Thrush
Sometimes it’s the little pediatric problems that are the most distressing for parents. Take, for example thrush. I’ve had many a parent tearing their hair out because of this unwelcome organism. Seen with many babies this common condition is caused by Candida albicans. Candida is found typically in the mouth and on the skin and other places in all people. Normal bacteria that are present and a healthy immune system keep Candida in check. People who are immunocompromised or infants whose immune systems are not fully matured yet can commonly get thrush. Thrush looks like small white plaque like material on the inner mouth and lips. Some children can be very fussy while others appear to have minimal discomfort.
Treatment is usually saved for those babies who are uncomfortable or who have a more extensive case. Traditionally the topical application of Nystatin suspension has been used to treat thrush. You can drop the medicine in the baby’s mouth or apply it directly to the lesions with a cotton tip applicator. But be careful not to contaminate the bottle of medicine by touching the medicine dropper to your baby’s mouth and then replacing the dropper in the bottle. Sterilize the nipples of baby bottles and pacifiers. Nursing mothers will need to treat their nipples as well.
Gentian Violet is another alternative to therapy besides Nystatin. No prescription is necessary and can often be found in drugstores. Like the name suggests it’s purple and messy! Using daily for three to four days is typical. If your baby has not responded after 3-4 days or they have sores that develop, discontinue use and call your pediatrician. For thrush that has not responded to Nystatin, there is another class of drugs – the Azoles- that can be used. However this has been shown to cause liver problems in some people and should only be used when prescribed by your pediatrician.
There is a popular theory that says that otherwise healthy people can get systemic candidiasis. This “Candida Hypersensitivity” is then claimed to be one of the causes of “Idiopathic Environmental Intolerances” of which the symptoms are a long list of general complaints including fatigue, depression and joint pain. It is reported that a “Candida diet” along with certain vitamins and supplements can help eliminate the body of excessive yeast and restore balance. There is no scientific evidence that this is necessary. The American Academy of Allergy, Asthma, and Immunology (AAAAI) has evaluated “Candida Hypersensitivity” and reports that “there is no scientific proof that Candida albicans causes such a condition.” Admittedly the information available for and against systemic yeast infections is massive and confusing. What we do know is that the rare person that does succumb to a systemic yeast infection is also immunocompromised and extremely ill. They are being cared for in an intensive care unit and not walking around with vague complaints. Stephen Barrett, M.D. of Quackwatch.org has done a great job of compiling information regarding this theory.
Talk with your pediatrician before starting any therapy particularly if your child’s thrush is recurrent or severe. Severe thrush along with other clinical signs can be an indicator that there is an underlying immune deficiency. Remember that infant oral thrush is common. Just because you see a little thrush in the mouth does not mean that treatment is necessary.
Sheila Cason, MD
Treatment is usually saved for those babies who are uncomfortable or who have a more extensive case. Traditionally the topical application of Nystatin suspension has been used to treat thrush. You can drop the medicine in the baby’s mouth or apply it directly to the lesions with a cotton tip applicator. But be careful not to contaminate the bottle of medicine by touching the medicine dropper to your baby’s mouth and then replacing the dropper in the bottle. Sterilize the nipples of baby bottles and pacifiers. Nursing mothers will need to treat their nipples as well.
Gentian Violet is another alternative to therapy besides Nystatin. No prescription is necessary and can often be found in drugstores. Like the name suggests it’s purple and messy! Using daily for three to four days is typical. If your baby has not responded after 3-4 days or they have sores that develop, discontinue use and call your pediatrician. For thrush that has not responded to Nystatin, there is another class of drugs – the Azoles- that can be used. However this has been shown to cause liver problems in some people and should only be used when prescribed by your pediatrician.
There is a popular theory that says that otherwise healthy people can get systemic candidiasis. This “Candida Hypersensitivity” is then claimed to be one of the causes of “Idiopathic Environmental Intolerances” of which the symptoms are a long list of general complaints including fatigue, depression and joint pain. It is reported that a “Candida diet” along with certain vitamins and supplements can help eliminate the body of excessive yeast and restore balance. There is no scientific evidence that this is necessary. The American Academy of Allergy, Asthma, and Immunology (AAAAI) has evaluated “Candida Hypersensitivity” and reports that “there is no scientific proof that Candida albicans causes such a condition.” Admittedly the information available for and against systemic yeast infections is massive and confusing. What we do know is that the rare person that does succumb to a systemic yeast infection is also immunocompromised and extremely ill. They are being cared for in an intensive care unit and not walking around with vague complaints. Stephen Barrett, M.D. of Quackwatch.org has done a great job of compiling information regarding this theory.
Talk with your pediatrician before starting any therapy particularly if your child’s thrush is recurrent or severe. Severe thrush along with other clinical signs can be an indicator that there is an underlying immune deficiency. Remember that infant oral thrush is common. Just because you see a little thrush in the mouth does not mean that treatment is necessary.
Sheila Cason, MD
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