Experiences with infant oral thrush

August 13, 2007 2:34 PM

YANMD: Infant/mother thrush advice sought

My 11 week old son developed oral thrush a couple of weeks ago. The pediatrician prescribed Nystatin a week ago but so far it hasn't improved anything. Today I got him a prescription for Fluconazole to use as well (this has all been done by phone consults, no examination yet). The pediatrician asked me to apply the nystatin onto my nipples (my son is breastfed) to help clear it from me. After a little internet research, I am concerned that I may have the thrush in my gut also (I have been really gassy recently, but I have no symptoms of oral or vaginal thrush that I can detect). If I did have thrush in my system, presumably this would explain why my son's treatment isnt working? Is thrush passed on through the breastmilk itself or just skin to skin contact? I am trying to get an appt with my doctor asap so I can get checked out. Other info - I am sterilising pacifiers, bottles (he has expressed milk at night for dreamfeeds) and pump equipment daily. I have drastically reduced (but not totally eliminated) dairy, sugars and carbs from my diet and I am eating live yogurt every day. Is there anything else I can do to help clear it from my system? Any similar experiences with this problem and how you solved it gratefully received.

posted by Joh to health (7 comments total)

Kellymom.com was a lifesaver when my child was small and I'm sure it will be helpful again when I have my second. See the thrush resources on the site. Everything there is research-based.
posted by acoutu at 2:43 PM on August 13, 2007 [1 favorite]

yogurt, with live cultures
posted by caddis at 2:50 PM on August 13, 2007

Caddis: She's already eating yogurt with live cultures. Although -- make sure the live cultures include "L. Acidophilus". Usually you'll only find it in organic or more expensive/organic brands, "Russian" and "Greek" yogurts especially. Stay away from the "Activa" etc. that only has B. Regularis.
posted by SpecialK at 3:11 PM on August 13, 2007

I need to read the questions more carefully sometimes. Jeez.
posted by caddis at 3:20 PM on August 13, 2007

We just went through this. For ten weeks. It was awful, but patience and persistence - and prescription drugs and boiling everything - got us to a thrush-free, pain-free state.

Dr. Jack Newman, breastfeeding expert, is your friend. Near the bottom of this page are 3 PDFs that will help shed more light on the available treatments.

Even if one of you is asymptomatic, you both need to be treated or you will pass the yeast back and forth. In my case, my prescription for fluconazole was for 3 weeks, but the baby's script for nystatin was for only one week. Many refills were required...

You will read a lot about Gentian Violet. Dr. Newman highly recommends it. It's cheap and easy and works within a few days, although in my case it made the problem much better without eliminating it completely. You put some olive oil on a q-tip and then dip it in the dye. (The oil dilutes the violet a little bit - you will find the violet in either a .5% or a 1% solution, and a lactation consultant told me that the 1% should be further diluted.) Then you let the baby suck on the q-tip until his mouth is purple...and then you let him nurse. Dr. Newman says something along the lines of "if you have purple nipples and a baby with a purple mouth, there's nothing more to do."

The drawback is it's super-messy and stains everything purple, including your baby's mouth and anything he subsequently drools upon. The color fades from the skin in about 4 days; until then you'll have a little goth baby. You are only supposed to do this regimen for about 4 days. If the symptoms have not improved, you are to go on to more conventional medicine solutions.

I am typing with one hand and a baby on my lap, so I'll try to get back to this later with any ideas I may have forgotten. Stick with the boiling of bottles and pacifiers, and bleach all your laundry (sheets, baby clothes, anything with milk or drool on it). Good luck!
posted by hsoltz at 3:27 PM on August 13, 2007

Thrush is absolutely not going to pass from your gut into your breastmilk - your GI tract is really far from your milk glands, biologically speaking, so it won't be excreted in your milk. That said, there's a lot to be said for getting rid of any yeast organisms that you may be harboring, since those could get passed from you to the baby in ways that we shall not contemplate. ;-)

Probiotics are awesome. I found that probiotic tablets from the health food store worked really well. You get a large dose the good bacteria found in yogurt, plus some others. The advantage of a big dose is that the good bugs overwhelm the bad ones (the fungus causing thrush).

You can even get probiotics for babies! Florastor is what my kids have used. It is quite safe, since it acts in the GI tract and is not absorbed systemically.
posted by selfmedicating at 4:38 PM on August 13, 2007

Yogurt is never enough for me. I like the probiotic Reuteri by Nature's Way, you can buy it at Whole Foods and other places (I buy it at the local co-op). I'm not a mom, and not a doctor, but the "women's yeast defense"-type tablets frequently have garlic in them, and if you like it, well, it can't hurt.
posted by Eringatang at 8:14 PM on August 13, 2007