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Ask Dr. Sears: Could My Baby Have a Blocked Tear Duct?

Q. My week-old newborn has pus or what some people may call "sleep crust" coming out of his right eye, much more than the other eye. Every time he wakes up, it's crusted so that he can't even open his eye. I am just wondering if it could be allergies or an infection. We are going to bring him to the doctor, but I thought maybe you can give some general input on what could be causing this?


A. Your newborn has an easily treatable problem called a blocked tear duct. It's very common  -- I see this condition with nearly half of the newborns in my pediatric practice. There are tiny tear ducts that normally drain the tears from the eyes into the cavities near the nose. Sometimes these tiny tear ducts are not completely open at birth or become clogged later on. Excess tears then well up in the eyes. As a general principle of the human body, if fluid can't normally drain, like water in a stagnant pond, it can get infected. This is what has happened in your baby. Here's how you and your doctor can clear up this condition.

Wash away the drainage. Using clear water on a clean, soft cloth, gently wipe the yellow discharge out of your baby's eyes. Do this several times a day or as often as necessary.

Massage the tear ducts. The tear ducts lie just beneath the nasal corner of the eyes. If they are very blocked, you can often feel a bump where the corners of the eyelids converge. Using the tip of a well-scrubbed finger, gently massage this area moving your fingertip in a semi-circle from the corner of the eye inward toward the nose. Do this for around five to ten strokes at least six times a day. Make it part of your daily routine, before every diaper change for instance. Putting gentle pressure on the fluid-filled tear duct will often force the fluid through the clogged passages and open them up.

Apply mother's milk. Mothers taught me about the antibiotic value of breast milk many years ago. It's an effective home remedy, if you are breastfeeding. Around six times a day, express a couple drops of your milk onto the tip of a clean finger and place them in the nasal corner of his draining eye. Each drop of your milk contains millions of infection-fighting white blood cells and natural antibacterial substances. And, it is kinder to sensitive little eyes than prescription drugs.

See the doctor. If these remedies don't clear up the discharge, your doctor may prescribe an antibacterial ointment or drops to be used four times a day until the tear duct opens and no further discharge occurs. Your doctor will probably advise you to use the prescription medicine in addition to all the above home remedies. On each routine well-baby checkup, report the status of your baby's tear-duct drainage to your doctor.

As baby grows, so do his tiny tear ducts. Most blocked tear ducts open and drain normally within a few weeks to a few months of using these home and doctor-prescribed treatments. Occasionally, tear ducts may remain closed because the nasal end of the ducts are sealed with membranous tissue. If they haven't opened and are still not draining normally by the time your baby is nine months old, your doctor may refer you to a pediatric eye specialist for a procedure called tear-duct probing. This brief procedure is usually done in the doctor's office. A tiny wire is inserted through the tear ducts to unclog the passages. While usually this is done as a quick doctor's office procedure, sometimes in older babies it is done on an outpatient basis in the hospital under a light, general anesthesia.

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