Thrush

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THRUSH is an overgrowth of the yeast germ, Candida albicans, producing white patches inside the mouth. It is most commonly seen in babies but may occur in anyone who has been on antibiotics for a long time. Each of us has the yeast germ in our mouths, as they live there in harmony with normal mouth bacteria.

Babies usually obtain both yeast and bacteria from their mother's birth canal. Occasionally the yeast growth overtakes bacterial growth before the body develops a balance between the two, and thrush develops. Thrush is not dangerous and it looks worse than it really is, although a baby with thrush might east less than normal. Mild thrush usually goes away by itself. When treatment is necessary, physicians often prescribe an antifungal medication that can be painted on the thrush four times each day (your pediatrician will describe in detail how to apply the medication). Breast-feeding mom might want to apply the same medication to their nipples as well. In addition, carefully wash pacifiers and anything else that goes into the baby's mouth. It is a good idea to store bottles, nipples, and pacifiers in the refrigerator - the yeast does not like a cold environment.

How can I take care of my child?

Nystatin oral medical - The drug for clearing this up is nystatin oral suspension. It requires a prescription. Give 1 ml of nystatin four times a day after meals or at least 30 minutes before you feed your baby. Place the nystatin in the front of the mouth on each side (it does not do any good once it is swallowed). If the patches of thrush in the mouth do not start improving in two (2) days, rub the Nystatin directly on the patches. Use a cotton swab or a gauze wrapped on your finger. Keep this up for at least seven (7) days, or until all the thrush has been gone for three days.
Decrease sucking time during feeding - If sucking on a nipple is painful for your child, temporarily use a cup or spoon. In any case, while your child has thrush, reduce sucking time to 20 minutes or less per feeding. If the thrush comes back after treatment and your child is bottle-fed, switch to a nipple with a different shape and made from silicone.
Restrict pacifier use to bedtime - While your child has thrush do not given him a pacifier, except when it is really needed for going to sleep. If your infant is using an orthodontic-type pacifier, switch to a smaller, regular one. Soak all nipples in water at 130° F (60° C), which is the temperature of most hot tap water, for 15 minutes.
Diaper rash associated with thrush - If your child has a diaper rash as well as thrush, assume the rash is caused by yeast. Ask for a prescription for Nystatin cream and put on your baby's bottom four times a day. Lotrimin-AF is an over-the-counter anti-fungal cream (apply three (3) times per day until cleared for three days) that works well for diaper rash caused by yeast.

When should I call my child's health care provider?

Call during the office if ….

Your child refuses to drink.
The thrush gets worse during treatment.
The thrush lasts beyond 14 days.
You have other concerns or questions.

Thrush

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