Effective Treatment Strategies for Thrush in Infants: A Guide for Parents

Treatment for oral thrush?

Hello, doctor.
I would like to ask some questions regarding the treatment of oral thrush.
Thank you!
1.
For a newborn (1 month old) with oral thrush, since the baby is breastfed, the hospital prescribed a powder for the mother to apply.
Should the powder be applied to the nipple before expressing milk, or should it be applied after expressing the milk?
2.
The hospital prescribed Mycostatin® for oral suspension for the newborn for about 7 days.
After using it for 7 days, if there are no signs of milk residue in the mouth, should we still return for a follow-up appointment? Is the normal treatment duration 7 days, or should it be extended a few more days to ensure the fungus is completely eradicated?
3.
Regarding the disinfection of baby bottles, nipples, and other items used by the newborn, if a steam sterilizer is available, should the items be boiled in hot water first before placing them in the sterilizer, or what is the recommended method for proper disinfection?

Niming, 30~39 year old female. Ask Date: 2024/03/16

Dr. Xiao Kaiwen reply Pediatrics

After expressing milk, apply the medication.
Continue using the medication for more than a week, and after the white patches disappear, use it for at least an additional 3 days to completely eradicate the bacteria.
After use, you can boil it in hot water for 20 minutes and let it dry to maintain dryness.

Reply Date: 2024/03/16

More Info

Thrush, or oral candidiasis, is a common fungal infection in infants, particularly those who are breastfed. It is caused by an overgrowth of Candida yeast in the mouth and can lead to discomfort for the baby. Here are effective treatment strategies and answers to your specific questions regarding thrush in infants.

1. Application of Medication: When treating thrush in a breastfeeding infant, the medication prescribed (such as Mycostatin®) should be applied to the mother’s nipples before breastfeeding. This ensures that the medication is present during feeding, which can help prevent the infant from re-infecting the mother and vice versa. After applying the medication, the mother can then express milk or breastfeed as usual. It’s essential to maintain good hygiene practices, such as washing hands before and after applying the medication.

2. Duration of Treatment: The typical treatment duration for thrush with Mycostatin® is indeed around seven days. If, after this period, there are no visible signs of thrush (such as white patches resembling milk curds), it is generally not necessary to return for a follow-up unless symptoms persist or worsen. However, if there are still signs of thrush after completing the medication, it is advisable to consult a healthcare provider for further evaluation. Sometimes, an extended course of treatment may be necessary to fully eradicate the infection, especially if the infant is at high risk for recurrence.

3. Disinfection of Feeding Supplies: Proper disinfection of feeding supplies is crucial in preventing the recurrence of thrush. If you have a steam sterilizer, it is not necessary to boil the bottles and nipples beforehand, as the steam sterilizer is effective on its own. However, if you are using boiling water, it is recommended to boil the items for at least 5-10 minutes before placing them in the steam sterilizer. Additionally, ensure that all items are thoroughly cleaned with soap and water before sterilization. Regularly cleaning and sterilizing bottles, nipples, and pacifiers can significantly reduce the risk of fungal infections.

Additional Tips for Parents:
- Maintain Oral Hygiene: For infants, wiping the gums and tongue with a clean, damp cloth after feedings can help reduce the buildup of yeast.

- Monitor Symptoms: Keep an eye on your baby for any signs of discomfort, such as fussiness during feeding or refusal to eat. If thrush appears to be causing significant discomfort, consult your pediatrician.

- Breastfeeding Considerations: If the mother has symptoms of thrush (such as itchy or painful nipples), she should also seek treatment to prevent passing the infection back to the baby.

- Dietary Considerations: If the infant is older and consuming solid foods, reducing sugar intake can help minimize yeast overgrowth.

In conclusion, treating thrush in infants involves a combination of medication, hygiene practices, and monitoring for symptoms. If you have any concerns or if symptoms persist, it is always best to consult with a healthcare provider for personalized advice and treatment options.

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