I feel like I just had a lightbulb go on.  Docs, please tell me if I'm right.

Not infrequently, the client of mine whose baby has a whitish tongue is
told that her baby does *not* have thrush.  Sometimes the moms follow thru
and treat it anyway, sometimes they don't.  Certainly some of the time
treating the whitish tongue that isn't thrush resolves both the whiteness
and the sore nipples (my goodness!).  But I've tended to defer to the docs'
opinion at first, figuring that they see a whole lot more tongues than I do
and are far better able to judge it than I am.  And I've always wondered
why the docs so rarely accept that those borderline tongues could be
thrush.

In preparing a mom yesterday for the possibility that her doctor would say
it wasn't thrush and wouldn't prescribe, it hit me that doctors never had
to bother with whitish tongues in bottle-fed babies.  It's unlikely that it
bothered the baby in any discernible way, it sure wasn't causing sore
rubber teats, and there was no reason for them to learn to recognize it or
even look for it.  Rampant thrush, yes, but anyone who's seen even one
picture of rampant thrush will know it when s/he sees it.  But those iffy
cases?  They've probably never even noticed them.  And here comes this LC
talking thrush in situations where no one else has ever mentioned it.
Therefore it couldn't be thrush.

I wonder now if doctors in general are no more skilled than *I* am at
distinguishing between a mildly thrushy tongue and a tongue that's just
whiter than average.  Lactnet doctors, is this a logical thought sequence?

Diane Wiessinger, MS, IBCLC  Ithaca, NY