THRUSH TREATMENT RECOMMENDATIONS

NYSTATIN (46% cure rate, there is an emergence of yeast resistance to nystatin):
Baby’s mouth: Apply to all surfaces of mouth every 3 hours. Yeast cells reproduce in about one hour, so
using nystatin oral suspension every three hours may be helpful when the infection is not clearing up as quickly as
anticipated. When treating with nystatin oral suspension, it is important to shake the bottle well before using. Put a
small amount (one milliliter) into a small cup (to avoid contaminating). Using a cotton swab, apply nystatin well
to all surfaces inside the baby’s mouth – between the cheeks and the gums, on the tongue, under the tongue on the
roof of the mouth and between the lips and gums. Unlike other medicines that work once swallowed, nystatin has to
come in direct contact with the yeast. Any medicine that is left in the cup can be given to the baby to drink.
Mother’s nipples: After feedings, rinse with a water/vinegar solution (1 cup water to 1 tablespoon
vinegar). Dry and apply nystatin solution every three hours or after every feed. (If solution is used, no need to
wipe off before next feed) If using breast pads, change them at each feeding. If the nipples are so painful that it
hurts to wear clothing, breast shells may provide comfort.

MotherLove THRUSH & Diaper Rash SALVE:
Contents: myrrh, oregon grape root, calendula, yarrow, olive oil and beeswax.
Coat nipple and areola after each feed. These certified organic ingredients are an excellent all-natural salve that is
effective on thrush infected nursing nipples. It also works wonders for diaper rash! Iincluding persistent, inflamed
diaper rash possibly caused by yeast. (This can be purchased at the offices of The Women’s Healthcare Group)
 DIFLUCAN (Fluconazole):
Studies have found it to have fungistatic activity against a variety of fungal strains including C. albicans, C.
tropicalis, T. glabrata, and C. neoformans. It is well tolerated and have adverse effects reported in about 5-30% of
patients (most common were vomiting, diarrhea, abdominal pain, and skin rashes).
Infants require separate therapy with oral suspension as maternal dosed milk levels do not provide adequate
treatment for the infant via milk.
*Oral diflucan is currently cleared for pediatric candidiasis for infants 6 months and older and has an FDA Safety
Profile for neonates 1 day and older. (86% cure rate of infant oral candidiasis)
*REC pediatric dosing (for 6 months old and older): 6mg/kg STAT followed by 3mg/kg/day. For systemic
candidiasis, 6-12mg/kd/day is generally recommended.
Infant dosing: .4mg/Kg/day
Diflucan (Mom):
INDICATION
DAY 1
for Candidiasis
Oropharyngeal & 200 mg
or Nipple only
200-400 mg STAT
DUCTAL
*DUCTAL {Persistant or Chronic}
Esophageal
200 mg
Systemic
400 mg
100 mg
Minimum Duration of
Therapy
14 days
100-200 mg (depending on severity
14 – 21 days (depending
of S&S)
on severity of S&S)
DAILY THERAPY
150 mg weekly or 100 mg bi-weekly Prophilactically
100 mg
3 weeks
200 mg
4 weeks
 GENTIAN VIOLET: Mother’s nipples and baby’s mouth:
Apply .5% or 1% solution to surfaces (nipples and all babe’s mouth surfaces) 1-2 times each day for 3 days.
*Yeast can grow into several layers of the skin. Gentian violet penetrates through several layers of the skin, so it
may be very effective if other antifungals are not helping.
Hale TW: Medications and Mothers’ Milk, Ninth Edition, Amarillo, Texas: Pharmasoft Medical Publishing, 2000