The one baby that I worked with at 6 months of age with similar oral
aversion to your client's baby, had thrush so thick that the top layer was
pale yellow. I'm sure that the yeast tendrils had invaded the tongue. She
would take nothing back into her mouth. She did a little drinking of milk
from the breast so long as the MER was strong.

There was a course of Diflucan for infant (wyich didn't resolve the
problem, but helped some) followed by acidophilus with bifidus 3 times a
day for several months, during which baby began to feed well again.  The
probiotics were administered by mother's wetting a finger, touching the
powdered acidophilus/bifidus, then letting baby suck on the finger.
Gradually the tongue returned to a healthy pink tongue, receding from tip
to throat. She is 18 months old now and is a fine eater, including
continued feeding at the breast.

Many people don't appreciate the pain in the mouth of a baby with yeast
overgrowth in her mouth.  Just ask any adult how thrush feels and she will
tell you that it is a terrible sore throat. One woman said, "My throat is
so sore that I can't eat at all and can drink only pear nectar."

You relayed that baby was treated for thrush with Nystatin, which was
stopped when he didn't tolerate it. You didn't say if baby's thrush was
treated further. Thursh will sometimes resolve itself without treatment but
more often it must be treated adequately.

Also you stated: ". It may be coincidental, but around that
time, baby began nursing on only one breast per feeding and nursed for
shorter durations."

This is a common symptom of thrush. Short feeds when there had been longer
ones. Again sore throat. When I get a call with "short feedings, frequent
intervals, sore nipples," I explore thrush.

Others on this list will have other suggestions but you could examine
baby's tongue. It should be a healthy pink as far back as you can see.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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