Yeast & Thrush

What is Thrush?

Thrush is an irritating yeast infection caused by the fungus "Candida albicans." It is most commonly seen in the mouths of newborns and babies less than six months of age and also causes diaper rash, sore nipples and vaginal yeast infections.

Candida albicans is a naturally occurring organism found in all human bodies. Certain conditions cause it to grow unchecked, which leads to a thrush infection. These conditions include treatment of the mother and/or infant with antibiotics, cracked or bleeding nipples, use of oral contraceptives, and/or diabetes.

Symptoms

Many infants have a white coating on their tongue, particularly after feeding, which is normal. With thrush, an infant has creamy white dots or patches inside the cheeks, gums, tongue and/or lips that do not scrape off easily, without causing bleeding. In addition, the baby may have a "fiery red" diaper rash (monilial) that does not respond to over-the-counter diaper rash remedies. The baby may be excessively gassy, repeatedly pull off the breast during feedings, and/or refuse the breast altogether because his/her mouth is sore.

The mother may experience the sudden onset of acute nipple pain, often described as "burning" during feedings. The pain is not improved with better latch-on and positioning. Nipples appear red, and may itch or burn during and/or after feedings. They may also be shiny or flaky, with a rash of tiny blisters. There may be cracks, particularly at the juncture of the nipple and areola, and a rash may develop on the areola. Shooting pain deep within the breast may also occur and sometimes radiate into the back and/or shoulder. The mother may also experience a vaginal yeast infection.

Treatment

The first step is to call your doctor and your baby's doctor for assessment and treatment. If thrush is diagnosed, both mother and baby must be treated with medication prescribed by their health care providers. It is important to note that even if either the mother or baby has no visible symptoms, to prevent re-infection both must be treated simultaneously. Treatment must be continued for at least 14 days even if symptoms disappear earlier.

Infant:

1. Many pediatricians treat thrush with oral Nystatin suspension, which must be applied to all affected areas with a Q-tip. Repeated use of a medicine dropper may prolong the infection.
2. Gently wipe out the infant's mouth with a gauze pad after each feeding and before applying medication.
3. Boil all pacifiers and bottle nipples each day.
4. Wash all teething toys daily in the dishwasher or very hot, soapy water.
5. Wash the baby's hands often, particularly if a thumb-sucker.
6. For a yeast diaper rash, wash baby's bottom with warm, soapy water.
   
7. An alternative over-the-counter medication is "gentian violet". This may be used in the infant's mouth and on the mother's nipples. Use a Q-tip for application, as described above. Although effective, this treatment is not popular, as the medication tends to stain the infant's mouth and lips purple.
8. A second alternative remedy is to prepare a paste of baking soda and water, then apply this paste to the affected areas in the baby's mouth with a Q-tip. This remedy may also be used on the mother's nipples.

Mother:

1. Many doctors treat nipple thrush with a topical Nystatin cream or suspension.  Apply the medication to nipples after each nursing.
2. If the nipples are very sore, use a cotton ball soaked in olive oil to remove medication.
3. After nursing and before applying medications, rinse your nipples in a solution of 1 cup water mixed with 1 tablespoon white vinegar or baking soda.
4. Use breast shells to prevent your bra from sticking to sore nipples.
5. Avoid breast pads, if possible. If you must wear them, use disposables and change them after each feeding.
6. Wash all bras, underpants, towels and wash clothes in hot water with bleach. Dry in a hot dryer.
7. Reduce consumption of dairy products, heavily sweetened foods and/or artificial sweeteners as these foods can predispose you to thrush.
8. Acidolophis and/or bifidus may be supplemented according to the directions on the label. These nutrients are friendly bacteria that help clear the body of fungus. They are available at health food stores in the refrigerator section.
9. For maternal thrush, call your health provider. The doctor may prescribe a one-time dose of an oral antifungal medication Fluconazole (diflucan). As symptoms clear, continue the home treatments described above for 14 days to prevent re-infection.