THRUSH

Main Symptoms

  • White, irregularly shaped patches in the mouth.
  • Coats the inside cheeks or inner lips.
  • Sometimes coats the tongue (if the only symptom is a uniformly white tongue, it's due to a milk diet, not thrush).
  • Adherent to the mouth (cannot be washed away or wiped off easily like milk curds).
  • Causes mild discomfort or no symptoms.
  • The child is bottle-fed or breast-fed.

Cause

  • Caused by a yeast (called Candida).

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR FOR THRUSH

Call Your Doctor Now (night or day) If:

  • Your child looks or acts very sick.
  • Signs of dehydration (very dry mouth, no tears and no urine in more than 8 hours).
  • Age less than 1 month old and looks or acts sick in any way.

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen.
  • Fever occurs.
  • Bleeding is present.

Call Your Doctor During Weekday Office Hours If:

  • Thrush, but none of the symptoms described above (reason: may need prescription medicine to treat it).
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HOME CARE ADVICE FOR THRUSH (Pending Talking With Your Doctor)

  1. Decrease Sucking Time to 20 Minutes per Feeding:  Reason: prolonged sucking (as when a baby sleeps with a bottle or pacifier) can irritate the lining of the mouth and make it more prone to yeast infection.  For severe mouth pain with bottle feeding, offer fluids in a cup,spoon or syringe rather than a bottle (reason: the nipple increases pain).
  2. Limit Pacifier Use to Bedtime:  Again, prolonged sucking on a pacifier can irritate the mouth.  If your infant is using an orthodontic pacifier, switch to a smaller, regular one (reason: bigger ones can irritate the mouth more).
  3. Breastfeeding:  If mother's nipples are red and sore, apply Lotrimin Cream (no prescription needed) 4 times per day AFTER feedings.
  4. Diaper Rash:  If there's a bad diaper rash, it's also probably due to yeast. Apply Lotrimin cream (no prescription needed) 4 times per day (see DIAPER RASH guideline).
  5. Contagiousness:  Thrush is not contagious, since it does not invade normal tissue. Your child can go to day care with thrush.
  6. Expected Course:  With treatment, thrush usually clears up in 4 to 5 days. Without treatment, it clears up in 2-8 weeks.
  7. Call Your Doctor If:
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 7/2004

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