First choice of treatment: If you don’t wear contact lenses and your symptoms are not severe, use self-help measures. Seek medical advice if symptoms don’t improve in 7 days.
If symptoms continue or get worse, there are treatment options suitable for use while breastfeeding, explained in detail below.
In this factsheet
Introduction
Conjunctivitis is inflammation of the conjunctiva (the mucous membrane that covers the front of your eye and lines the inside of your eyelids). It can be infective, caused by bacteria or viruses, or non-infective, caused by allergies or irritation.
Infective conjunctivitis (also known as acute bacterial conjunctivitis) is highly contagious. It will usually resolve within a week without treatment. Viral conjunctivitis will resolve by itself within 1-2 weeks and is often associated with a blocked nose during a cold.
See our factsheet on antihistamines and breastfeeding for more information on treating allergies, including allergic conjunctivitis.
Symptoms of conjunctivitis
The symptoms of all types of conjunctivitis can appear in one, but usually both, eyes.
Symptoms of allergic conjunctivitis include
- Pinkness or redness
- Watery eyes
- Itching
- Puffy eyelids
- Symptoms may be accompanied by other hay fever symptoms such as runny nose.
If the conjunctivitis is infective, you may also experience
- Burning or a gritty feeling in your eye
- Pus that sticks to your lashes or a yellow discharge around your eyes. Your eyes may feel stuck together, especially in the morning.
- Symptoms may be accompanied by a cold or similar viral illness including flu-like illness.
See the NHS page on conjunctivitis for more information.
If your symptoms include:
- pain in your eyes
- sensitivity to light
- changes in your vision, like wavy lines or flashing
- very red eyes (1 eye or both eyes)
You should seek medical attention as soon as possible.
A newborn with conjunctivitis needs to be seen by a doctor immediately (NHS)
Avoid spreading infection
Viral and bacterial conjunctivitis are infectious. To avoid spreading the infection
- avoid rubbing your eyes
- wash your hands regularly with warm soapy water
- cover your mouth and nose when sneezing and put used tissues in the bin
- don’t share pillows and towels
- wash your pillowcases, towels and face cloths in hot water and detergent
Do you need to stay away from work or keep your infected child off school?
Public Health England advises that you do not need to stay away from work or school if you or your child has conjunctivitis, unless you are feeling particularly unwell.
First Line Self-Help Measures
- Do not wear contact lenses until all symptoms and signs of infection have completely resolved and any treatment has been completed as directed by your healthcare professional. Discard any used contact lenses. When your infection has resolved you should follow advice from your optician and wear new contact lenses.
- Wash your eyelids and lashes with clean, cooled boiled water. Use a fresh cotton wool pad for each eye. Eyelid care wipes are available over the counter and in shops but are no more effective than cheaper options such as a cotton wool pad used with cooled boiled water.
- Place a clean, damp, cool, facecloth (cold compress) over your eyes and rest it there for a few minutes. Cold compresses for the eyes are available over the counter and in shops but are more expensive than a simple facecloth. Wash your face cloth or cold compress after each use.
- If your conjunctivitis is allergic, see our factsheets on antihistamines and hayfever for more information on treating allergies.
Using breastmilk to treat conjunctivitis?
In some cultures, breastmilk has traditionally been used to bathe eyes and treat conjunctivitis (Witkowska-Zimn et al., 2019). Some research studies suggest breastmilk could help conjunctivitis, maybe due to its antimicrobial properties (Sugimura et al, 2021). However, others find it is not effective against some of the most common causes of conjunctivitis and may make an infection worse by introducing other bacteria (Baynham et al., 2013, Patel et al., 2025).
First line, over-the-counter pharmacy treatments
Your pharmacist can advise you on available options to help your symptoms. These are first line options to use alongside simple self-help measures above. They are available over the counter in pharmacies only, without prescription.
Lubricant eye drops, gel or ointment, also known as artificial tears, (e.g. hypromellose, sodium hyaluronate or carbomer) may reduce your discomfort (CKS). They are compatible with breastfeeding. You can use them multiple times a day, according to the instructions, to reduce discomfort. These should be used at a separate time to antibiotic drops or ointment.
Propamidine antiseptic eye drops (e.g. Brolene®, Golden Eye®) are a mild antibacterial topical treatment available over the counter in pharmacies, to treat minor eye infections including conjunctivitis and blepharitis. While there is no data available for the use of propamidine while breastfeeding, the drops act directly on the surface of the eye and are not absorbed into your body. Manufacturers of one brand of propamidine eye drops report that absorption is negligible, meaning it would not be detectable in your system after applying the drops to your eyes. Because there is limited to no absorption of these drops into the body, they would not be expected to reach your milk. They are compatible with breastfeeding.
What if self-help and first-line treatments don’t help in the first week of infection?
If your symptoms don’t improve after 7 days of self-care, or if they become more severe, you may need antibiotic eye drops.
If your symptoms become more severe, as described above, at any time, please contact your GP practice or seek medical assistance as soon as possible.
After 7 days, if your symptoms have not improved,your local pharmacist can give you information and advise you on next steps. Antibiotic treatments that may be prescribed by a healthcare professional or sold over the counter in a pharmacy, known as “pharmacy only” medicines, are discussed below.
Pharmacy only and prescribed antibiotic treatments
Chloramphenicol antibacterial eye drops and ointment are available over the counter in a pharmacy or on prescription. Topical chloramphenicol works against most bacteria that cause conjunctivitis. Chloramphenicol eye drops or ointment are usually the preferred choice to treat conjunctivitis. They may be used with caution while breastfeeding if clinically appropriate for you. There is more information on the NHS webpage.
SPS advises that chloramphenicol eye and ear preparations can be used with caution during breastfeeding, but infant monitoring is required (see below for details). You should not use them if you have a past or family history of any sort of blood disorder, including aplastic anaemia. Check with your doctor or pharmacist before using them. If your healthcare professional considers chloramphenicol the appropriate treatment, you can use it as directed while you are breastfeeding. Depending on guidance used locally by your healthcare professionals, fusidic acid eye drops may be a preferred option while breastfeeding if chloramphenicol is not suitable for you.
Fusidic acid antibacterial eye drops have a narrower range of effect on bacteria compared to chloramphenicol. Fusidic acid can stop certain bacteria from continuing to grow, including Staphylococcus bacteria which may be the cause of conjunctivitis. Once the bacteria cannot grow, your immune system then has a chance to clear the infection. They are applied twice daily. The full course should be completed as instructed to prevent the infection returning.
Fusidic acid eye drops are compatible with breastfeeding and may be the preferred choice of topical antibiotic treatment if chloramphenicol is not suitable for you.
If you use chloramphenicol eye drops or ointment, take care to avoid direct contact between them and your breastfeeding infant, by washing hands your thoroughly after application and before touching your infant. Follow the guidance on infant monitoring below.
If you wish, to minimise the absorption of any drug into your blood stream, you can press over your tear duct to close it off as you use the drops.
Infant monitoring whilst using chloramphenicol
Side effects in your breastfed child are unlikely, but as a precaution, you should monitor them for:
- abdominal distension (swelling)
- poor feeding
- sedation
- vomiting or diarrhoea
- anaemia (pallor, lethargy)
- rash
- unusual bruising or bleeding
Monitoring your child will quickly pick up any potential issues, but usually further investigation is required before the cause can be identified. If you suspect a side effect, contact a healthcare professional for further advice straight away.
You should continue precautionary monitoring for signs of aplastic anaemia (anaemia, rash, bruising or bleeding) for a period of time after the course has finished.
If you are recommended an alternative antibiotic eye drop not mentioned in this factsheet, you can get in touch with the Drugs in Breastmilk Service team for more information.
More detailed information on chloramphenicol and breastfeeding
The patient information leaflets for chloramphenicol eye drops and ointment “pharmacy only” formulations sold over the counter in pharmacies state that they are suitable for use in children aged 2 years and over. However, the patient information leaflets for the “prescription-only medication” formulations say they can be used by newborn babies. These are the same medications and the same doses, but the way medications can be used when sold over the counter in a pharmacy is often more restricted than the instructions that can be included when prescribed. This difference is what we call the “licenced indications”.
As prescription-only formulations are provided under closer clinical supervision than over-the-counter products, the instructions/ accepted uses are often broader than for products solely made for over-the-counter use. Sometimes, your pharmacist will supply a “pharmacy-only” pack for a prescription if they don’t have a “prescription-only medicine” pack in stock to avoid delaying supply of a prescription for chloramphenicol to you.
The patient information leaflets for chloramphenicol eye drops and ointment say you should not use them if you are breastfeeding unless considered essential by your doctor or healthcare professional. This is based on theoretical risks to your baby. There have been rare cases in the past where people have developed severe side effects such as aplastic anaemia after using chloramphenicol themselves, usually from taking it orally or intravenously.
SPS states that aplastic anaemia is extremely rare, and specialist opinion is that the risk is low with short courses of chloramphenicol for patients with no prior or family history of blood dyscrasias.
There have also been some cases of premature or young infants developing grey baby syndrome after having high doses of chloramphenicol directly.
There are no reports of these side effects in breastfed infants whose mother/breastfeeding parent used chloramphenicol drops or ointment.
Levels of the drug in your milk are expected to be very low. However, there is still a theoretical risk. This risk will be lower in older breastfed infants or children (SPS).
Related Factsheets
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References
Click here to see the references
- Baynham JT, Moorman MA, Donnellan C, Cevallos V, Keenan JD. Antibacterial effect of human milk for common causes of paediatric conjunctivitis. Br J Ophthalmol. 2013;97(3):377-379. doi:10.1136/bjophthalmol-2012-302833
- Besamusca FW, Bastiaensen LA. Blood dyscrasias and topically applied chloramphenicol in ophthalmology. Doc Ophthalmol 1986; 64:87-95.
- British National Formulary: https://bnf.nice.org.uk/
- Clinical Knowledge Summary; Conjunctivitis Infective 2022 https://cks.nice.org.uk/conjunctivitis-infective
- Drugs and Lactation Database (LactMed®): https://www.ncbi.nlm.nih.gov/books/NBK501922/
- E-Lactancia website: https://e-lactancia.org/
- Health Products Regulatory Authority (Republic of Ireland): https://assets.hpra.ie/products/Human/40596/Licence_PA23520-001-001_13062025125132.pdf
- Moorfields Eye Hospital: https://www.moorfields.nhs.uk/ae/patient-guides/allergic-conjunctivitis
- Moorfields Eye Hospital: https://www.moorfields.nhs.uk/eye-conditions/conjunctivitis
- NHS website: https://www.nhs.uk/conditions/conjunctivitis/
- Patel M, Gondkar P, Dalal D, Patel K. Neonatal Eye Infections: Microbial Risks, Transmission Routes, and the Paradox of Traditional Human Milk Applications. J Perinat Neonatal Nurs. Published online November 25, 2025. doi:10.1097/JPN.0000000000000973
- Rietveld, R.P, ter Riet, G., Bindels, P.J.E. et al. (2005) The treatment of acute infectious conjunctivitis with fusidic acid: a randomised controlled trial. British Journal of General Practice 55(521), 924-930.
- Rose, P. Management strategies for acute infective conjunctivitis in primary care: a systematic review. Expert Opinion on Pharmacotherapy 2007;8(12), 1903-1921
- Rutter P. Community Pharmacy: Symptoms, Diagnosis and Treatment, 3e 2013
- Specialist Pharmacy Service Safety in Lactation: Using chloramphenicol during breastfeeding, 2026.
- Sugimura T, Seo T, Terasaki N, et al. Efficacy and safety of breast milk eye drops in infants with eye discharge. Acta Paediatr. 2021;110(4):1322-1329. doi:10.1111/apa.15628
- UK Health Security Agency: https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/public-health-exclusion-periods-in-children-and-young-peoples-settings
- Walker, S., Diaper, C.J., Bowman, R. et al. Lack of evidence for systemic toxicity following topical chloramphenicol use. Eye 1998; 12(5), 875-879
- Witkowska-Zimny M, Kamińska-El-Hassan E, Wróbel E. Milk Therapy: Unexpected Uses for Human Breast Milk. Nutrients. 2019;11(5):944. Published 2019 Apr 26. doi:10.3390/nu11050944
©The Breastfeeding Network. Version 2.0. Published July 2026.
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