Thrush is caused by a yeast infection that grows on the lining of the mouth. It can cause bleeding of the mouth and gums if it is severe. It is very common in babies. Sometimes parents see white material inside the baby's mouth and wonder if it is thrush or just milk residue. Milk residue is thin and wipes or rinses out of the mouth easily. It is usually just found on the tongue. Thrush, on the other hand, can't be easily removed from the mouth lining or tongue. The thick, white plaques, when scraped off, usually leave small ulcers or bleeding underneath. Also, thrush usually covers the gums and the inside of the cheeks. Thrush is treated by removing sources of yeast from the baby and with medications, such as Nystatin.
How to apply Nystatin
Nystatin is a topical medicine - it works only on the surfaces it can touch. Therefore, it is very important that the nystatin gets applied directly to the areas with thrush. Sometimes parents just splash the medicine in the baby's mouth, which mostly dribbles out or gets swallowed before it has a chance to work. The best way to apply nystatin is with a Q-tip. Measure out the dose into a small cup. Dip a cotton swab into the medicine, then rub the swab gently against the white areas in the baby's mouth. Repeat with an additional dose inside the other cheek. Use the nystatin every day until the baby's mouth looks clear, then continue the medication for two more days after that. If it's still not getting better after a week of treatment, let us know.
Other things you must do
As with most other illnesses in pediatrics, prescription medicine is only half of the treatment. Sources of yeast must be eliminated. Otherwise, the baby will keep getting re-infected and the nystatin won't do any good. For breastfed babies, mothers need to treat their breasts with Nystatin cream. Mothers may have yeast on their nipples that keeps re-infecting the baby. Usually mothers will have red, cracked nipples, but this is not always the case. For bottle-fed babies, boil all the nipples. This will kill any yeast lurking in the nipples. Throw away the pacifiers. It is very hard to get rid of the yeast completely as long as the infant uses a pacifier.