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| |    Thrush by Lynn Cates, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Thrush is a yeast infection of the mouth that is most commonly seen in otherwise healthy infants. It looks like white patches of milk, or "cheesy" material, on the inside of the cheeks, gums, palate, and tongue. You can tell that it isn't milk because it won't rinse off, and if you try to scrape it off, you may see some bleeding. Most babies aren't bothered at all by mild thrush, but some have sufficient pain to make them fussy and interfere with their ability to suck and swallow normally. What causes thrush? Thrush is caused by a yeast (a type of fungus) known as Candida albicans, which is one of the microorganisms normally found in our gastrointestinal tracts (and is quite different from the yeast used to bake bread). Usually, Candida lives in balance with other organisms like E. coli and doesn't cause any problems. However, under certain conditions, such as when antibiotic treatment wipes out normal bacteria and leaves more room for yeast to grow, it can proliferate to such an extent that it causes diseases collectively known as candidiasis. These include thrush, Candida (also known as monilial) diaper rashes, and, in females, vaginal yeast infections. Who gets it? Thrush is most common in babies, particularly if they have been treated with antibiotics. Children and adults whose immune systems are weak (e.g., those who are on chemotherapy for cancer, or who have HIV infections) also are prone to thrush. How is it diagnosed and treated? Most of the time, thrush can be diagnosed just by looking at the rash. Mild cases may go away without treatment, but others need a prescription for a liquid medicine called nystatin (as is found in Mycostatin). Unlike most other medicines, you don't want your baby to swallow this one right away because it needs to have contact with the rash to kill the yeast. For this reason, be sure to put it into the front of your child's mouth, and don't give her anything to eat or drink for at least a half hour afterwards. You may find it easier to get it into the right part of the mouth by using your finger to paint the medicine right onto the thrush. Also, since these yeast are present throughout the gastrointestinal tract, they can cause rashes literally at both ends. So if your baby has a diaper rash at the same time as her thrush, she may need nystatin cream or ointment for her diaper area. Preventing reinfection In addition to treating thrush, it is important to prevent reinfection by getting rid of yeast from surfaces that come into contact with your infant's mouth. These include:
The good news is that thrush usually goes away completely with just a few days of appropriate treatment. The bad news is that it tends to recur, particularly if the baby is given antibiotics, so don't be frustrated if your child gets it again.
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