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This article is an excerpt from "The Nursing Mother's Problem Solver" by Claire Martin.

Thrush appears as white blisters, as red dots, or as a peeling rash. It is painful for both mother and baby. Yeast is a kind of fungus. Thrush is an overgrowth of yeast. It survives by consuming sugars digested from other sources. Mother and baby must be treated simultaneously. It is extremely contagious; if one of you has thrush, the other almost certainly has it too, or will soon.

Pediatricians or OB/GYNs typically suggest topical ointments, including clotrimazole (in 1 percent or 2 percent concentrations) and Nystatin, which often are used together in treatment. Clotrimazole will work on thrush. If you find the 1 percent cream too slow or ineffective, try the 2 percent miconazole cream. Wash off Clotrimazole before you nurse (use water, not soap), and reapply afterward.

This prevents the thrush yeast from reproducing; it must be applied to all affected areas four times a day, and you can't nurse for 10 minutes after you use Nystatin. Because it contains sugar, Nystatin can leave your nipples sticky: It never really dries. (If you thought your nipples were sore before, try peeling Nystatin- covered nipples from a nursing bra or nursing pads.)

If you put a little Lotrimin on your nipples, they won't stick to your bra. It's absorbed pretty quickly and thoroughly into the skin. You don't need to wash it off unless your baby wants to nurse the instant you've applied it.

An alternative treatment for thrush is gentian violet. You paint it on your nipples, inside the baby's mouth, on the baby's genitals, and on any other area affected by the thrush. Gentian violet works fast, and it's nearly foolproof, often better at resolving thrush than commercial medications. However, gentian violet has one drawback: Anything it touches will be permanently stained purple. And it takes several days for the gentian violet to work its way through a baby's system or wear off your skin. Plan on wearing dark clothing, using dark towels, and sleeping on dark sheets. On the upside: gentian violet resolves thrush within 2 or 3 days, and you'll have lots of opportunities to teach your baby about the color purple.

Another option for your baby is a relatively new drug called Diflucan, an oral medication that is mixed with water and given to the baby twice a day for 2 weeks. It's a lot easier than swabbing the baby's mouth, and you see results in 48 hours. A pill form of the same medication is an option for adults. One caution about Diflucan: It can damage your liver. Don't take it lightly.

Until the thrush is gone, it's extremely important to sterilize everything that touches the baby's mouth or your nipples. That means boiling all bottle nipples, pacifiers, breast pump parts, and toys. Wash all clothing-yours and the baby's-in hot water. Thrush, as you've learned, is highly contagious.

Don't despair: Thrush can be treated, and you can prevent its return by monitoring your diet and making sure you use breathable, not moisture-proof, nursing pads in your bra. The initial pain should subside within 72 hours.

About the Author

Claire Martin is a parenting writer at the Denver Post. Her writing has won national and regional awards, and has appeared in publications such as the St. Petersburg Times, Good Housekeeping, and Sunset magazine. She lives in Denver with her husband and two daughters, both of whom were breastfed.

From THE NURSING MOTHER'S PROBLEM SOLVER by Claire Martin. Copyright © 2000 by Claire Martin. Reprinted by permission of Simon & Schuster, Inc.


If you are expecting parents or are looking for a new pediatrician, please join us for our "Meet the Pediatricians" nights.  They will be held at our Beverly Office at 30 Tozer Road on:
June 14th (6:30 pm)
July 19th (6:30 pm)

Dr. Morgan and Dr. McAuliffe are once again participating in the Bruins Beard-A-Thon. If you are not familiar with this, you pledge to grow your beard until your team either wins the Stanley Cup or is eliminated from the playoffs.


The Bruins have not made the playoffs the last two years so are beards have not made an appearance for several years now. Both have participated in the past to support the Bruins and Gail Wright who was one of the original PAGS front staff employees. She was a huge Bruins fan and passed away in May 2011 from Breast Cancer.

Congratulations to Dr. Campbell, Dr. D'Souza, Dr. Jalali and Dr. Mandell for being voted top pediatricans in Northshore Magazine (March 2017).  We have a great team at PAGS!

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