What is Thrush?

Thrush is an infection of the mouth caused by Candida, a type of yeast. Candida normally lives in and on our bodies. It normally does not cause problems but when there is overgrowth of Candida, it can cause infections such as thrush or diaper candidiasis (diaper rash).

How do infants and children get thrush and other Candida infections?

Newborns get exposed to Candida while in the uterus or during delivery when they pass through the vagina during birth. Some children develop candidiasis after taking antibiotics or with inhaled steroids. While the antibiotics fight bacteria appropriately, they can also kill “healthy” bacteria as a side effect, which opens up real estate on the body allowing Candida to overgrow.

Signs and Symptoms of Oral Thrush

White or yellow patches on the tongue, lips, gums, roof of mouth, and/or inner cheeks that cannot be scraped off. It can lead to pain when eating and swallowing. A white tongue alone in babies is generally not thrush and is typically caused by milk residue. Unlike thrush, which can and often does affect the whole mouth and even its outside corners, milk residue only affects the tongue. It’s hard to distinguish between the two just by looking, but milk residue can be gently scraped away whereas thrush cannot.

Treatment for Oral Thrush:

Candidiasis is treated with antifungal medications, most commonly Nystatin. Nystatin is applied 4 times per day directly on to the white patches. Do not feed your baby anything for 30 mins after the medication is given. Continue the medication for at least 7 days and until the thrush has been gone for 3 days.

Once treatment is started, most candidiasis infections resolve in about 2 weeks. It is not uncommon for infections to return however, especially if candida is present on bottles of pacifiers.

It is important to sterilize all bottles, nipples, pacifiers, and nipple shields after every use when treating thrush. This may be done by placing these materials in boiling water for 10 mins and letting them cool before using them or place them in the dishwasher and wash with hot water and a heated dry cycle. If you are breastfeeding, clean each breast with water and air-dry after each feeding. If your breasts develop sharp pain, redness, or soreness, you may also need to be treated for thrush. Common topical medications for your breast include topical nystatin or topical clotrimazole.

Please contact the office if any of the following occur:

  • Thrush is not improving after two weeks
  • Your child is drinking less than normal
  • Child appears dehydrated
  • If you have any other concerns
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