Treating Thrush

My baby has thrush. What should I do?

Dr. Greene’s Answer:

In otherwise healthy children, thrush is a self-limited condition, usually resolving within a month from its first appearance. No treatment is required. Even though it will improve on its own, treatment is often recommended either to alleviate oral discomfort or to treat (or prevent) painful yeast diaper rashes.

Treatment usually consists of an antifungal medicine such as nystatin suspension. This can be applied, gently, directly to the plaques with a cotton-tipped applicator, or given orally 1-2ml four times daily. Sidney Hurwitz, M.D., in Clinical Pediatric Dermatology, suggests using a cotton-tipped applicator dipped into a mixture of one-fourth teaspoon of baking soda and one or two drops of mild liquid detergent (without ammonia or bleach) mixed in a glass of warm water.

Stronger medicines are available, though usually unnecessary. If the thrush persists, yeast on nipples or pacifiers should be considered as sources for reinfection. Nystatin can also be placed on mother’s breasts; artificial nipples and pacifiers can be sterilized.

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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