III Effects of Silver Nitrate Prophylaxis on Visual Alertness in Neonates

In a series of investigations we have studied whether silver nitrate used as prophylaxis against neonatal gonococcal ophthalmia has mainly positive or negative consequences. In this study 39 newborns, randomly divided into three groups given silver nitrate or the less irritating Hexarginum or physiological saline (placebo) as prophylaxis were studied. The eye drops were administered two hours after delivery. The groups were observed on days 2 and 4 post partum. The soothing effect and the effect on visual alertness were compared between the groups when infants were lifted from supine position to the shoulder. On day 2 infants in the silver nitrate group showed less alertness and scanning behaviour than did children in the Hexarginum and saline groups. There were no indications that the chemical conjunctivitis caused by silver nitrate interfered with soothability on either day 2 or day 4 or with visual stimulation on the fourth day of life. The design of the study permitted parental eye contact with the infant during the first two hours of life. It is still an open question whether or not silver nitrate administered within a few minutes after delivery, which would prevent the early eye contact, would have any long-lasting effects on visual alertness or on parent-infant relationship.