<On the subject of thrush and discarding things, LLL [1] suggests that
all bottle nipples, pacifiers etc be discarded after one week of thrush
treatment. This is no small change for someone frequently expressing
and using high-quality, high-cost silicone teats. Surely boiling these
items for ten minutes would be more than adequate to eliminate any live
yeast?>

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. I think silicone is less likely to crack than cheaper
rubber (or whatever they are). And I imagine teats don't spend as much time
in the baby's mouth and so don't get as damaged as dummies.
I have seen dummies that have fungal growth visible to the naked eye (and
confirmed microscopically) - as some parents don't think about changing
them.
So, I think common sense is needed. Objects that spend a lot of time in the
baby's mouth should be replaced regularly (I would say weekly until the
mother is over her thrush problem). Objects that are used infrequently don't
need to be replaced as often.
A short report in Archives of Disease in Childhood, titled "Oral candida: is
dummy carriage the culprit?" reported on a 16 week study of 95 healthy
children (1-24 months). They found that children using dummies were almost
twice as likely to be colonized with candida than non-users (52% compared to
28%). Silicone dummies were less likely to be carrying candida (22%) than
rubber latex dummies (75%). They show 2 scanning electronmicrographs of
silicone and rubber dummies after 16 weeks of use - the surface of the
latter is "markedly fissured". (Sio et al Arch Dis Child 1987; 62: 406-8).
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

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