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Gwinnett Pediatrics & Adolescent Medicine
Lawrenceville Office: 595 Hurricane Shoals Rd NW, Lawrenceville, GA 30046 | Phone: 404-355-0078
Duluth Office: 3790 Pleasant Hill Rd, Suite 230, Duluth, GA 30096 | Phone: 770-995-0823
Hamilton Mill Office: 2089 Teron Trace, Suite 100, Dacula, GA 30019 | Phone: 770-995-0823
Sugar Hill Office: 4700 Nelson Brogdon Blvd NE #180, Sugar Hill, GA 30518 | Phone: 770-995-0823

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  • White, irregularly shaped patches that coat the inside of the mouth and sometimes the tongue, adhere to the mouth, and cannot be washed away or wiped off easily like milk. (If the only symptom is a uniformly white tongue, it's due to a milk diet, not thrush.) Thrush causes mild discomfort.
  • Bottle-fed or breast-fed child


Thrush is caused by a yeast (Candida) that grows rapidly on the lining of the mouth in areas abraded by prolonged sucking (as when a baby sleeps with a bottle or pacifier). A large pacifier or nipple can also injure the lining of the mouth. Thrush may also occur when your child has recently been taking a broad-spectrum antibiotic. Thrush is not contagious since it does not invade normal tissue.


Nystalin Oral Medicine. The drug for clearing this up is nystalin oral suspension. It requires a prescription. Give 1 mL of nystalin four times daily. Place it in the front of the mouth on each side (it doesn't do any good once it's swallowed). If the thrush isn't responding, rub the nystalin directly on the affected areas with a cotton swab or with gauze wrapped around your finger. Apply it after meals, or at least don't feed your baby anything for 30 minutes after application. Do this for at least 7 days or until all the thrush has been gone for 3 days. If you are breastfeeding, apply nystalin to any irritated areas on your nipples.

Decrease Sucking Time to 20 Minutes per Feeding. Prolonged sucking (as when a baby sleeps with a bottle or pacifier) can abrade the lining of the mouth and make it more prone to yeast infection. If sucking on a nipple is painful for your child, temporarily use a cup. If the thrush recurs and your child is bottle-fed, switch to a nipple with a different shape and made from silicone.

Restrict Pacifier Use to Bedtime. Eliminate the pacifier temporarily except when it's really needed for going to sleep. If your infant is using an orthodontic-type pacifier, switch to a smaller, regular one. Soak all nipples in water at 130°F (55°C), the temperature of most hot tap water, for 15 minutes.

Diaper Rash Associated with Thrush. If your child has an associated diaper rash, assume it is due to yeast. Request nystalin cream and apply it four times daily.


During regular hours if

  • Your child refuses to drink.
  • The thrush gets worse on treatment.
  • The thrush lasts beyond 10 days.
  • You have other concerns or questions

Instructions for Pediatric Patients, 2nd Edition, ©1999 by WB Saunders Company.
Written by Barton D. Schmitt, MD, pediatrician and author of Your Child’s Health, Bantam Books, a book for parents.

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