When Do Babies Start Producing Tears?

Parents often wonder when babies get tears. They may worry that something is wrong if they notice that their newborn isn't making tears when they cry. However, not making tears right away is normal. It is rarely a true medical problem for infants. 

At about two weeks old, newborns make just enough tears to keep their eyes moist. They don't produce real tears that you can see when they cry. Infants often don't develop real tears that you can see until they are about two months old.

When Do Babies Start Making Tears?

Babies' eyes aren't completely dry at birth, but they have minimal moisture. Newborns start making more tears once their lacrimal glands are fully developed. This typically happens sometime after two weeks of age.

The ability to produce tears continues to increase over the next several weeks. Note that it may take premature babies a bit longer to start producing noticeable tears.

After two to three months, tear production will ramp up so that tears become visible during crying. When a baby cries, the lacrimal glands produce excess tears that drain into the tear ducts and spill out over the eyelids. This overflow of tears from the eyes is what we call "real tears."

Eye Problems That Affect Baby Tears 

If your baby truly wasn't making any tears, then their eyes would likely be very red, dry, and irritated. This could be caused by a problem with the tear glands (the lacrimal glands) or the ducts that carry the tears to the eye. In that case, your baby should see a pediatric ophthalmologist as soon as possible for an evaluation.

If your baby has tears when not crying, then a blocked duct may be to blame. About 10% of infants have a blocked tear duct at some point. This condition will usually go away on its own.

If you notice swelling, redness, or pus around the eye, call a pediatrician immediately, as these symptoms suggest that there may be an infection.

There are several possible causes of either reduced or excess infant tears.

Dehydration

If your baby is dehydrated, they may not have enough moisture in their bodies to produce tears. Signs of dehydration in babies include poor feeding, lethargy, fussiness, fewer wet diapers, and less or no tears when crying (if old enough to produce tears while crying).

Contact your child's pediatrician right away if you suspect they are dehydrated. Continue feeding them breast milk or formula to increase their fluid levels (do not give your baby water).

Blocked Tear Ducts (Dacryostenosis)

A narrowing or blockage of the tear ducts which drain tears from the eye into the nose can cause tear build-up. You will most likely notice that your baby has a watery eye, with tears running down their face when they are not crying.

Importantly, the eye will not be red, nor will the eyelid be swollen, with a blocked tear duct. Redness or swelling indicates that there may be an infection.

Pink Eye (Conjunctivitis)

Pink eye in a newborn can be caused by an infection, a blocked tear duct, or irritation. The condition is most dangerous when caused by an infection, most commonly gonorrhea or chlamydia. To help prevent this, newborns are given erythromycin ointment to the eyes shortly after birth.

Glaucoma

Glaucoma is very rare in babies. However, childhood and congenital (present at birth) glaucoma are very important to diagnose early as these diseases can be devastating if left untreated.

Symptoms of glaucoma include enlarged corneas, excessive tearing, cloudy eyes, fussiness, and sensitivity to light. Elevated eye pressure, damage to the optic nerve, and vision loss are all concerns for children exhibiting symptoms of glaucoma.

A Word From Verywell

Healthy newborns don't have tears at first. Some conditions will cause delayed or excessive tearing but, in most cases, you won't see "real" tears in your infant's eyes until around 2 months old. Rest assured that this is totally normal.

Additionally, your baby will be screened for eye conditions at birth and at their well-baby check-ups. However, if you have any concerns about your baby's eyes or tears, don't hesitate to consult with a pediatrician.