Sticky and Pink Eyes in Babies: Causes and What to Do

Sticky eyes are one of the first things to alarm new parents. The baby wakes up, one eye is gummed shut with yellow goo, and you're pulling apart eyelids that feel stuck together. It usually looks worse than it is. Most sticky eyes in young babies are a plumbing problem — a tear duct that hasn't fully opened yet — not an infection.

This article walks through what causes sticky eyes at different ages, when it's just plumbing, and the red flags that mean you should be on the phone to the GP.

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Blocked Tear Duct: Far the Most Common Cause

The nasolacrimal duct is the tiny tube that drains tears from the inner corner of each eye down into the back of the nose. About 1 in 10 babies is born with one or both ducts not fully open. Tears and the natural mucus they carry can't drain, and the eye looks watery and sticky. This condition is called dacryostenosis or congenital nasolacrimal duct obstruction.

What it looks like:

• The eye waters constantly, even when the baby isn't crying.
• After sleep, the eyelashes are crusted with yellow or whitish discharge that wipes off easily.
• The white of the eye is not red.
• The eyelid is not swollen.
• The baby is otherwise well — feeding, comfortable, alert.

What to do:

• Clean gently with cooled boiled water on cotton wool. One swipe per eye, from the inner corner outward, then a fresh piece of cotton wool for the next swipe. Don't reuse.
• Lacrimal sac massage two to three times a day. With a clean little finger, apply gentle downward pressure on the side of the nose just below the inner corner of the eye, and stroke down toward the nostril. About 5–10 strokes. This helps push the membrane at the bottom of the duct open.
• Patience. Around 90 per cent of cases resolve by the baby's first birthday.

If symptoms persist after 12 months, the GP can refer to ophthalmology. A short procedure called probing of the duct is sometimes done under brief anaesthetic, with high success rates.

The blocked duct is not infected unless the eye becomes red and swollen. If that happens, see the GP — sometimes secondary infection (dacryocystitis) develops and needs antibiotics.

Bacterial Conjunctivitis

True bacterial conjunctivitis looks different from a simple sticky eye:

• Thick yellow or green pus, not just crust on the lashes.
• Red whites of the eye.
• Eyelid swelling, sometimes pronounced.
• Often one eye first, then the other within a day or two.
• Baby may be uncomfortable but is generally feeding and behaving normally.

The usual bacteria are Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae.

Treatment:

• Chloramphenicol eye drops are first-line in the UK. Available over the counter for children aged 2 and over; on prescription only for under-2s. Drops every 2 hours for the first 2 days, then four times a day for a total of 5 days, or as directed. Continue for 48 hours after the eye looks normal.
• Eye cleaning with cooled boiled water continues alongside the drops.
• Wash hands before and after touching the eye area.
• Don't share towels, flannels, pillowcases. Wash and change them daily during the infection.

Most bacterial conjunctivitis improves within 2–3 days of starting drops. If it isn't clearly better after 5 days, see the GP again.

Viral Conjunctivitis

Viral conjunctivitis usually accompanies a cold. Common viruses include adenovirus, rhinovirus, and the family of viruses that cause routine respiratory infections.

What it looks like:

• Watery discharge, not thick pus.
• Red or pink whites of the eye, often both eyes.
• Sometimes a swollen tender lymph node in front of the ear on the same side.
• Cold symptoms — runny nose, mild cough — at the same time.

Treatment is supportive. Antibiotics don't help. The infection runs its course over 7–14 days. Eye cleaning with cooled boiled water keeps the lashes from getting crusty. Cool damp cloths on the eyes can soothe.

Viral conjunctivitis is highly contagious. Hand hygiene matters a lot, and the baby can pass it on for as long as the eye is red and weeping.

Allergic Conjunctivitis

Less common in babies than in older children. Both eyes are itchy, watery, and sometimes puffy. The discharge is clear and watery. Often associated with seasonal pollen, dust mites, or pets. Discuss with the GP if you suspect an allergic cause; antihistamine drops may be appropriate over a certain age.

When to Be Concerned: Newborns

Eye discharge in the first 28 days of life has a different list of causes, and one of them is a genuine emergency.

Gonorrhoeal conjunctivitis of the newborn — caught from the birth canal during delivery — typically appears in the first 2 to 4 days of life with:

• Profuse pus (sometimes pouring from the eye)
• Marked eyelid swelling — often the eye can barely be opened
• Rapid worsening over hours

Without prompt antibiotic treatment, gonorrhoeal conjunctivitis can damage the cornea and cause permanent visual loss within days. It is treated with intravenous antibiotics in hospital.

Chlamydial conjunctivitis of the newborn appears later — around days 5 to 14 — and is generally less acute, but still needs systemic antibiotic treatment (oral erythromycin) because chlamydia can also cause pneumonia in the baby.

Practical rule: any baby in the first 2 weeks of life with significant pus discharge from the eye, or significant eyelid swelling, needs same-day medical review. Most won't have gonorrhoea or chlamydia, but the cost of missing it is too high.

Other Red Flags at Any Age

Things that need same-day medical review:

• Eyelid red, swollen, or hot — could be peri-orbital or orbital cellulitis, which needs IV antibiotics in hospital.
• Baby holding eye closed and resisting opening — pain or photophobia.
• Whites of the eye look more than mildly pink — bright red or with visible blood.
• Cloudiness of the cornea (the front clear part of the eye).
• Bulging or displacement of the eye.
• Baby unwell with the eye symptoms — fever, lethargy, off feeds.
• Vision concern — baby not following objects with the eye, light reflex looks different from the other side.
• No improvement after 5 days of treatment for presumed bacterial conjunctivitis.

In all of these, ring 111, the GP, or attend A&E if the baby is unwell.

Practical Tips at Home

• One eye, one wipe, one piece of cotton wool. Don't go back over a cleaned area or use the same piece on the other eye.
• Cooled boiled water is sufficient. No salt solution, no breast milk in the eye (despite some social media claims), no chamomile tea.
• Wash your own hands before and after touching baby's eyes — bacterial conjunctivitis is easily passed back and forth.
• Wash flannels, towels, and pillowcases at high temperature during an active infection.
• Stay home from nursery if your baby attends one until the eye is clear or the GP confirms it's safe to return — most nurseries have specific exclusion policies.

Most sticky eyes in newborns aren't infection — they're from a tear duct that hasn't fully opened yet. Around 1 in 10 babies has this and it almost always resolves by their first birthday. Real conjunctivitis (red, swollen eye plus pus discharge) needs treatment; bacterial gets antibiotic eye drops, viral gets time. Two situations are urgent: any significant pus discharge in the first 2 weeks of life (gonorrhoea or chlamydia from delivery is a medical emergency) and any red painful eye that won't open.