Thrush

This article is an excerpt from "The Nursing Mother's Problem Solver"
by Claire Martin.

Thrush appears as white blisters, as red dots, or as a peeling rash. It is painful
for both mother and baby. Yeast is a kind of fungus. Thrush is an overgrowth of
yeast. It survives by consuming sugars digested from other sources. Mother and baby
must be treated simultaneously. It is extremely contagious; if one of you has thrush,
the other almost certainly has it too, or will soon.

Pediatricians or OB/GYNs typically suggest topical ointments, including clotrimazole
(in 1 percent or 2 percent concentrations) and Nystatin, which often are used together
in treatment. Clotrimazole will work on thrush. If you find the 1 percent cream
too slow or ineffective, try the 2 percent miconazole cream. Wash off Clotrimazole
before you nurse (use water, not soap), and reapply afterward.

prevents the thrush yeast from reproducing; it must be applied to all affected areas
four times a day, and you can't nurse for 10 minutes after you use Nystatin. Because
it contains sugar, Nystatin can leave your nipples sticky: It never really dries.
(If you thought your nipples were sore before, try peeling Nystatin- covered nipples
from a nursing bra or nursing pads.)

If you put a little Lotrimin on your nipples, they won't stick to your bra. It's
absorbed pretty quickly and thoroughly into the skin. You don't need to wash it
off unless your baby wants to nurse the instant you've applied it.

An alternative treatment for thrush is gentian violet. You paint it on your nipples,
inside the baby's mouth, on the baby's genitals, and on any other area affected
by the thrush. Gentian violet works fast, and it's nearly foolproof, often better
at resolving thrush than commercial medications. However, gentian violet has one
drawback: Anything it touches will be permanently stained purple. And it takes several
days for the gentian violet to work its way through a baby's system or wear off
your skin. Plan on wearing dark clothing, using dark towels, and sleeping on dark
sheets. On the upside: gentian violet resolves thrush within 2 or 3 days, and you'll
have lots of opportunities to teach your baby about the color purple.

Another option for your baby is a relatively new drug called Diflucan, an oral medication
that is mixed with water and given to the baby twice a day for 2 weeks. It's a lot
easier than swabbing the baby's mouth, and you see results in 48 hours. A pill form
of the same medication is an option for adults. One caution about Diflucan: It can
damage your liver. Don't take it lightly.

Until the thrush is gone, it's extremely important to sterilize everything that
touches the baby's mouth or your nipples. That means boiling all bottle nipples,
pacifiers, breast pump parts, and toys. Wash all clothing-yours and the baby's-in
hot water. Thrush, as you've learned, is highly contagious.

Don't despair: Thrush can be treated, and you can prevent its return by monitoring
your diet and making sure you use breathable, not moisture-proof, nursing pads in
your bra. The initial pain should subside within 72 hours.

Pediatric Healthcare Associates

615 6th Avenue Altoona, Pennsylvania 16602 Phone: 814-944-7383 | Fax: 814-944-7608