Thrush

What is Thrush?

Thrush is a fungal infection caused by a yeast called Candida. In babies, thrush often occurs in areas where the lining of the mouth is cracking and moist. Thrush causes mild mouth discomfort. If your child has thrush, he or she will have:

1. White, irregularly shaped patches coat the inside of the mouth and sometimes the tongue. (If the only sign is a white coating on the tongue, this is due to milk coating the tongue and is not thrush.)
2. White coating that sticks to the mouth and cannot be washed away or wiped off.

What Causes Thrush?

Most people already have Candida in their mouth and other parts of their bodies. Sometimes certain conditions, such as use of an antibiotic or too much moisture can cause the yeast to grow rapidly and cause thrush. In babies, thrush often occurs in areas where the lining of the mouth is cracking and moist from too much sucking (as when a baby sleeps with a bottle or pacifier).

Thrush is generally not spread to others under normal conditions. However, if you are breast-feeding and your baby has thrush, the yeast may cause an irritation on the nipple. If this nipple yeast infection is not treated, the infection will continue to spread between mother and baby.

Treatment

Nystatin Oral Suspension (prescription)

Give 1 ml of nystatin (comes with a dropper) in each corner of the mouth four times a day (it doesn't do any good once it’s swallowed). Do not apply right before feeding. If the patches of thrush in the mouth don't start improving in 2 days, rub the nystatin directly on the patches. Use a cotton swab or a gauze wrapped on your finger. Continue this for at least 7 days, or until all the thrush has been gone for 3 days.

If you are breast-feeding, apply nystatin four times per day to any irritated areas on your nipples. It is not necessary to wipe off the nystatin before feeding.

Diaper Rash Associated with Thrush

If your child has a diaper rash in addition to thrush, the rash is probably also caused by yeast. Use an OTC antifungal cream such as generic Lotrimin (clotrimazole) or Nizoral (ketoconazole) and apply to the diaper rash 4 times a day until better. Air exposure is the best healing agent.

When Should I Call The Office?

Call during office hours if:

1. Your child refuses to drink.
2. The thrush gets worse despite treatment.
3. The thrush lasts beyond 10 days.
4. You have other concerns or questions.

Adapted from article written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.