Thrush — children and babies

Tuesday, May 16, 2006
If your new baby is fussy with feeds and not suckling contentedly, he or she may have a sore mouth. Perhaps the most common reason for a sore mouth in infancy is thrush. It is quite likely that many babies are infected with Candida albicans when they are born, passing through the birth canal or vagina where Candida lives. Babies who have been given antibiotics by mouth or injection for even a few days are particularly likely to develop thrush. Very ill babies are also at higher risk of infection.

It is often claimed that babies who bottle-feed and suck dummies get thrush more readily, especially if you don't adequately sterilise bottles, teats and dummies. However, in my experience, lots of babies have thrush in the early days, whether breast or bottle-fed.

Symptoms
Look inside your child's mouth — the signs of a Candida infection are obvious. The tongue, palate (roof of the mouth) and inside the cheeks will look red and inflamed. There will be white flecks or patches on some or all of these surfaces. You might think that these white areas are milk curds but curds can be wiped away while thrush plaques cannot.

Treatment
As with any infection, the first rule is to try to eliminate the source of the infection. If you are breastfeeding and have sore nipples, it is possible that you have a thrush infection yourself, so this should be treated. If you are bottle-feeding, it is important to check that you are sterilising bottles and teats according to instructions. Don't forget that dummies need the same treatment. Once you have dealt with the source of infection, the mainstay of treatment is the use of medications for the mouth which are available in the form of drops and gels.

Thrush and nappy rash
Nappy rash can make mothers feel quite anxious. You may feel as though you have neglected your child — but in fact nappy rash happens at some time to most babies. Babies with particularly sensitive skin are prone to having it more often than others. Nappy rash is just a term describing a rash, redness or sores in the area of the body covered by the nappy. The main cause of nappy rash is the fact that a napkin wet with urine and perhaps faeces is held close to the skin for a long time, especially overnight. The urine and faeces irritate the skin and the napkin prevents it from drying, so that the skin barrier is damaged. When this happens, an infection with Candida albicans often results.

Preventing nappy rash

  • Change baby's nappies often (modern disposable nappies are extremely absorbent and do a good job in keeping moisture away from babies skin).
  • Use nappy liners if using cloth nappies.
  • Cloth nappies should be machine washed and rinsed thoroughly.
  • A fabric softener or couple of minutes in the tumble dryer at the end of drying time will soften nappies and reduce the tendency to chafe.
  • Try to make time every day when baby can have a kick without a nappy.
  • Avoid using soap on the baby as it dries out the skin.
  • Wash baby with warm water and a non-drying baby wash (if needed) at nappy changes.
  • Don't use disinfectants on baby's skin.

Treating nappy rash
Anti-fungal creams for adult skin infections are often used in combination with a hydrocortisone one percent preparation to control inflammation. The two creams can be mixed together on your hand before applying to baby's bottom. There is also a ready-mixed preparation (Hydrozole) containing clotrimazole mixed with hydrocortisone. Daktozin ointment is another combination preparation containing miconazole for the treatment of thrush and zinc oxide as a moisture barrier.


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