North American Registry of Midwives (NARM) Practice Exam

When is the best time to apply eye prophylaxis in newborns?

1. Immediately after birth

2. At 1 to 2 hours after birth

3. At 12 hours after birth

4. Before discharge from the hospital

The correct answer is: At 1 to 2 hours after birth

Applying eye prophylaxis in newborns is ideally performed within the first hour after birth, though practice can vary slightly based on circumstances and local protocols. The rationale for doing it shortly after birth is to protect the newborn’s eyes from potential infections, particularly gonococcal ophthalmia neonatorum, which can result from bacteria present in the birth canal. This condition can lead to severe complications, including blindness, if not treated promptly. Given that the best window for application is aligned with the need for early intervention, doing it promptly — typically around one to two hours after birth — allows healthcare providers to maximize protection while still being mindful of the newborn's immediate stabilization needs and bonding time with the parents. This timing takes into account not only the procedure itself but also ensures that it does not interfere with mother-infant interactions that are critical immediately postpartum. Other times noted, such as 12 hours after birth or before discharge, would not be as effective in preventing potential complications, as they delay the timely administration of necessary prophylaxis.