can provide relief from itching and pain. Antihistamines may also be helpful, especially if the swelling is caused by allergies.

In any case, if you have concerns or doubts about your baby's health, always seek advice from a healthcare professional as soon as possible.

Frequently asked questions