Common causes of puffy eyes in a baby include viral or bacterial infections such as conjunctivitis, and allergies. Puffy eyes that occur immediately after delivery may be related to pressure being exerted on the infant's face during the delivery process. This is very common when babies are delivered vaginally, though less common in babies delivered by Cesarean section.
Conjunctivitis, also known as pink eye, can occur anytime and is very contagious. Older children who are infected can easily transmit conjunctivitis to a baby directly, for example, and it can also be transmitted through washcloths, towels, or bedding. Environmental irritants, such as household cleaners, laundry soaps, and perfumes, can also give a baby puffy eyes.
Although puffy eyes are a common symptom of pink eye in a baby, this is seldom the only indicator of the condition. The baby may also have red, irritated or bloodshot eyes, excessive tearing, watery discharge, and profound itching. In addition, eyelid crusting and light sensitivity are common. Treatment for bacterial conjunctivitis includes antibiotics, but if the condition is related to a viral infection, this medication will not be effective.
The appearance of puffy eyes in a baby can look ominous, but it is usually not serious. Puffiness can be simply the result of crying, in many cases. After a baby is born, eye drops are put into his or her eyes to help prevent infection. These eye drops can burn, but are generally harmless. When caused by the drops, the puffiness should resolve in a day or two.
Sometimes, eye puffiness can be caused by a blocked tear duct. This condition prevents tears from draining, and it can even cause the eye to look as if it's swollen shut. Blocked eyelid glands can also cause swollen eyes in babies, as can a sty. These blockages usually clear up on their own, but if the problem persists, a minor procedure using a probe to alleviate the obstruction can be used.
Since babies are unable to make their needs known, parents and caregivers should be on the lookout for excessive eye rubbing that may indicate eye irritation. If symptoms persist, the baby should be seen by a pediatrician to determine the cause of the problem. The medical professional may refer the baby to an eye doctor who can recommend further testing to determine the cause. In rare cases, the baby may be found to have a corneal abrasion, caused by scratching the cornea with a fingernail or other object.