Diagnostic Findings
White, irregularly shaped patches that coat the inside of the mouth and sometimes the tongue, adhere to the mouth, and cannot be washed away or wiped off easily like milk (If the only symptom is a uniformly white tongue, it’s due to a milk diet, not thrush)
Bottle-fed or breast-fed child
Thrush is caused by a yeast (called Candida) that
grows rapidly on the lining of the mouth in areas abraded by prolonged sucking
(as when a baby sleeps with a bottle or a pacifier). A large pacifier or nipple can also injure the lining of the
mouth. Thrush may also occur when your
child has recently been on a broad-spectrum antibiotic. Thrush is not contagious since it does not
invade normal tissue.
The drug for clearing this up is nystatin oral
suspension. It requires a
prescription. Give 1 ml of nystatin
four times daily. Place it in the front
of the mouth on each side (it doesn’t do any good once it is swallowed). If the
thrush isn’t responding, rub the nystatin directly on the affected areas with a
cotton swab or with gauze wrapped around your finger. Apply it after meals or at least don’t feed your baby anything
for 30 minutes after the application.
Do this for at least 7 days or until all the thrush has been gone for 3
days. If you are breast-feeding, apply
nystatin to any irritated areas on your nipples.
If eating and sucking are painful for your child,
temporarily use a cup and spoon. In any
event, reduce sucking time to 20 minutes or less per feeding.
Eliminate the pacifier temporarily 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 degrees Fahrenheit (55 degrees Celsius; the temperature of most hot tap water) for 15 minutes. If thrush recurs and your child is bottle fed, switch to a nipple made with a different shape and made from silicone.
If your child has an associated diaper rash, assume it is due to yeast. Request nystatin cream and apply it four times daily.
During regular hours if:
v Your child refuses to eat
v The thrush gets worse on treatment
v The thrush lasts beyond 10 days
v An unexplained fever (over 100 degrees Fahrenheit [37.8 degrees C]) occurs
v You have other concerns or questions