Conjunctivitis in babies: sticky eyes, pink eye and what they mean
A sticky, crusty or pink eye in a baby is almost always conjunctivitis, and in most cases it resolves on its own with gentle cleaning. But knowing which type you are dealing with, and when to get help quickly, makes all the difference. Here is what the NHS and paediatric guidance says.
Three types of conjunctivitis
Conjunctivitis is inflammation of the conjunctiva, the thin membrane lining the inside of the eyelid and covering the white of the eye. There are three common causes in babies and young children, and each behaves differently.
Bacterial conjunctivitis produces a yellow or green sticky discharge. It often starts in one eye and spreads to the second eye within a day or two. The eye looks red but your baby is not usually rubbing at it because it does not tend to itch. The eyelids may stick together after sleep.
Viral conjunctivitis causes a watery, clear or slightly white discharge. It frequently affects both eyes at the same time and very often comes alongside a cold, runny nose, or sore throat. It is caused by viruses including adenovirus, and it spreads easily between family members.
Allergic conjunctivitis causes intense itching and affects both eyes. Your baby may rub their eyes frequently. It tends to be worse during pollen season and may come with a runny nose or sneezing. It is less common in infants under 12 months but does occur.
Neonatal conjunctivitis: different rules entirely
If your baby develops a red or sticky eye in the first 28 days of life, the rules are different and you should see a doctor the same day. Conjunctivitis in a newborn can be caused by bacteria including Chlamydia trachomatis or Neisseria gonorrhoeae that were passed during delivery. These infections can damage vision if untreated and need specific antibiotic treatment that is not the same as standard eye drops.
A blocked tear duct, which is very common in newborns, looks similar but is a different condition entirely. If the white of your baby's eye is clear and they do not seem bothered, a blocked duct is more likely. If there is any redness of the eye itself, see a doctor.
How to clean sticky eyes at home
Whether the cause is bacterial, viral, or uncertain, gently cleaning the eye provides comfort and helps prevent discharge building up. The NHS recommends the following technique:
Use cooled boiled water, not tap water directly from the tap. Soak a clean piece of cotton wool in the water and gently wipe from the inner corner of the eye (the corner nearest the nose) toward the outer corner, using one smooth stroke. Use a fresh piece of cotton wool for every stroke, and a completely separate set for the other eye. Never wipe back from the outer corner inward, as this drags discharge back across the eye.
Wash your hands before and after cleaning, and keep your baby's face cloths and towels separate from everyone else's in the household.
Bacterial conjunctivitis: does it need antibiotics?
Mild bacterial conjunctivitis in babies and children often clears on its own within 2 to 5 days with just careful cleaning, according to the NHS. Antibiotic eye drops (typically chloramphenicol) are prescribed when symptoms are not improving after a few days, the discharge is heavy, or the baby is very young and you want to speed recovery to allow a nursery return.
If your GP does prescribe antibiotic drops, complete the full course even if your baby's eye looks clear after 24 hours.
Viral conjunctivitis: no antibiotic will help
Viral conjunctivitis does not respond to antibiotics, so they are not prescribed for it. The infection typically resolves by itself in 1 to 2 weeks. The main management is careful eye cleaning for comfort, regular handwashing, and keeping your baby's things separate to avoid spreading it to the rest of the family.
Cold, damp cotton wool pads held gently over the closed eye for a few minutes can help reduce discomfort.
When your baby can go back to nursery
Conjunctivitis spreads easily in group settings, so most nurseries have clear policies. For bacterial conjunctivitis, the general guidance is that your baby can return once the discharge has resolved or after 24 hours of antibiotic treatment. For viral conjunctivitis, most settings ask that the discharge has cleared. Always check your specific nursery's policy as it can vary between providers.
When to get help urgently
Most conjunctivitis is mild, but contact your GP or call 111 same-day if:
- Your baby is under 28 days old and has any eye discharge or redness.
- Your baby seems to be in significant pain or is very unsettled by their eye.
- Your baby is sensitive to light (photophobia), flinching, or closing their eye in normal light.
- The cornea (the clear front of the eye) looks cloudy, hazy, or white instead of clear.
- The eyelids themselves are swollen, very red, or feel warm, which may suggest a skin or orbital infection rather than conjunctivitis.
- Symptoms are not improving after a week of careful cleaning.
Frequently asked questions
How do I clean my baby's sticky eyes?
Use cooled boiled water and a fresh piece of cotton wool for every single wipe. Wipe from the inner corner of the eye outward in one stroke, then discard that piece. Use a separate set of cotton wool for the other eye. Always wash your hands before and after.
Does conjunctivitis need antibiotics?
Not always. Mild bacterial conjunctivitis often clears within 2 to 5 days without treatment. Viral conjunctivitis does not respond to antibiotics at all. Antibiotic drops are most helpful when discharge is heavy, not improving, or when you need to speed up a nursery return.
When can my baby go back to nursery with conjunctivitis?
For bacterial conjunctivitis, most settings require that discharge has cleared or that 24 hours of antibiotic treatment is complete. For viral conjunctivitis, they usually ask that the discharge has resolved. Check your nursery's specific policy.
Is conjunctivitis in a newborn serious?
Conjunctivitis in a baby under 28 days old must be assessed by a doctor the same day. It can be caused by bacteria passed during birth that need specific treatment and can affect vision if missed. Do not wait.
What is the difference between bacterial and viral conjunctivitis?
Bacterial conjunctivitis produces yellow-green discharge, often starts in one eye, and is not usually itchy. Viral conjunctivitis produces watery discharge, typically affects both eyes, and often comes with cold symptoms. Allergic conjunctivitis causes intense itching in both eyes and is associated with pollen or other allergens.
Can conjunctivitis clear without treatment?
Yes. Mild bacterial conjunctivitis usually clears within 2 to 5 days with careful cleaning alone. Viral conjunctivitis resolves in 1 to 2 weeks without medicine. The main job is keeping the eye clean and comfortable while the immune system does its work.
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