Routine Newborn Medications and Preventive Care

Routine newborn medications prevent serious disease before symptoms begin. Link each medication to one job.

Vitamin K

Vitamin K prevents vitamin K deficiency bleeding. Newborn vitamin K stores are low, and breast milk contains little vitamin K. Give one intramuscular dose in the vastus lateralis within 6 hours after birth. The injection provides more reliable protection than oral vitamin K. Confirm vitamin K was given before circumcision.

Erythromycin eye ointment

Erythromycin ophthalmic ointment prevents gonococcal ophthalmia neonatorum, a severe eye infection that can damage the cornea. Apply a thin ribbon to both lower conjunctival sacs within 24 hours after birth. Leave the medication in place. Wipe away excess after 1 minute and keep the eyes unrinsed. Temporary blurred vision or mild redness can occur.

Hepatitis B protection

Check the mother's hepatitis B surface antigen, or HBsAg, result.

When the mother is HBsAg positive, give the newborn hepatitis B vaccine and hepatitis B immune globulin, called HBIG, within 12 hours after birth. Give them intramuscularly in separate limbs.

When maternal HBsAg status is unknown, give hepatitis B vaccine within 12 hours and obtain the maternal result promptly. Then follow the current weight- and status-based HBIG pathway.

For an HBsAg-negative mother, follow current facility policy. The American Academy of Pediatrics continues to support a universal birth dose within 24 hours. Current CDC guidance uses shared decision-making for this group.

Report now

Escalate immediately when prophylaxis for an exposed newborn is delayed, maternal HBsAg status remains unknown, the newborn has unexplained bleeding, the eyes develop purulent drainage with marked swelling, or signs of a severe allergic reaction appear.

The simple match is: vitamin K prevents bleeding, erythromycin protects the eyes, and hepatitis B vaccine plus HBIG protects a newborn exposed at birth.