I get calls very frequently from parents of newborns that their babies' eyes are gooey, or teary, and they think their babies have pink eye. A lot of babies are born with what's called lacrimal duct stenosis, which is the tear duct between the eye and the nose is clogged. It could be clogged for many reasons. Sometimes the sac at the bottom has not opened yet. And sometimes it's just a little bit clogged from mucous. So, it causes the baby's eye to tear and run.
If the eye is tearing, and it's clear, and the mucous is just white what we usually recommend is that the parents wipe away the mucous or the tears with a warm washcloth or a cotton ball, and if you don't have a sharp nail to take your finger and massage two or three times a day right here in the nasolacrimal fold. This helps open the sac at the bottom and helps open the duct. Babies can have obstructed tear ducts up until about six months of age.
If you see that the eye is red and that the mucous is becoming green or infected looking then you should contact your pediatrician, because the child might actually get pink eye or a conjunctivitis from rubbing. Because, what happens is when the eye is very teary as the babies get older they tend to rub it more. We all have bacteria on our hands. Then they auto-infect their eye.
Those would be the few cases that we might treat with antibiotic eye drops, but just note that usually it would go away even without the eye drops, and usually it will recur with or without the eye drops. Because it's a kind of chronic thing until this tear duct opens.
These babies who have lacrimal duct stenosis don't often present the first week of life. Parents can call me at two months and say, oh my God my child's eye is running all the time, what do I do. This is the same as the children who have this from birth.
If the tear duct does not open by one year of age you should have a referral to a pediatric ophthalmologist. The ophthalmologist at that time might probe the duct to open it, and usually that resolves the problem. If it keeps on recurring there are some patients who ultimately have to have a stent put in, but those are very rare cases. Most cases of tear duct blockage or lacrimal duct stenosis will open between four and five months of age.