Dr. Mona's Mom Blog

Thrush

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What does it look like? What is it? Why do newborns get it?

Thrush looks like white patches in the mouth, notably in the inner cheeks and lips and tongue. Patches on the tongue alone are NOT thrush as this can be caked-on breast milk or formula. The key is to look at the gum line and inner cheeks for white patches that you can’t easily rub off.

What is Thrush?

Thrush is a fungal infection caused by Candida (a type of yeast). Candida lives in our bodies in a normal, healthy state but can sometimes overgrow causing thrush.

Why do newborns get it?

Newborns do not have fully formed immune systems and sometimes this normally-occurring yeast can overgrow. The mouth is a dark, moist environment where yeast can flourish. Prolonged sucking in breastfeeding combined with moisture can make this yeast flourish hence why it’s more common in breastfed babies or bottle-fed babies where bottles are left in their mouth for long periods of time.

Symptoms for the breastfeeding mom?

  • Itchy our burning nipples that appear fiery or shiny
  • Cracked nipples
  • Shooting pains during or after breastfeeding

What is the treatment for thrush?

  • It’s important to take your baby in to see a clinician if you are concerned they have thrush to confirm the diagnosis. Sometimes the yeast can appear in the diaper area for the baby or other parts of the body so treatment can be dependent on degree of spread.
  • Yeast can be stubborn and resistance to some therapies, so I know it can be hard but IT WILL GET BETTER.
  • If breastfeeding, mom and baby both need to be treated.
  • Nystatin (a topical ointment) is the first-line treatment. This is typically administered to the front of the mouth on each side four times a day. You can also use a cotton ball and rub it directly on the spots with a clean finger. Don’t feed baby for 30 minutes after administering this medicine.
    • If symptoms improve within seven days, you can continue 3 days after symptoms completely resolve.
    • If symptoms worsen or don’t improve after 7 days, your clinician will want to make sure proper sterilizing is happening and recontamination is not occurring (see hygiene recommendations below).
    • If not adequate, make sure to sterilize items and continue Nystatin 3 days after symptoms completely resolve.
    • If adequate, oral fluconazole (and oral anti-fungal) will be prescribed for baby with follow up to assure it’s improving.
  • Gentian Violet (less than 0.5% aqueous solution) can also be used daily for no more than 7 days. A side effect of long-term use over 7 days can be skin breakdown.
  • Breastfeeding moms who also have thrush will be treated with a topical anti-fungal.

Hygiene Recommendations

If your baby has thrush, it’s important to sterilize everything besides the finger or breast that goes into baby’s mouth for 20 minutes every day for 10 days. This includes the dropper you use to administer medicine! Boil these items in hot water to sterilize once daily.

How to manage the pain with thrush and preserve supply

  • Thrush can be very painful and make many moms stop their breastfeeding journey.
  • Breastfeeding DOES NOT HAVE TO STOP
  • Short frequent feedings can help you and baby. Sucking can irritate the lining of the
  • mouth.
  • Take pain meds as cleared by your OB/GYN.
  • If your nipples are cracked, pump your milk and make sure to continue to sterilize pump parts. You can still give your baby your pumped milk if you or them are being treated for thrush.

Please know it’s common, there is help and you will get through it.

Join The New Mom’s Survival Guide where you will find even more resources for this topic, and there’s also a community where you can go to for support. We will get you through it and help you continue your feeding goals.

PS: Follow the PEDSDOCTALK IG, where I share stories and posts about other common concerns when it comes to newborns!

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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.

It is the responsibility of the guardian to seek appropriate medical attention when they are concerned about their child.

All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.