Pink Eye in Babies and Toddlers

Your little one’s eyes are red and watery. Is pink eye to blame? It could be, since pink eye is one of the most common eye infections in American kids and adults, with around 3 million cases diagnosed every year.

Although pink eye is uncomfortable and can be extremely contagious, it fortunately looks a whole lot worse than it actually is. Here’s what you need to know to keep it under wraps, from symptoms of pink eye in babies to treatments and home remedies.

What is pink eye?

Pink eye (officially known as conjunctivitis) is an inflammation of the conjunctiva, or the membrane lining the eyes and lids. The white part of the eye turns pink or red — the most telltale symptom of pink eye in babies — as the eye’s blood vessels become inflamed due to an infection, irritant or allergies. You can have pink eye in one eye or both eyes, and some types can be very contagious.

Causes of pink eye in babies and toddlers

There are several causes behind pink eye in babies and toddlers:

• Viruses, many of which also cause colds, are the most common cause (in fact, kids often develop pink eye when they get the sniffles — so you can think of conjunctivitis as a "cold" in your toddler's eye)
• Bacteria, some of which also cause strep throat
• Allergens like dust, pollen, animal dander or mold
• Irritants including smog or chlorine

It’s also possible for a sexually transmitted infection (like gonorrhea and chlamydia) to pass from a mom to her newborn at birth, causing pink eye — which is why all babies are given antibiotic eye drops or ointment upon arrival. These eye drops may cause mild chemical pink eye, which should go away on its own.

Is pink eye contagious?

Bacterial and viral pink eye are both very contagious. They’re transmitted by coughing, sneezing and hand-eye contact with eye secretions.

Pink eye from allergies or irritants is not contagious.

Pink eye symptoms in babies and toddlers

Pink eye symptoms in babies and toddlers vary depending on the type of infection and the severity.

The following symptoms of pink eye in babies can help you to determine the cause of the infection:

Viral infection

• One or both eyes are pink
• The same eye(s) is watery  
• Toddlers may tell you that their eyes burn
• Your child may also have a cold or adenovirus, which is a virus commonly linked to pink eye that may cause fever, sore throat and other symptoms of a chest cold

Bacterial infection

• One or both eyes are pink or red
• The same eye(s) has yellow or green discharge
• Toddlers may tell you that their eyes hurt
• Your child may also have an ear infection, which often accompanies bacterial pink eye

Allergies

• Both eyes are red and teary
• They're accompanied by a stuffy or runny nose
• Toddlers may complain of an itchy nose
• Other allergy-like symptoms appear when local pollen counts are high

Chemical irritants

• Both eyes are red and teary  
• The eyelids look puffy 
• Symptoms appear after swimming in a pool or when air pollution levels are high

Treatments for pink eye in babies and toddlers

Pediatricians prescribe antibiotics if they suspect a bacterial infection. Only a bacterial infection responds to antibiotics.

Since viral pink eye goes away on its own, if your doctor thinks a virus is behind your child’s symptoms he or she will likely recommend steps to avoid spreading the infection and help your little one feel better while you wait it out.

If your doctor suspects that your child has allergic pink eye, he or she may recommend antihistamine eye drops. In the case an irritant like chlorine is causing the redness, your doctor may help you rinse your child’s eyes or suggest using special eye drops. Just be sure to get your doctor’s okay before using anything in your child’s eye.

Otherwise, you can keep your child comfortable with the following home remedies for pink eye in babies and toddlers:

• Wipe goop and crusties from your toddler’s eyes using clean, wet cloths, gauze or cotton balls, especially in the mornings and after naps.
• Apply compresses (warm if it's bacterial/viral; cool if it’s allergies or other irritants) to reduce the swelling.
• With your doctor’s approval, offer your child an age-appropriate dose of acetaminophen to relieve the discomfort. If your child is 6 months or older, you can give her ibuprofen with your doctor’s approval.
• Use over-the counter lubricating eye drops (artificial tears) — but only after checking with your child’s doctor. (Never use red-reducing drops like Visine, which can make symptoms worse.)
• Some blogs recommend using breast milk on pink eye, but research has shown this doesn’t work. In fact, breast milk may introduce new bacteria into baby’s eye, which can cause serious eye infections. So skip the breast milk — and never put anything into your baby’s eye without checking with your doctor first.

How long does pink eye last?

Viral and bacterial pink eye usually run their course in one to two weeks. The symptoms of bacterial pink eye should get better within 24 hours of starting antibiotics.

How do you prevent pink eye from spreading to others in the family and other children?

Because kids rub their eyes a lot and then touch things (meaning everything and everyone!), one child with a case of contagious conjunctivitis can start an epidemic in day care or preschool and at home. So if your little one has a case of pink eye, it's best to keep her home if she appears ill or has a fever. 

To help prevent your child’s infection from spreading to the rest of the family, follow these tips:

• Change your child’s bed linens and towels every day.
• Use a clean towel or tissue every time you wipe your child’s face and eyes.
• Wash used towels and bedding in hot water separately from the rest of the family laundry.
• Make sure everyone in your house uses his or her own washcloths and towels. This is one time when you don’t want to encourage sharing!
• Ask everyone to be extra careful about washing their hands frequently with soap and warm water for at least 20 seconds. Encourage your tot to keep scrubbing until she’s gotten through two verses of the "Happy Birthday” song.
• Wipe or spray disinfectants on commonly-used items around the house, including the faucet, door handles and plastic toys.
• Inform your child’s day care center that your little one has pink eye so that they can disinfect the area.
• Remind every family member not to touch his or her eyes.

Can pink eye become more serious? How long does it usually take to clear in babies and toddlers?

Pink eye infections should clear within three to five days with treatment or up to two weeks without treatment (if it's viral, for example). Any infection that lingers longer should be reevaluated by your pediatrician. Also see your pediatrician right away if your baby or toddler seems to have a hard time seeing, is very sensitive to light (especially indoor light), or if her eyes are extremely red.

Rarely, severe cases of pink eye can be caused by the herpes virus (you’ll usually also notice blisters on the skin), chickenpox or measles. In the case of a measles infection, a measles rash will usually show up around the same time as pink eye.

If your doctor suspects a more severe case of pink eye, he or she will test a sample of discharge from an infected eye. If a more serious infection is responsible for pink eye, your doctor will likely prescribe an antiviral medication.

Any time you notice pink eye discoloration in your baby, it’s a good idea to check in with your pediatrician. Even if you suspect it's only allergies, treatment can help your little one feel better — and if it’s an infection, you’ll hopefully avoid sharing it with the rest of the family!