Generally, I'll try oral nystatin as first line. For resistant (or poor compliant) patients, I've found diflucan 5 mg/kg PO qd x 1 day followed by 2.5 mg/kg PO qd x 6 extremely effective. Generally moderate to severe cases are eliminated after the 1st to 3rd day of treatment. The drawback is cost. In most infants (approx. 3 kg) we are talking about just about less than 10 cc for total treatment (Diflucan 10mg/ml). I think the pharmacies, at lease for Medicaid patients, have to charge for the entire bottle. Eric M. Goodman MSN CPNP ----- Original Message ----- From: Jennifer Smolka <> To: <> Sent: Thursday, October 07, 1999 4:01 PM Subject: Thrush > With son #2 & son #3, I had experience with Thrush. My first occurance I didn't > know what it was and therefore took too long to treat. Through my breastfeeding > consultant we tried Nystatin Oral for baby and cream on me. I also increase > yogurt and wash methodically, never reusing a towel, bra or bra pads. We > successfully treated the lesser of two sides. However, the primary infection > couldn't be beat - I ended up having to discontinue on that side due to sheer > pain. > > With the second infection, I knew what it was in the very beginning stages and > whipped it with Nystatin and the other non-medicine treatments. I truly believe > that one of the keys to a quick recovery is a quick diagnosis. All moms in the > hospital should be given information (and pictures) of what thrush is. > > PS thank goodness for breastfeeding consultants!! > > Jennifer Smolka > http://www.mypediatrician.com > > > > wrote: > > > In a message dated 10/7/1999 1:56:54 PM Central Daylight Time, > > writes: > > > > << what are your thoughts on mgt. of > > thrush? How long to treat with Nystatin? Do you have frequent recurrance? > > The reason I am asking is because a colleage of mine believes genetian > > violet to be "better", "less recurrance". I can't agree but am open to > > discussion on it. Purpled mouth and nipples is a big drawback, IMHO. I > > really can't in my mind recommend this as a first choice. Any thoughts? > > >> > > > > So what's the problem w/ purple nipples unless she's a topless dancer? If > > Nystatin/Lotrimin don't work w/in 2 to 3 weeks, max, I would definitely > > recommend GV. Even though it is old, it is effective. And I find a lot of > > thrush resistant to Nystatin/Lotrimin. (Or reasonable facsimiles thereof). > > > > Jan -- who is ONLY an RN, but is also an IBCLC and sees more thrush than she > > would like. > > group. > > > > group. > >