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Ask Dr. Sears: Tearing Up

Q. My 1-month-old's left eye constantly fills up with tears and tends to be crusty. What could be causing this?

A. Your infant most likely has a blocked tear duct, very common among infants. Normally, tears drain through tiny openings in the inside corner of the eyes. When these ducts are blocked by a thin membrane  -- which should naturally break open shortly after birth but sometimes doesn't  -- tears can't drain properly, so they back up in the affected eye. This, in turn, causes crusty mucus to form on the eyes, lids, and lashes.

Most tear ducts will open by the time a baby is 9 months old. Until then, you can help unclog them by gently massaging the ducts, located beneath the tiny bump in the inside corner of the eyes. With a clean index finger, massage toward the nose in a circular motion throughout the day, such as before each diaper change or after each feeding. This puts pressure on the ducts, eventually popping them open.

Often, blocked tear ducts can lead to an infection, and you'll see yellow, pussy drainage. In that case, wipe it away with a warm washcloth and visit your doctor; he'll likely prescribe antibiotic eye ointment or drops. Also consider my wife's home remedy: Put a couple of drops of expressed breast milk, which is loaded with natural antibiotics, in the affected eye. Through the years, many mothers in my pediatric practice have found this method to be successful.

If the ducts don't open, your pediatrician may advise you to consult an eye specialist, who will open them with a tiny wire probe while your baby's under general anesthesia. This procedure sounds serious, but it's relatively quick and easy.

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