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How Do I Treat Thrush?

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Baby boy (9-12 months) crying
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Question: How Do I Treat Thrush?
Oral thrush is an infection caused by a yeast fungus (Candida albicans). Sometimes this infection is brought on after antibiotic use, as this changes the environment of the mouth, making it easy for overgrowth of yeast to occur. In addition, if a nursing mother is experiencing a yeast infection, thrush can be passed on to her baby. In this case, both mother and child should be treated simultaneously.
Answer:

Symptoms of thrush for babies include white or yellowish raised spots on the sides of the mouth and on the tongue. Initially, these spots are painless, but they can quickly become irritated and lead to sore throat and mouth pain. It can also spread to the diaper area, causing redness and soreness. Your baby may also cry or seem irritated during feedings.

In nursing mothers, symptoms can include vaginal yeast infection, red sore nipples and a burning sensation in the nipples or breast after breastfeeding.

Thrush is usually diagnosed by sight, and most practitioners can even make a diagnosis over the phone based on your accurate description of symptoms. Occasionally a specimen taken from a tongue scraping may be necessary to rule out other illnesses if symptoms unrelated to thrush are present.

Treatment usually includes application of an antifungal like Nystatin applied several times daily to the inside of the mouth. Diflucan is also an effective treatment which may be prescribed by your physician and should be given as directed. If the diaper area is affected, Nystatin or Lotrimin (which is available without a prescription) work well here, too. Care should be taken to avoid wipes that may contain high amounts of alcohol which can perpetuate the conditions necessary for the growth of yeast.

If you are breastfeeding, it is important that any yeast infection be treated and special attention should be given to cleaning the nipples after each feeding. You can apply Nystatin or other specially-formulated creams, or you can apply gentian violet1 to your nipples 2-3 times daily. In addition, you may want to talk to a lactation consultant or La Leche League leader about making changes to your diet in order to return your body to a state where yeast overgrowth is prohibited. This often includes the addition of yogurt, buttermilk and acidophilus and the avoidance of sugars wherever possible.

To help treatment speed along and to prevent reinfection, it is also important that you clean all cups, bottles, nipples, pacifiers and other objects that your child has placed in his or her mouth on a daily basis for at least two weeks during treatment and until symptoms have disappeared. You can boil, bleach or just use the regular cycle on your dishwasher if the temperature of your hot water is above 125 degrees Fahrenheit.

If symptoms persist for more than a week without improvement, become worse, or if you or your child are experiencing continued pain even after a week of treatment, contact your health care provider immediately.

1Some Lactation Consultants recommend complete treatment with gentian violet, such as the course outlined here.

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