THRUSH

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Thrush is a whitish plaque or film on the inside check, tongue or roof of the mouth that cannot be rubbed off. Formula and breast milk look similar, but can be rubbed off.

Thrush is a yeast infection of the mouth. We all have bacteria and yeast all over our bodies and this is very normal. Yeast and bacteria usually live in harmony with the bacteria keeping the yeast from over growing and vise-versa. When factors are present that limit the bacteria growth (antibiotics) or promote the growth of yeast (warmth, high dose of yeast when pacifier falls on floor, moisture), then the yeast will over grow and you will have thrush. These same mechanisms cause yeast infections in the vaginal area also. Having thrush does not mean that your child is dirty or that you are not clean, it only means that you have to be a little more careful with the pacifier or nipples.

Thrush is contagious if pacifiers or nipples are shared. But thrush is not that contagious. Most children never get thrush no matter how dirty the pacifiers are. Some children are so prone to getting it, that parents have to carry around a dozen pacifiers in case on falls on the floor. These parents can't just wash the pacifier off, they have to sterilize it. If a child is breast feeding, then a child may get thrush from his or her mothers nipples if mom has a yeast infection there. By the way, I can't remember the last time I saw thrush in a child that never used pacifiers.

Even without treatment, most thrush will go away on its own. Most pediatrician's, though, would recommend some treatment.

First, read the above about how thrush is spread and look at your situation with pacifiers, etc. Second, if you are breast feeding and your nipples are sore or redder than usual, then you probably have a yeast infection yourself. Try to keep your breasts as dry as possible by: cleaning your breasts frequently, especially before and after feeding, keep your nipples dry by changing pads often and or leaving them open to air frequently and finally, use the medicine mentioned below on your breast as often as you do on your child. Third, use Gentian Violet or Nystatin (anti-yeast medications). Gentian is pronounced "gin-shun" or "gent-shun". Professionally, I recommend the Gentian Violet because it works quicker, is over the counter and you only have to use it once a day. The only draw back to Gentian Violet is that it is a permanent dye, that is, it will permanently stain any clothes it touches. The dye will come off of the skin in 1 to 2 days. Nystatin is a prescription drug. Both Gentian Violet and Nystatin are used in the same way:

1. Place 1/4th tsp in a bathroom cup
2. Do not work from the bottle as you will contaminate it
3. Use a cotton swab to coat the entire mouth with the medicine, not just where you can see it
4. Do this until the thrush is gone for at least 2 days or it may come back
5. For Gentian Violet, treat the mouth 1 time a day
6. For Nystatin, treat the mouth 4 times a day.

Formula or Breast Milk: they look similar to thrush, but can be rubbed off, while thrush cannot be rubbed off.

Stomatitis or Hand Foot and Mouth Disease: This gives shallow ulcers with a white center that are very painful. These sores are surrounded by redness and look exactly like those sore you get when you bite your lip. Thrush is not painful at all.

Dehydration: a very dry mouth will get a thin film of whiteness that can be rubbed off. The dehydrated child will also be ill, while thrush causes no real symptoms.

 CALL YOUR PEDIATRICIAN IMMEDIATELY:

Your child has any difficulty swallowing.
The white places are bleeding.

CALL YOUR PEDIATRICIAN DURING BUSINESS HOURS:

Your child has thrush that does not show signs of improvement to the above treatment within 3 to 5 days.
Your child has thrush that does not completely resolve with the above treatment within 3 weeks.
Your child has severe thrush (covering all surfaces of the mouth).
You would prefer to use Nystatin instead of Gentian Violet. Most pediatricians will want to examine your child before giving you a prescription to ensure it is thrush and nothing else is wrong with your child

NOTIFY YOUR PEDIATRICIAN DURING THE NEXT OFFICE VISIT IF:

Your child gets thrush very easily and it is very difficult to get rid of.

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