How do Thrush in Infants happen?

Thrush is a condition in which a germ (yeast fungus) causes white or yellow patches to form in the mouth. The patches often form on the tongue. They may look like milk or cottage cheese.

If your baby has thrush, his or her mouth may hurt when eating or drinking. He or she may be fussy and may not want to eat. Your baby may have diaper rash if he or she has thrush. Thrush usually goes away in a week or two with treatment.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s doctor.
• If your child was prescribed a medicine for thrush (antifungal medicine), apply it or give it as told by the doctor. Do not stop using it even if your child gets better.
• If told, rinse your baby’s mouth with a little water after giving him or her any antibiotic medicine. You may be told to do this if your baby is taking antibiotics for a different problem.

General instructions

• Clean all pacifiers and bottle nipples in hot water or a dishwasher each time you use them.
• Store all prepared bottles in a refrigerator. This will help to keep yeast from growing.
• Do not use a bottle after it has been sitting around. If it has been more than an hour since your baby drank from that bottle, do not use it until it has been cleaned.
• Clean all toys or other things that your child may be putting in his or her mouth. Wash those things in hot water or a dishwasher.
• Change your baby’s wet or dirty diapers as soon as you can.
• The baby’s mother should breastfeed him or her if possible. Mothers who have red or sore nipples should contact their doctor.
• Keep all follow-up visits as told by your child’s doctor. This is important.

Contact a doctor if:

• Your child’s symptoms get worse or they do not get better in 1 week.
• Your child will not eat.
• Your child seems to have pain with feeding.
• Your child seems to have trouble swallowing.
• Your child is throwing up (vomiting).

Get help right away if:

• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

Thrush and Breastfeeding

Thrush, also called candidiasis, is a fungal infection that can be passed between a mother and her baby during breastfeeding. It can cause nipple pain and sensitivity, and can cause symptoms in a baby, such as a rash or white patches in the mouth.

If you are breastfeeding, you and your baby may need treatment at the same time in order to clear up the infection, even if one does not have symptoms. Occasionally, other family members, especially your sexual partner, may need to be treated at the same time.

What are the causes?

This condition is caused by a sudden increase (overgrowth) of the Candida fungus. This fungus is normally present in small amounts in warm, dark, and moist places of the body, such as skin folds under the breast and wet nipples covered by bras or nursing bra pads. Normally, the fungus is kept at healthy levels by the natural bacteria in our bodies. When the body’s natural balance of bacteria is altered, the fungus can grow and multiply quickly.

What increases the risk?

You are more likely to develop this condition if:

• You or your baby has been taking antibiotic medicines.
• Your nipples are cracked.
• You are taking birth control pills (oral contraceptives).
• You are taking medicines to reduce inflammation (steroids), such as asthma medicines.
• You have had a previous yeast infection.

What are the signs or symptoms?

Symptoms of this condition include:

• Breast pain during, between, or right after feedings.
• Nipples that are:
  • Sore. Soreness may start suddenly two weeks after giving birth.
  • Sensitive. They may be painful even with a light touch.
  • A deep pink or red color. They may have small blisters on them.
  • Puffy and shiny.
  • Leaky.
  • Itchy.
  • Cracked, scaly, or flaky.

Your baby may have the following symptoms:

• Bright red rash on the buttocks.
• Sore-looking blisters or pimples (pustules) on the buttocks.
• White patches on the tongue. The patches cannot be wiped off with a clean paper towel.
• Fussiness.
• Refusal to breastfeed.

How is this diagnosed?

This condition is diagnosed based on:

• Your symptoms.
• Culture tests. This is when samples of discharge from your breasts are grown and then checked under a microscope.

How is this treated?

This condition may be treated by:

• Applying antifungal cream to your nipples after each feeding.
• Medicine for you or your baby.

Symptoms usually improve within 24–48 hours after starting treatment. In some cases, symptoms may get worse before they get better.

Make sure that you, your baby, and your sexual partner get checked for thrush and treated at the same time.

Follow these instructions at home:

Medicines

• Take or use over-the-counter and prescription medicines, creams, and ointments only as told by your health care provider.
• Give your child over-the-counter and prescription medicines only as told by his or her health care provider.
• If you or your child were prescribed an antifungal medicine, apply it or give it as told by your health care provider. Do not stop using the medicine even if you or your child starts to feel better. Stopping the medicine early can cause symptoms to return.
• If directed, take a probiotic supplement. Probiotics are the good bacteria and yeasts that live in your body and keep you and your digestive system healthy.

General hygiene

• Wash your hands often with hot, soapy water, and pat them dry. Wash them before and after nursing, after changing diapers, and after using the bathroom.
• Wash your baby’s hands often, especially if he or she sucks on his or her fingers.
• Before breastfeeding, wash your nipples with warm water. Let nipples air dry after washing and feeding.
• If your baby uses a pacifier, rubber nipples, teethers, or mouth toys, boil them for 20 minutes a day and replace them every week.
• Wash your breast pump and all its parts thoroughly in a solution of water and bleach. Boil all parts that touch milk (except the rubber gaskets).
• Wear 100% cotton bras and wash them every day in hot water. Consider using bleach to kill fungus. Change bra pads after each feeding.
• Use very hot water to wash any towels or clothing that has contact with infected areas.

General instructions

• Make sure that your baby is seen by a health care provider, and that you and your baby get treated at the same time.
• Try nursing more often but for shorter periods of time. Start nursing on the least sore side.
• If nursing becomes too painful, try temporarily pumping your milk instead. Do not save or freeze this milk, because giving it to your baby after treatment is done could cause the infection to return.
• Eat yogurt that has active, live cultures.

Contact a health care provider if:

• You or your baby get worse or do not get better after 24–48 hours of treatment.
• You take antibiotics and then your breasts develop shooting pains, discomfort, itching, or burning.

Get help right away if:

• You have a fever or other symptoms that do not improve or get worse.
• You develop swelling and severe pain in your breast.
• You develop blisters on your breast.
• You feel a lump in your breast, with or without pain.
• Your nipple starts bleeding.

Summary

• Thrush is a fungal infection that can be passed between a mother and her baby during breastfeeding.
• This condition may be treated with topical antifungal creams applied to the nipple after each feeding.
• The spread of the infection can be controlled by washing hands, keeping your nipples clean and dry, and washing and sterilizing breast pumps, pacifiers, and other items that touch infected areas.