Thrush

When To Call

Call Doctor or Seek Care Now

• Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
• Age less than 1 month old and looks or acts abnormal in any way
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Fever occurs
• Bleeding in the mouth
• Drinking less than normal
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Thrush, but none of the symptoms above. Reason: may need a prescription medicine to treat it.
• You have other questions or concerns

Care Advice

What You Should Know About Thrush:

• Thrush is common during the early months of life.
• It's caused by a yeast infection in the mouth. Most often, it's due to prolonged sucking.
• Thrush causes only mild discomfort. It's easy to treat at home.
• Here is some care advice that should help until you call your doctor.

Anti-Yeast Medicine (Prescription):

• Your doctor will probably prescribe an anti-yeast liquid medicine. Use it as follows:
• Age Under 1 Month: use 1 mL.
• Age Over 1 Month: use 2 mLs.
• Place in the front of the mouth on each side. Also, put it wherever you see the thrush. It doesn't do any good once it's swallowed.
• Do this 4 times per day.
• If the thrush isn't getting better, rub the medicine directly on the thrush. Use a cotton swab to do this.
• Don't feed your baby anything for 30 minutes after the medicine.
• Keep this up for at least 7 days. Also, continue it until all thrush has been gone for 3 days.

Decrease Sucking Time to 20 Minutes per Feeding:

• Reason: too much sucking can irritate the lining of the mouth. This makes it more prone to a yeast infection.  A common example of this is when a baby sleeps with a bottle.
• For severe mouth pain with bottle feeding, don't use a bottle. Reason: the nipple can make pain worse.
• Try giving fluids in a cup, spoon or syringe instead.

Limit Pacifier Use:

• Too much sucking on a pacifier can irritate the mouth.
• Limit pacifier use to times when nothing else will calm your baby.
• If your infant is using an orthodontic pacifier, switch to a smaller, regular one. Reason: bigger ones can cause more friction in the mouth.
• Special washing or boiling of pacifiers or bottle nipples is not needed or helpful.

Special Washing of Pacifiers and Nipples - Not Helpful:

• Pacifiers and bottle nipples can be washed the usual way with soap and water.
• They do not need to be boiled or sterilized.
• They do not need to be thrown out.
• Yeast is a germ that is found in normal mouths.
• It only causes thrush if the lining of the mouth is irritated or damaged.
• Get better results by reducing nipple time and pacifier time.
• Note: follow your doctor's advice if it is different.

Breastfeeding and Yeast Symptoms:

• If the mother's nipples are red and sore, it's probably a yeast infection.
• Use an anti-yeast cream (such as Lotrimin AF) on the nipple area.
• No prescription is needed.
• Put it on 2 times per day after feedings.
• Wash the cream off the nipples before each nursing. Avoid soap which dries out the skin.
• Many mothers will need treatment with an oral anti-yeast medicine (such as Diflucan). Call your PCP or OB within 24 hours for advice.

Diaper Rash Treatment:

• If there's a bad diaper rash, it can also be due to yeast.
• Use an anti-yeast cream (such as Lotrimin AF) on the diaper rash.
• No prescription is needed.
• Put it on 2 times per day.
• See Diaper Rash care guide.

Return to Child Care:

• Thrush cannot be spread to others, since it does not invade normal skin.
• Your child can go to child care with thrush.

What to Expect:

• With treatment, thrush usually clears up in 4 to 5 days.
• Without treatment, it clears up in 2-8 weeks.

Call Your Doctor If:

• Starts drinking less than normal
• You think your child needs to be seen
• Your child becomes worse

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