A nurse is caring for a newborn immediately following birth.
For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?
A.
To facilitate bonding between the newborn and parent.
B.
The newborn weighs less than 2.5 kg (5.5 lb).
C.
To allow manifestations of infection to be identified.
D.
The newborn was delivered via cesarean birth.
The Correct Answer and Explanation is:
The correct answer is A. To facilitate bonding between the newborn and parent.
In the immediate postpartum period, facilitating bonding between the newborn and parent is a crucial aspect of care. One of the ways bonding is promoted is through early skin-to-skin contact and eye contact between the parent and the newborn. The application of antibiotic ophthalmic ointment, typically erythromycin, is a standard procedure to prevent neonatal eye infections such as ophthalmia neonatorum, which can be caused by exposure to bacteria like gonorrhea or chlamydia during birth.
However, applying the ointment right after birth can temporarily blur the newborn’s vision, as the ointment causes a mild film over the eyes. Newborns are naturally alert during the first hour after birth, and this period is considered optimal for bonding through eye contact between the parents and the infant. Delaying the instillation of the ointment allows for uninterrupted bonding, enabling the newborn to focus on the parent’s face, which can be particularly important for establishing an emotional connection and promoting breastfeeding.
The rationale behind delaying the ointment application for a short period is to maximize this bonding opportunity. However, it is essential to administer the ointment within the first one to two hours of life to ensure protection against potential eye infections. The delay should be brief and is not recommended for an extended period, as untreated bacterial exposure can lead to serious complications.
The other options are incorrect. Newborn weight does not affect the timing of antibiotic administration (B), delaying the ointment does not help in identifying infections (C), and cesarean birth (D) does not preclude the need for antibiotic prophylaxis, as the infant could still be exposed to infectious agents.