Partners in Pediatrics

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Thrush usually makes a suprise appearance during the newborn period. Many parents will recognize the tell-tale signs of thrush: whitish-gray patches inside a baby's mouth and inflammation of the gums and mucus membranes. A similar process can affect the diaper area. Read on for more information.

	APPEARANCE Whitish-gray patches on the inner cheeks, the roof of the mouth, the gum line, and the tongue along with inflammation and redness of the mucus membranes. These white, irregular patches look like curdled milk but cannot be washed away or wiped off easily like milk. CAUSE Thrush is caused by a yeast (called candida) that grows rapidly on the lining of the mouth in areas abraded by prolonged sucking. It may also occur when your child has recently been on an antibiotic. Thrush is not considered contagious, since it does not invade normal tissue. HOME CARE The drug for clearing up this condition is Nystatin oral suspension. It requires a prescription. It is to be applied to the affected areas three to four times per day after meals. To speed up the healing, spread the Nystatin directly on the affected areas with a cotton swab (use a clean Q-tip each time it is dipped into the bottle of medicine). Continue to use for one week after the thrush seems to be gone. If you are breastfeeding, wash nipple and areola with warm water after feedings. Let skin air dry. Apply Lotrimin cream to nipple and areola after each feeding. It does not need to be washed off before feedings. If you have burning/stinging pain in your breast during or between feedings, you need to call or obstetrician. Boil all pacifiers, nipples, and mouth toys for 15 minutes at the end of each day. Rinse mouth with water after each feeding. Yeast will grow more if milk residue is left in the mouth. If not improved after ten days, the child should be seen. YEAST DIAPER RASH APPEARANCE This rash develops on the skin area covered by the diaper. It becomes bright red and raw and has small, pinpoint to pimple-sized, raised areas. CAUSE It is caused by a yeast called candida. HOME CARE Change diapers frequently. Try to keep the area dry and clean. During this time, the use of disposable diapers is preferable. Gently wash diaper area with an antibacterial soap and water. Rinse skin completely of all soap. Pat skin dry with a soft towel or air dry, or dry skin with a hair dryer using cool setting. Keep bottom open to air as much as possible (eliminates moisture). If not improving after five to seven days, the child should be seen by your health care provider.