Sticky or watery eyes are common in newborns, and the usual cause is a tear duct that's narrow or hasn't fully opened yet. The NHS Frimley Healthier Together guide to sticky eyes says blocked tear ducts generally open up and start draining normally within the first few months, and the AAP's blocked tear duct guide says over 90% open on their own by 12 months. Until then, gently cleaning the eye is usually all it needs.
A blocked tear duct isn't the same as conjunctivitis, an infection of the eye's surface. A red eye, puffy eyelids or yellow-green pus suggest infection. Red, swollen eyelids with discharge in a baby's first weeks, or redness and swelling around the eye with a fever, need a doctor quickly. This guide covers what causes a sticky eye, how to clean it, what the sources say about tear-duct massage, how to tell a blocked duct from conjunctivitis, and when to get help.
What causes sticky eyes in babies?
Tears drain through a tiny tube, the tear duct (nasolacrimal duct), from the inner corner of the eye into the nose. In some babies this tube is narrow or still blocked at birth, so tears and mucus pool in the eye instead of draining away.
What you may notice:
- A watery eye. The AAP says the main sign is a constant watery eye, with tears running down the face even when your baby isn't crying. It notes the watering may not be noticed until 1 or 2 months, when the eye starts making more tears.
- Sticky discharge. The Frimley guide describes a sticky white or yellow discharge in the corner of one or both eyes, which can make the lashes stick together.
- A normal-looking eye. With a blocked duct alone, the AAP says the white of the eye isn't red and the eyelid isn't swollen.
Symptoms of a blocked duct can get worse after a cold, according to the American Academy of Ophthalmology (AAO).
How common is a blocked tear duct, and when does it clear?
Very common, though estimates vary. The AAP says a tear duct is blocked in about 10% of newborns, with both sides blocked in 30% of these babies. The AAO's overview of blocked tear ducts estimates nearly 20 percent.
| Source | How it usually clears |
|---|---|
| NHS Frimley guide (UK) | Generally opens within the first few months; discharge can last several months |
| NHS watering eyes (UK) | Usually better by the time a baby is a few weeks old |
| AAO (US) | Usually resolves on its own within 4 to 6 months |
| AAP (US) | Over 90% open on their own, by 12 months |
The NHS watering eyes page gives the shortest timeline, while the Royal Children's Hospital Melbourne conjunctivitis fact sheet in Australia notes that discharge and crusting from a clearing tear duct can persist for many months. So a sticky eye that comes and goes for several months is still common.
If your baby's eye is still sticky or watery at about 12 months, see your doctor. The AAP says your doctor may refer you to an eye doctor, and the AAO describes probing and flushing the duct for babies and toddlers whose tear ducts don't open on their own. The Royal Children's Hospital Melbourne's ophthalmology referral guidelines list sticky eyes or blocked tear ducts lasting more than 12 months as a routine referral.
How do I clean my baby's sticky eye?
The Frimley guide and the NHS conjunctivitis page suggest clean, cooled boiled water and cotton wool. The Royal Children's Hospital Melbourne and the AAP use warm water, so let boiled water cool until it's lukewarm.
- Wash your hands before you start.
- Dampen a piece of cotton wool in the cooled boiled water.
- Wipe from the corner by the nose outwards, in one direction only. The Royal Children's Hospital Melbourne says this stops the infection spreading to the other eye if only one eye is affected.
- Use a fresh piece of cotton wool for each wipe, and for each eye.
- Gently wipe crusts from the lashes, as the NHS describes, without rubbing.
- Don't clean inside the eyelids. The Royal Children's Hospital Melbourne says this may damage the eye's surface.
- Wash your hands afterwards and use a separate towel for your baby.
Clean as often as you need to, such as at diaper changes or after sleeps. The Royal Children's Hospital Melbourne says breast milk doesn't treat conjunctivitis and has no benefit on the eyes, though it isn't harmful, and that formula should never be used. The AAO's guide to pink eye in babies advises against putting breast milk in the eye.
The Royal Children's Hospital Melbourne says antibiotic drops aren't needed for the discharge from a blocked duct. Don't buy eye drops for a baby without advice: the NHS says a child under 2 needs a doctor prescription for them.
Should I massage my baby's tear duct?
It may help, but sources describe it differently and the AAP says it isn't required.
| Source | What it describes |
|---|---|
| NHS Frimley guide (UK) | Gentle pressure with a clean finger on the outside of the nose, near the corner of the eye, every few hours |
| AAO (US) | An ophthalmologist shows you how; press an index finger on the tear sac, between the inner corner of the eye and the side of the nose, and hold a few seconds; ten strokes, morning and evening |
| AAP (US) | Optional; some doctors suggest it and others don't. If advised, a cotton bud pressing gently upward from the inner corner, no more than once a day |
The AAO's blocked tear duct treatment page suggests doing it at a diaper change, keeping your other hand on the side of your baby's face. Whichever method you use, wash your hands first, be gentle, and ask your doctor or pediatrician to show you before you start. Stop and get your baby checked if the area becomes red, swollen or tender.
Is it a blocked tear duct or conjunctivitis?
| Sign | Blocked tear duct | Conjunctivitis |
|---|---|---|
| White of the eye | Not red | Red or pink |
| Eyelids | Not swollen | Often puffy or swollen |
| Discharge | Tears, sticky white or yellow | Yellow or green pus that keeps coming back |
| Antibiotic drops | Not needed | Sometimes, if bacterial |
The Royal Children's Hospital Melbourne lists the signs of conjunctivitis as a red or pink eye, puffy swollen eyelids, excess tears, and yellow-green discharge that crusts the lids during sleep. The AAP's eye discharge guide describes bacterial conjunctivitis as lots of yellow or green pus that keeps coming back during the day, often with lashes stuck together after sleep. A blocked duct can also become infected, so the two can overlap.
The Frimley guide notes that conjunctivitis in babies may be caused by infections picked up during or after birth. The AAO says pink eye affects only about 2% of babies in the first month of life, that most cases are mild and easily treated, but that rarely an infection can spread and threaten sight. That's why a newborn with a red, sticky eye should be checked quickly rather than watched at home.
Infectious conjunctivitis is highly contagious while there's discharge, according to the Royal Children's Hospital Melbourne, so wash your hands well and don't share towels. If you're not sure which it is, the Royal Children's Hospital Melbourne suggests having your baby examined by your doctor or pediatrician to find the cause.
Which red flags need a doctor quickly?
Red, swollen eyelids with discharge in the first weeks of life. This can be neonatal conjunctivitis, an eye infection often caught during birth. The NHS says a baby under 30 days old with red, sticky eyes needs an urgent doctor appointment or a call to your pediatrician's after-hours nurse line, and the Royal Children's Hospital Melbourne treats sticky eyes in newborns up to 2 weeks old as an urgent eye referral. If the eyelids are so swollen your baby can't open the eye, the Frimley guide says to go to the emergency room or call 911, and the AAO says to see a doctor or go to the emergency room right away.
Redness and swelling around the eye, especially with a fever. This can be periorbital cellulitis, an infection of the eyelid and the skin around the eye. The Royal Children's Hospital Melbourne's clinical guideline describes it as usually affecting one side, and warns that infection spreading behind the eye (orbital cellulitis) is an emergency with serious complications. The AAP's eyelid swelling guide says a very red, swollen eyelid with a fever needs care now, and the NHS cellulitis page says to call an ambulance or go to the emergency room for cellulitis with a very high temperature, or if your baby feels hot, cold or shivery. This guide uses the stricter advice: go to the emergency room.
A red, tender lump at the inner corner of the eye. The AAO lists swelling, tenderness and redness at the inner corner, or around the eye and nose, among the signs that a blocked duct has become infected. The AAP says to see a doctor within 24 hours for a red lump at the inner corner.
What's worth noting about your baby's sticky eye?
Note which eye is affected, when the stickiness started, whether the white of the eye is red, and the color of the discharge (clear, white, yellow or green). A clear photo in good light each day helps a doctor or pediatrician see whether it's improving, and whether redness or swelling is spreading. Note any fever, with the time and reading.
When should I get help?
Call 911 now, or go straight to the nearest emergency room, if your baby:
- has redness and swelling of the eyelids or the skin around the eye with a fever
- has eyelids so swollen they can't open the eye, or the eye seems to bulge
- is under 3 months and has a temperature of 38°C (100.4°F) or higher
- is 3 to 6 months old and has a temperature of 39°C (102.2°F) or higher
- is floppy, much sleepier than usual, hard to wake or can't be woken
- is struggling to breathe, or has blue, gray, pale or blotchy skin, lips or tongue
- has a rash that doesn't fade when you press a glass against it (the NHS urgent-help guide lists these as reasons to call an ambulance)
Get medical help today if your baby:
- is under 30 days old and has red, swollen eyelids, a red eye or sticky discharge
- has a red or swollen eyelid, or redness around the eye, without a fever
- has a red, tender lump or swelling at the inner corner of the eye
- has yellow or green pus that keeps coming back, or the eye stays red
- has been on antibiotic eye drops for more than 3 days and still has pus (the AAP says to contact a doctor within 24 hours)
- has a cloudy area on the clear front part of the eye (the AAP says to seek care now)
- is refusing feeds or feeding much less than usual
Talk to your doctor or pediatrician if:
- your baby has a sticky or watery eye that a doctor or nurse hasn't checked yet
- the eye is still sticky or watery at about 12 months
- your baby's conjunctivitis isn't getting better after two days (from the Royal Children's Hospital Melbourne)
- you'd like to be shown how to clean the eye or massage the tear duct (call your pediatrician's after-hours nurse line after hours with questions)