No tears at one month

Unlike her elderly siblings, my one month old baby is yet to shed any tears while crying. Kindly let me know if she is okay.

Lizzy (by SMS)

There are several medical conditions that are associated with decreased tear production or collection. Infants can become dehydrated when they are unable to feed well or are losing body fluids due to an illness.  The first sign of dehydration is a reduced number of wet (urine) diapers. If ongoing fluid losses are not replaced, dry lips and an absence of tears while crying may be evident.

Sunken eyes, lethargy, or increased irritability are signs of severe dehydration that require emergency medical treatment. It is common for newborns to have a temporary obstruction of the duct that drains tears from the eyes into the nose. In most cases, the lacrimal duct is blocked by a membrane at birth that takes a few days to open. In other cases, there is a problem with the duct itself, usually due to immature development. This causes pooling of tears at the inner corner of the eye. At times, a white mucous may form that can be easily wiped away.

This differs from the kind of mucous that forms during an eye infection which is typically yellow or green. When the lacrimal gland fails to develop during fetal life, this can result in the absence of tears. This very rare occurrence can be an isolated finding or one component of another genetic disorder. Because of there is no lubrication from tears, the eye is prone to dryness and inflammation.

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Other common causes of childhood dry eye are medications such as for acne or allergies and contact lens use. Some studies have shown that environmental allergens and pollutants can alter the amount of mucous or fatty acids in tears Most babies produce tears.

Look closely the next time your baby cries. If the eyes appear dry and irritated, contact your pediatrician. There are medical conditions associated with a lack of or a reduced amount of tears, but they are very rare. If you are concerned that something may not be right about your baby’s eyes, it is best to have them checked by a doctor.