<Lisa Amir wrote "Lara, the concern is that objects like dummies (pacifiers)
which spend long
periods of time in the infant's mouth develop microscopic cracks that can
harbour the fungus. "

Lisa, I wondered about this too but wouldn't the heat (i.e. boiling at 100oC
for a good length of time) kill the yeast? >

Hi Sara, Yes, heat can kill the yeast, but I wonder if there is a quantity
of yeast stuck in a crack it may not be effective.
I just went back to another reference I have in my candida file which I
thought made this point (Robson A and Anderson K. Thrush in infants: The
disadvantages of teat sterilization by sodium hypochlorite. Med J Aust 1964:
519-21).
But actually, boiling was successful in each case (0/24 positive) - it was
the hypochlorite solution (Milton) that was not always successful in
eradicating candida (14/24 were still positive). The researchers had forced
a candida culture into the opening of rubber teats.
In Australia, Milton solution has been widely used to disinfect bottles /
teats/ dummies in hospitals as well as homes. This article raised our
awareness that boiling may be better than using a solution.
So, I guess the recommendation to discard everything each week is probably
too conservative. I think boiling everything daily should be enough. Except
for dummies (pacifiers), if they are being used for hours each day - they
should be discarded on a regular basis.
(Perhaps there has been some recent research on candida survival, but I
don't think so. This is an opportunity for someone looking for some micro
research projects).
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia - who will be talking about staph
at the ILCA conference in Sydney (but I'm sure candida will get a mention!)

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