Yeast, thrush, candida--if I get one more call about this....Candida affects
about 5% of healthy infants, usually in the first weeks of life. Peak
colonization is at about 1 month. The word "Candida" refers to the white robes
worn by candidates for the Roman senate and albicans means "to whiten." There
are over 150 species within the Candida genus, with Candida albicans the most
common. Lab diagnosis is something I have been recommending in situations
where there is a refusal to treat or where symptoms persist after trying many
therapies. A skin scraping is placed in a 10% KOH wet mount and looked at
under a microscope. You are looking for pseudohyphae. Budding yeasts or hyphae
may indicate pathogenic yeast. Direct cultures can also be done which
sometimes reveal different species of Candida or different but related
strains.

C albicans strains are different in various geographic locations. They can
also be different between the mouth and the diaper area, ie not genetically
related. Many babies with thrush in the mouth also have the infection in the
intestine and stools which can contribute to the skin infection on baby's
bottom. Many strains are becoming resistant to the first-line medications
which may explain why some treatments continue to fail.

When C albicans proliferates due to an upset in the normal balance of factors
that keep it in check, the normally non-invasive yeast can change to a fungus-
like microbe that produces rhizoids (long root like components able to pierce
duct walls and release toxins or allergens into nearby tissues. I wonder if
this is what is responsible for the deep shooting pains mothers often
describe.

Pacifiers also contribute to an enormous amount of thrush. I have learned the
hard way to always ask if the baby has ever been given a pacifier by anyone!

Marsha Walker
Weston, Massachusetts