Thrush in a FF baby?
Xander was on two powerful antibiotics at birth. Gentamiacin and Ampicillin were given for suspision of sepsis because he was preterm and having tons oof trouble breathing.
Within about 10 days he got a nasty, nasty yeast infection down below and luckily with the right compound prescription from the doc, that has come and gone. As soon as that was on the mend, the thrush came on. He has been on the medication since 2/14 (two weeks today) and it is still here. It has gotten better and then got worse while still on the medication. I have been steralizing his bottle nipples after each feed and he gets the medication every 6 hours. He doesn't take a paci so I am not concerned about that.
The doctor wrote "for 15 days" on the script but gave two refills. Do I need to call the office and let him know that it has been just about 15 days and he is no where near cleared up? He did say that the effects of the antibiotics could last for sometime because of his size.
He is on Nystatin, anyone know of something different that he may prescribe since this isn't cutting it?
Re: Thrush in a FF baby?
I'm a pediatric dermatology PA. Nystatin isn't the greatest, but it's really the only one formulated to go in the mouth. But if it's been past 2 weeks, he may need an oral antifungal like Diflucan (Fluconazole). I've seen tons of babies get it who are FF. Are you washing the nipples / boiling them? They are contaminated and need to be boiled after each use so that you are not re-infected your son. Also, are they sure it's not "milk tongue". It looks like thrush but it's just a build up of milk. It's usually centered int he middle of the tongue, right where the bottle would be dripping, whereas thrush spreads to the insides of the cheeks, etc. Also, if you take a piece of gauze and try to wipe off the white stuff, thrush will bleed (not much so don't worry), whereas milk tongue does not. Here is a pic of milk tongue:
Camryn Grace ~ July 6th, 2009 ~ 7lbs 9oz, 20.5"
Brayden Richard Drew ~ December 20, 2010~7lbs 9oz, 20"
I can't see the picture, but it isn't on his tongue at all. It is in the insides of his cheeks in in his upper and lower lip. I did forget to mention that it isn't severe, it doesn't cause him any discomfort at all and it does not keep him from eating. It is like the nystatin keeps it from getting any worse, just not any better either.
Our ped did take a long q-tip and try to rub it off and he couldn't get it off either. I have been using the medication after feeds so that it sits in his mouth. The ped said to make sure to pour it (with a one mL syringe) into each cheek and its ok that he spits some out and swallows some. but at least it is sitting/coated on for awhile between feeds.
Hmmm, not sure why the pic is working. When I posted it I saw it. Are you boiling the bottle nipples and pacifiers? Since it's all over, it's not milk tongue. And it's fine that he spits some out. For older kids/adults, we say "swish and spit". Did he have it at birth? Did you ever see his mouth without it? There is something called Lichen Planus that can be in the mouth (or any part of the body). It's nothing bad and resolves on it's own. I just think it's weird that it's not getting any better.
Here's a pic of Lichen Planus (hopefully it works)
Camryn Grace ~ July 6th, 2009 ~ 7lbs 9oz, 20.5"
Brayden Richard Drew ~ December 20, 2010~7lbs 9oz, 20"
Eww... that is gross! Yeah, he didn't have it until about a week after the antibiotics were finished and toward the end of the yeast infection in his diaper area. The diaper area has started to flare too in the last two days so we started the cream down there again to keep it from getting bad.
We are steralizing his bottles and nipples in a micorwave steralizing bag after each feed. I am only using two different nipples so that we don't contaminate all of them and I plan on tossing these two when we get a grip on this.
It started in his cheeks and spread to his lips after about a week. Do you think I should call the ped back since it has been the 15 days as stated on the script or since it isn't getting worse, leave it be for a little bit? I am usually more of a worry wart but with this, I just don't know because it doesn't seem to bother him but it isn't getting better. I don't really know....
Ok, so not milk tongue, not lichen striatus, LOL. Sorry, I'm just trying to go through everything that's white and in the mouth!
Yeah, call the pedi. 15 days is sufficient time. I would ask to put him on an oral, like I mentioned, I use Diflucan (fluconazole). Even though it's not getting worse, it's still there. And it's not comfortable! Some babies I have come in are refusing to eat because it hurts.
Camryn Grace ~ July 6th, 2009 ~ 7lbs 9oz, 20.5"
Brayden Richard Drew ~ December 20, 2010~7lbs 9oz, 20"
DD had a BAD case of it and I think it took 3 (maybe 4) refills to finally get it gone. I would go ahead and use the second refill and if it still hasn't cleared up THEN call the dr. and let them know. DD's dr. also said to just give it to them was not as effective but if you get like a baby washcloth or a fingertip toothbrush and really rub it in it is more effective. Good Luck!
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