Friday 15 December 2017

Dear Dr Nina: Could breast milk really cure my son's eye problem?

I have a three-month-old son who is a great eater and sleeper and is a very happy baby. However, ever since he was born he has had lots of mucous coming out of his right eye, and often when he wakes in the morning his eye is crusted over.

 I have been told of various ways to deal with it. The public health nurse has suggested that I spray breast milk into his eye, but I don't know if that is such a good idea. While another mother at one of the toddler groups we attend, told me her older child had it, and grew out of it after a year. What do you think? Should I spray the breast milk? Or will he grow out of it?

Dr Nina replies: In newborn babies recurrent tearing and discharge from the eye may be quite common. Parents often get distressed thinking there is a serious underlying problem. They need not be over concerned. It is usually due to a blocked nasolacrimal duct.

Tears produced in a tear gland in the upper eye drain from the eye through the tear duct which runs from the inner corner of the eye to the back of the nose. Some 5pc of newborn babies will have an immature tear duct. This is usually due to the failure of a membrane at the end of the duct to open at or near the time of birth. This causes an effective blockage in the drainage system.

Watering or tearing of the eye may start days or weeks after birth. Sticky discharge occurs at times, as the normal process for clearing bacteria from the surface of the eye is impaired. Symptoms sometimes increase during a cold or respiratory infection as tear production may be increased.

Thankfully the tear duct issue resolves itself in 90pc of cases by the time the child is twelve months and so specialist review or any kind of procedure is not necessary unless infections are severe or symptoms persist beyond the first year of life. If the condition continues beyond a year the child is usually referred to an eye specialist and surgery is sometimes required to open the tear duct.

If discharge is thick or the conjunctiva is becoming red or inflamed, infection may be present. This is usually treated with antibiotic ointment or drops which can be very effective. The conjunctiva is the white part of the eye and redness here could suggest infection.

Antibiotics don't clear the duct and so if the duct is narrow or immature discharge can reoccur. Taking a medical swab of the eye will help to identify the bacterial cause of an infection. Treatment may be guided based on the result of these swabs.

For cases where infection is not present regular 'eye toilet' can help. This involves applying a compress of cooled boiled water to the eye. Massaging from the inner corner of the eye to the outer corner of the nose and from the side of the nose to the inner corner of the eye will help clear any debris from the nasolacrimal duct. Then put a drop of baby shampoo into the water and cleanse along the lashes as if you were removing mascara. Baby shampoo helps to emulsify any waxy discharge which may be hard to remove with water alone. Black tea also works to help emulsify waxy discharge. I am not familiar with the benefits of putting breast milk on the lashes and this is not something I would advise.

Eye toilet may need to be done many times a day. It may also be necessary to continue this for many months. If symptoms persist more than a year you may be referred to see an eye specialist who can perform a procedure to clear or open the duct.

Recurrent sticky eye in newborns is rarely due to other bacterial infections such as chlamydia, gonorrhoea or viral infections. In these cases the conjunctivae is usually red and infected and the baby may be unwell in itself. These causes are rare. Most of these infections are present at birth and as such are picked up in the hospital prior to transfer home.

Is it bad for your health to hold your wee?

The urinary tract acts as a drainage system to help the body rid itself of toxins and excess fluid. Urine is produced in the kidney, travels down a tube called the ureter to the bladder where it is stored until a person decides to pass urine. It then travels from the bladder down another tube called the urethra and out of the body. Urine is normally sterile.

 It is important to pass urine when the urge occurs and avoid resisting the urge to go. It is also important for healthy functioning of the urinary tract that the kidneys are flushed with plenty of fluids and that the bladder empties regularly.Passing urine after intercourse will also help flush out any bacteria that may have entered the body.

If we don’t look after the urinary tract one of the most common complications is a urinary tract infection (UTI). UTI’s are the second most common type of infection in the body and left untreated, serious UTI’s can cause infection of the blood and kidney failure.

If you have a UTI you may feel the urge to urinate more frequently but only pass a small amount. There may be pain or stinging passing your urine and it may even appear cloudy, foul smelling or blood tinged. Other symptoms include back pain, fever, nausea or pressure or pain in the abdomen. In pregnant women, the elderly or children symptoms may be very vague, but still may require a trip to the GP to rule out infections.

Resisting the urge to pass urine may, over time, affects the nerve response in the bladder leading to an over or underactive bladder. This ultimately may lead to ‘urge incontinence’. As with most things in health, prevention is the best way. So drink plenty and wee often.

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