How to deal with your baby’s blocked tear duct

At almost two weeks old, my newborn daughter, Alice, was perfect except for one small concern: The eyelashes on her right eye were covered in a yellow-ish, crusty buildup. According to the baby books I’d devoured over the past few weeks, Alice was likely suffering from a blocked tear duct, a fairly harmless condition in which the tubes responsible for draining a baby’s tears aren’t yet fully developed. Still, it was a lot of gunk on her eye. Thankfully, we had an upcoming doctor’s appointment where I was able to unload my many questions.

At the appointment, we learned that Alice was part of the six percent of infants born with nasolacrimal duct obstruction, better known as a blocked tear duct.

What causes a blocked tear duct in a baby?

Stephanie Liu, an Edmonton-based family physician and co-author of Instagram blog HautHealth, explains that the inner corners of our eyes contain small tubes that drain our tears into our nose. In some babies, these tubes don’t fully develop and open up until several months after birth. “That stops the tears from being able to drain properly,” she says. The result is persistent tearing, discharge from the eye and something called mattering, which Liu describes as “gunk on the eye.” Made up of dried tears, it’s often crusty and comes in a range of colours including white, brown and yellow.

Liu says blocked tear ducts can happen in one or both eyes. Why the tubes fail to fully develop isn’t known, nor is it known how to prevent this condition. While it is possible for adults and children to develop blocked tear ducts, usually as the result of an eye injury or infection, Edmonton-based paediatrician Michelle Bischoff says congenital blocked tear ducts most commonly occur in babies within the first few months of life. Some newborns will show signs of blocked ducts within the first few days of life, but others might not display any symptoms until weeks or even a couple of months after birth. This is because the ability to produce and shed tears typically takes a few weeks to develop and, until your baby is able to cry real tears, the symptoms of a blocked duct probably will not be visible.

How do you get rid of a baby's blocked tear duct?

Fortunately, the majority of blocked tear ducts require no medical action and most babies with the condition can easily be treated at home. Doctors recommend massaging the tear duct area two to three times a day with freshly washed hands. Using your index finger, apply medium pressure to the part of your baby’s eye closest to the nose and massage downward, toward the nose. During the massage, you might see some fluid come out of your baby’s nose, says Liu—or you may see nothing at all. Lui also recommends that you have your doctor show you exactly how to perform this massage.

One home remedy for blocked tear ducts is applying breastmilk to the eye. But Bischoff doesn’t endorse the practice because breastmilk can’t open up the passageway, and there’s no research to prove that it might be helpful. Bischoff also recommends that parents don’t apply any kind of antibacterial ointment on or around the eye unless told to by their doctor because it won’t help unless there is an infection, and it could contribute to antibacterial resistance.

In 90 percent of babies, the condition will resolve itself in the first six months. This resolution comes when the ducts naturally open up on their own, a process that shouldn’t involve any discomfort. If the problem still persists at six months, Bischoff recommends that you see your child’s doctor, who may refer you to a paediatric ophthalmologist. A surgical procedure known as “probing” may be done in order to open up the tubes. In more severe cases, surgery under general anesthesia may be needed.

While blocked tear ducts are generally considered harmless, parents can keep an eye on the condition as well as mention it to their child’s physician, since there is a small chance that it can develop into an infection. Signs of an infection include fever, swelling, redness and heat around the eye, and redness and pus in the eye itself. Bischoff says that any baby displaying these symptoms needs to see a doctor because they may need antibiotics. 

We treated Alice’s blocked tear ducts by using a warm, soft cloth to clean off the mattering, then massaging her tear duct area, usually twice a day. Slowly, the amount of gunk on her eye decreased and, by her two-month appointment, her right eye was as clear and tear-free as her left one.

Read more: Baby ear infection: How to spot and treat the pain Newborn vision: What your baby sees