Baby thrush is a common yeast infection affecting the mouth (oral thrush) or the diaper (nappy) area or both.
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Thrush is an infection caused by a yeast, Candida albicans. It is common in babies. It usually involves the mouth or the diaper (nappy)area.
Babies are particularly likely to get oral (mouth) thrush in the first weeks of life, with a peak in the second week. You baby will have white, cheesy coating of the tongue and you won't be able to wipe it off (compared to milk coating of the tongue whih you can wipe off). The tongue and the mouth generally can also look red and inflamed. It is often associated with thrush in the diaper area.
Babies with oral thrush need to have treatment with an antifungal agent, such as:
Miconazole gel and Fluconazole are both more effective than Nystatin and should be used if Nystatin has failed.
Breast-feeding mothers will often need to apply some nystatin, miconazole or clotrimazole cream (Mycostatin, Micatin, Daktarin, Canesten) to the area around the nipple. Apply after feeding.
Many diaper (nappy) rashes caused by moisture will get colonized by the Candida yeast if they continue for more than a few days, so any diaper (nappy) rash that has been present for 4 days or more, is likely to also have thrush.
The key features of the thrush diaper (nappy) rash are that there is redness and there may be white scaling as well.
Unlike moisture rashes that spare the skin creases in the thigh, thrush will involve the skin creases. You will also see what we call "satellite lesions" - these are spots that are distant to the main rash.
So it isn't just one big red rash, there are outlying spots - as in the photo above.
When you have diaper (nappy) thrush or any diaper (nappy) rash that has lasted at least 4 days, the treatment involves both:
If your baby has thrush in the diaper area, you need can use the cream (topical treatment). But you need to also use the oral Nystatin suspension. If you don't use the oral suspension, the thrush will often come back. The yeast is in the gut and so comes out with your baby's poop (poo) - if you don't treat from the top end, you won't get cure the thrush.
No. Baby thrush is common in the mouth and diaper (nappy) area. If your baby has thrush in other places (like the esophagus), it may signify an immune problem. If that is the case, speak to your doctor.
Last reviewed 8 July 2012
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