How to Prevent and Treat Thrush in Your Baby

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Thrush Baby

As noted elsewhere on The Pulse, thrush is a common infection in babies. It is a fungal infection in the mouth, caused by the Candida species of yeast, causing whitish plaques on the tongue, gums, and lining of the mouth. In can cause some mild discomfort, and affects the taste of food or milk, so can interfere with feeding. But sometimes it is asymptomatic, so it can be difficult for mothers to know if their babies have thrush. The good news is there are ways to prevent the infection, and if needed, treat it.

Prevention

Like all yeast infections, thrush thrives because the environment is conducive to the yeast’s growth: warm, moist, and dark. Athlete’s foot, jock itch, and vaginal yeast infections are examples of similar infections, and all have the same type of warm, dark, and moist environment.

If you are breastfeeding, you can get the yeast infection on your nipples, and pass it to the baby through breastfeeding. This is sometimes very painful to the mother, but in the beginning, may just be uncomfortable. So to prevent the growth of the yeast, try to keep your nipples and breasts cool, dry, and open to air and light as much as possible:

The best way to do this is to limit the use of breast pads: sure, you don’t want to leak through your blouse or shirt in front of company, but when possible, avoid the breast pad, which traps moisture next to your nipple and promotes yeast growth. Leave your feeding bra flaps down and let your breasts air dry after feeding, if possible.

Taking antibiotics can also predispose you to yeast or fungal infections, so try to reduce your use of antibiotics. If your doctor prescribes an antibiotic for you or your child, discuss if this is really necessary.1,2

If you are bottle-feeding, have enough nipples and bottles to let them completely air dry after use to prevent the growth of yeast. Washing them in hot water will help, but the key is to let them air dry.

If your baby uses a pacifier, wash it thoroughly with hot water and have a few of them to let each of them air dry at least once a day. Pacifiers, bottles, and nipples that are constantly moist will promote growth of yeast.1,3

Treatment

If your baby gets thrush, both the baby and you should be treated, even if you don’t have any symptoms. Most likely, if you don’t have symptoms now, you will, and then you and your infant will be passing the infection back and forth.

Treatment for the baby usually consists of an anti-fungal suspension such as nystatin, clotrimazole, fluconazole, or itranconzole. For mom, it usually consists of putting a topical cream or ointment on your nipples after feeding, and then wiping it off before the next feed. Common ointments used include nystatin, clotrimazole (LotriminÒ), miconazole, ketoconazole, or others.1,2

Sometimes it can be difficult to eradicate the yeast, and recurrences are common. If so, an oral medicine may be used for the breastfeeding mother, such as fluconazole.

The baby may also have a diaper rash caused by the same yeast that is in the mouth. If your baby has a diaper rash at the same time as thrush, point this out to your doctor. Again, treatment for this is usually with a topical ointment such as nystatin.1

It is also important to leave the diaper open to air and light as much as much as possible for as long as possible to eliminate the yeast.

If you are breastfeeding, don’t use any pumped breast milk from when the baby had untreated thrush or you were infected and untreated. Even freezing the breast milk from this time is not helpful to kill the yeast: heat or hot water will kill it, but not cold or freezing temperatures.3

References:

  1. Thrush and Other Candida Infections.
  2. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001 Sep;40 (9):503-6.
  3. Gahlod N, Atulkar, M. Scarlet Hidden in Reef: A breif review on Oral Thrush in children. Journal of Pediatric Oral Health Research. 2017 Nov.-Dec.;1 (1):23-8.
Ruben Rucoba
Dr. Rucoba has over 25 years of experience as a primary care pediatrician after completing medical school at the University of California, San Francisco. His clinical areas of expertise include caring for children with special health care needs and assisting families with international adoption. He has been a freelance medical writer since 2010, writing for health websites, continuing medical education providers, and various print outlets. He currently works at Wheaton Pediatrics in the suburbs of Chicago, where he lives with his wife and four daughters, including a set of twins.

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