Question
What are the signs of thrush? If we have it, how do we get rid of it?

Learn about it
Thrush (Candida albicans) is a common yeast infection that occurs in a baby’s mouth and diaper area, and on a nursing mother’s nipples. It is almost always harmless, but because it thrives in these warm, moist places, it is extremely stubborn and difficult to eliminate. In addition, it can be very annoying because it is quickly and easily transferred back and forth from mother to baby, until both are totally clear of it.

The signs of thrush in the baby
You baby may have all of these signs, some of them, or even none. If you suspect thrush, review both the signs for a baby and the symptoms that you have. The following are typical signs of thrush in a baby:

• White or gray spots or patches on the inside of your baby’s mouth, gums, or on his tongue. (A milk coating on the tongue wipes off easily; thrush does not.)
• An opalescent shine on your baby’s lips or inside his mouth.
• Red face, particularly on the cheeks.
• Persistent diaper rash that doesn’t respond well to usual remedies.
• Fussiness that appears worse during or after feeding.
• Bleeding of the mouth or gums in severe cases.

Signs of thrush in the mother
The following are typical signs of thrush, but many of these can signal other problems as well. If you review the list for yourself and that for your baby, and suspect thrush is the problem, call your healthcare provider, lactation consultant, or La Leche League leader.

• Pain in the nipples or breasts during or after feedings that may persist between feedings
• Deep pink, red or purple discoloration of the nipple and areola
• A shiny glow on the areola
• Dry, peeling nipples
• Rash or white spots on the nipples
• Itching or soreness that indicates a vaginal yeast infection

Note: You are particularly susceptible to thrush infection following the use of antibiotics, as these medications kill off not just “bad” bacteria, but the “good” types that keep candida under control.

Treating the family
If you suspect a thrush infection, both you and your baby will need treatment simultaneously until all signs of thrush are gone. If you are also nursing an older child, you will have to treat her, too. In some cases, your partner or other members of the family may shows signs of thrush (athlete’s foot, severe dandruff, jock itch, vaginal yeast infection) that will have to be treated to prevent the recurrence of thrush in the family.

Treating the baby
Many babies with thrush show little response to the yeast infection. For others, it is painful and prevents proper nursing. In that case, the infection should be treated promptly and aggressively so that your baby’s growth is not compromised. It’s important that you talk to your baby’s doctor, who may prescribe a topical medication that can be applied directly to your baby’s mouth for pain relief and to clear up the infection. The most common medication is a prescription anti-fungal cream. A homeopathic doctor can talk with you about using a tincture made of usnea lichen, mugwort, rosemary, or unsweetened yogurt with active cultures.

An alternative treatment is 1% gentian violet solution, painted with clean cotton swabs onto affected areas once a day prior to breastfeeding. These areas include your baby’s mouth as well as your nipples and areolae. It’s very messy and will turn your baby’s lips and your nipples purple for a few days, but it is often very effective. (Watch your baby’s mouth carefully for any signs of negative reaction, such as sores, from the treatment. Too much of the solution can burn the skin’s surface. If anything seems amiss, or if no relief occurs within four days, stop treatment and visit your doctor.)

In addition, the following may help your baby feel better, speed up the eradication of the infection, and prevent it from recurring:

• Change diapers immediately when your baby’s wet or soiled.
• Coat baby’s bottom with a diaper ointment between changes.
• Avoid using diaper wipes with ingredients that may cause stinging.
• Let your baby’s bottom dry thoroughly before re-diapering, and allow your baby to be naked for a time during the day.
• Avoid using plastic diaper covers. Instead, use coverings that allow air to circulate, or go cover-less if you’re not expecting a big poop anytime soon.
• Wash cloth diapers, cloth wipes, towels, and washcloths in very hot water to remove all traces of the yeast. A vinegar rinse will complete the disinfecting process.

Treating the mother
Talk with your doctor or lactation consultant about your suspicion of a thrush infection. She will confirm the diagnosis and prescribe a medication to clear up the thrush and any accompanying vaginal yeast infection. As mentioned earlier, if thrush is confirmed in the mother, the baby must be treated also, or the infection may continue to be passed back and forth between you. The following also can be helpful when treating thrush:

• Take an over-the-counter medication, such as acetaminophen (such as Tylenol) or ibuprofen (such as Advil), for breast pain; alternatively, try chamomile, skullcap, or low doses of valerian.
• Place ice packs on the nipples prior to feeding to reduce pain.
• Massage the breasts to stimulate letdown before attaching your baby to the breast.
• Start feeding sessions on the least painful side.
• Take extra care in ensuring a proper latch when nursing.
• Position your baby tummy-to-tummy with you for feeding to create a straight latch position and reduce pulling on the nipple.
• Break the suction with your finger to gently detach baby from your breast.
• Go braless or topless, or keep the flaps down on your nursing bra to allow your nipples to air dry.
• Avoid using breast pads, as these create a warm, moist place for yeast to thrive.

How to prevent recurring infections

• Clean and sterilize all pacifiers, teethers, and bottle nipples after each use.
• Let nipples dry after breastfeeding before covering them with clothing.
• Avoid letting your baby suck for long periods on a bottle or pacifier.
• Discard breastmilk that was expressed and stored during a thrush infection.
• Maintain diligent hygiene with frequent handwashing after breastfeeding, diapering, and using the toilet. Pay attention to underneath the fingernails, too. Wash your baby’s hands frequently.
• Avoid excess sugar ¾ that applies to you and baby.
• Add plain yogurt to your diet (and to your baby’s diet if she is eating solid food).
• Avoid fermented foods, such as cheese, beer, and wine.
• Wear clothing that allows the skin to breathe, and avoid synthetic fabrics.
• Use regular hand soap instead of antibacterial soap ¾ it kills beneficial bacteria that control yeast growth.
• Disinfect toothbrushes and mouth appliances regularly with a bleach and water solution, or put them in the dishwasher.
• Wash dishes in very hot water.
• Discard solid deodorants used during a thrush infection.
• If the thrush infection isn’t going away, have other family members and even pets checked to see if they are carriers.

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author:
Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines. Visit Elizabeth’s web site http://www.pantley.com/elizabeth.

With my first son, Phillip, we had a great Pediatrician from India. This man was very gentle with babies and you could tell when he held a baby that he loved children. When my son was a few days old, this doctor told me something that I had a difficult time grasping at first. He said, “Don’t wipe your baby’s bottom every time you change the diaper.”

This seemed foreign to me. I listened but I walked away thinking he didn’t know what he was talking about. I was under the impression that I was to clean that baby thoroughly every time I changed him.

Well, I set out to do just what the doctor told me; after all, he was the expert and I was a new mom! I realized somewhere along the line that the doctor was right. The only time I would wipe the baby’s bottom was when he had a bowel movement never when he was wet. Looking back I realized how wise that doctor really was. He understood that the PH of the baby’s skin was the same as the acid in the urine. Rubbing the baby’s sensitive skin 9 or 10 times a day, coupled with the constant PH change was a sure cause of a sore baby bottom. The urine didn’t cause a diaper rash, the wiping did! There was one other culprit that would cause a rash and that was a bowel movement.

With 5 children over several years, I can tell you that diaper rash honestly did not happen at our house. I attribute this to a quick and immediate change with diaper wipes whenever there was a bowel movement and NO wiping baby’s bottom when there wasn’t a bowel movement. Over the years I received many snide comments from on-lookers and well-intentioned friends and family but I would happily report to them that it was the doctor’s orders! What could they say to that?

To wipe or not to wipe must be a personal decision and I will leave you with this bit of “only wiping with bowel movement” information to do with what you will. One more thing though, after years of dealing with doctors, I wish I could tell you that they were all “experts” and that you should always do exactly everything they say, unfortunately, I have not found this to be true. I have found that there are some really good doctors out there and even then you should use your best judgment when dealing you’re your child.

While we are on the subject of baby bottoms and baby wipes, you might want to use this recipe. I made these wipes for over 5 years and always had them on hand. They were easy and saved a lot of money and my husband and I always felt they were just as good as the store brand!

Home Made Baby Wipes
If you go to a second hand store you can pick up an electric knife for about $3 and use it to cut your paper towels in half the short way. I tried other paper towels that were cheaper than Bounty and they would fall apart and mold if you left them in the container, so stick with Bounty for best results.

• ½ Roll of Bounty paper towels
• 1-Cup Water
• 1 TBS baby oil
• 2 TBS baby shampoo or baby bath of your choice
• Rubbermaid cylinder type container or old baby wipe container.

Mix all liquid ingredients in cylinder container. Remove outside plastic and inner cardboard tube from paper towels and place them in the container and put the lid on tight. Flip container over and wait until towels are thoroughly saturated. Pull wipes from middle. Want a printable version of this recipe? Go to: http://www.keys2kids.com/babywipes print.htm

Happy wiping!

© 2003 by Michelle Shelton. All rights reserved

About the Author
Michelle Shelton is an author, parenting coach, parent consultant, acclaimed public speaker, and Arizona Real Estate Agent and parent educator. Michelle is the author of the well known column Life with all these Kids. Visit her web site www.askmichelleshelton.com or contact her at 480-577-8272.

What Causes Them?
Diaper rashes can be caused by a number of different things. It can be caused because a baby is left in a wet or dirty diaper for a long period of time. It can also however be a reaction that your baby may have to milk, citrus fruits, and other baby food. It doesn’t necessarily mean that your baby is allergic to what you are feeding them; it may just be that it doesn’t go out as easily as it goes in. When your baby is sick and has diarrhea, they can easily get diaper rash just from one bowel movement.

How Severe Can It Get?
Diaper rashes can resemble anything from a little redness to a bum that is broken open, red and bleeding. Your baby may have a rash that covers his butt, or it may be centralized to one area. It might be red, or have bumps resembling blisters, or actually be blistered. In the worst cases it can get bloody and pussy, or turn into a yeast infection which may need prescription medication to be treated.

How Do You Get Rid of It?
Sometimes getting rid of diaper rash can be simple, other times it may take a few days. There are a lot of different diaper rash creams and gels on the market that contain zinc oxide from companies like Desitin, Aveeno and Balmex, one company even makes a cream calls “Butt Paste”. Vaseline can also be used to help cure and prevent diaper rash. Although no longer recommended by all pediatricians, some will tell you to put baby powder on your child when you change his diaper to help keep him dry. Be sure to consult your child’s’ pediatrician to see what he recommends.

In more severe cases of diaper rash, where the creams just don’t seem to get rid of it, try placing your baby in a bath consisting of water and baking soda. The baking soda can help aid in drying out your baby’s rash and healing it. If your baby is bleeding and pussy, or if you just want a second opinion, do not hesitate to call your pediatrician to have your baby looked at.

How Can You Prevent It
You may not be able to always prevent diaper rashes. In the case of it being related to a food your baby eats or drinks, like orange juice when he is a toddler, all you can do to avoid it is eliminate that food from your baby’s diet. In order to prevent diaper rash in general though try to check and change your baby’s diaper frequently, not leaving him in an overly wet or poopy diaper any longer than necessary. Use the creams and gels as a preventative measure, instead of just as a treatment. Try making sure that your baby’s skin is completely dry before putting on a diaper, so that the wetness does not get on the diaper and lay against your baby’s skin.

If your baby gets a diaper rash when you first introduce a new food, try to not give him that food till the diaper rash has cleared. If the baby gets a rash when you introduce it again, then you will know that the food does not agree with your baby and you will be able to steer clear from that, and other foods that contain the same ingredient. The last thing you can try is changing the brand of diapers and wipes you use to see if that makes a difference.

When In Doubt…
If you are not sure if your baby has an allergy, a rash, or how severe his rash is, don’t hesitate to call your pediatrician and have your baby seen. That is their job and they may even have more recommendations to help you heal your baby’s butt.

Baby Acne
Pimples on your baby are as common as the breakouts you had during your teenage years. As the hormones leave your baby his skin is caused by an increase of oil production. This normally clears on its’ own within a few weeks without needing treatment. It is also no indication of acne problems in your baby as they reach puberty.

Eczema
Dry skin can be very common in your baby and toddler. It is often describes as an itching, oozing, crusty rash that can be found mainly on your baby’s face and scalp. Unlike cradle cap which will generally go away on its’ own before your baby’s first birthday, eczema will require either a prescription or over-the-counter topical, steroid-free antihistamine in order to clear up. Be sure you ask your baby’s pediatrician about any rash on your baby’s skin at your next well-check.

Diaper Rash
Your poor baby’s bum is not always soft. There will probably come a time when it will be red and sore, possibly even a bit bloody if your baby develops a severe diaper rash. While it can be caused by infrequent diaper changes, diaper rash is not necessarily caused by you not changing a baby’s diaper quick enough. It can be caused by a food or juice that your baby eats or drinks that doesn’t agree with him. It can also come as a side effect to teething. Diaper rash can be treated with over-the-counter creams or prescription medications if your doctor deems necessary. Be sure to ask your pediatrician at your baby’s next appointment.

Birthmarks
In most cases a birthmark on your baby’s skin is not dangerous. If you are concerned about one your baby has ask your pediatrician. Most of the time it is a little light red or brown colored spot. Sometimes they can grow. If your baby’s pediatrician thinks that there is a problem with your baby’s birthmark, there are medicines he can prescribe to help it fade or disappear.

All these skin problems that your baby can have can be exhausting for you! Between the acne, rashes and birthmarks the fun never ends for you as a new parent. Like many other things when it comes to your new baby…this too shall pass.

More than 100,000 babies each year suffer from milk allergy. The condition causes digestive, respiratory and/or skin problems and is often difficult to recognize.

“These babies cannot process the complex protein chains found in milk-based baby formula. And many also react to soy-based formulas,” says Dr. John Moissidis, a Board certified pediatric allergist at The Asthma Allergy Clinic in Shreveport, La.

Infant milk allergy is treated by either eliminating the milk proteins from the nursing mother’s diet, or by replacing the regular formula with an amino acid-based formula.

“An amino acid-based formula is safe for babies with milk and soy allergies because it is comprised of non-allergenic amino acids, the building blocks of protein, instead of partial or complete protein chains found in other formulas,” says Sarah O’Brien, nutrition specialist for Nutricia North America, the manufacturer of amino acid-based formula Neocate.

This specialized formula does not require a prescription, but infants taking it should be under the care of a physician.

Here are eight signs, provided by Dr. Moissidis, to help parents of infants identify a potential milk allergy.

1. Diarrhea
Diarrhea is common in babies, but if it is persistent (an average of two to four times a day for more than five to seven days) and/or if there is blood in the stool, it could signal a more serious milk allergy.

2. Vomiting
Babies often spit up bits of food, but vomiting beyond the typical mealtime regurgitation should be examined by a doctor. Reflux symptoms, such as spit-up and difficulty swallowing, can also be milk allergy symptoms.

3. Skin Rash
There are many causes for infant skin rashes like eczema. Milk allergy is one possible cause, especially if the rash occurs along with some of these other symptoms.

4. Extreme Fussiness
Every baby cries, but crying continuously and inconsolably for long periods of time is abnormal. When there is no apparent reason, this is usually called colic. Sometimes this extreme fussiness is actually caused by the gastrointestinal pain resulting from an allergy to the proteins found in milk.

5. Low or No Weight Gain
Most infants double their weight by six months and triple it by 12 months. But when babies are not getting the nutrition they need because of excessive diarrhea and vomiting, they are unable to grow like they should.

6. Gassiness
All babies have gas, but when it occurs along with several of these other symptoms, it can also signal an allergy to milk proteins.

7. Respiratory Problems
Colds are common for infants, but wheezing, struggling to breathe and developing excess mucus in the nose and throat is not. For some kids, these respiratory problems can be the baby’s reaction to the protein found in milk.

8. Failure to Thrive
Babies with milk allergy often suffer from a lack of proper nutrition characterized by dehydration, loss of appetite and lack of energy. This overall failure to thrive is often the result of the effect of the other symptoms effect on the infant’s body.

Parents can take the allergy test and learn more about infant milk allergy and amino acid-based formula at www.testforallergy.com.

Courtesy of ARA Content

As humans we shed skin cells and grow new ones quickly and often without even realizing it. This action begins in infancy; however many times on babies the new skin grows in faster than it can fall off, leaving the old skin stuck to the head on top of the old.

Causes
The sebaceous glands in babies skin is often overactive because of the hormones passed from mom, through the placenta, into the baby shortly before birth. These glands create a greasy substance which can be sticky and keeps the old skin from falling off. It generally appears in a baby within the first three months and rarely after the first birthday until later on in the teen years when puberty begins. It is normally gone by eight months, if not much earlier.

The scaly skin can also appear underneath your baby’s eyebrows, and around/behind his ears. It is important to clean these areas just like you would wash the top of his head. In some cases it may appear on other parts of the body. If you are concerned, ask your pediatrician.

Treatment
Most of the time treatment is not necessary unless it bothers you or your baby. Some pediatricians will suggest putting olive oil on your baby’s head, waiting for it to loosen the scales and then gently brushing this off. However this will not keep it from reappearing. If the scabbing and skin are extra red or inflamed your baby’s doctor may tell you to use some over-the-counter cortisone cream to help clear it up. If the pediatrician makes a suggestion that does not seem to help matters, be sure to mention it at your next appointment as it may be a sign that something else is going on.

Prevention
There is no real way to easily prevent cradle cap from appearing. Since it doesn’t normally bother a baby, it is best to let it take its’ course, treat it if necessary, and let it fade on its’ own.