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Abstract: A couple came to the oral clinic with their 3-month-old baby girl. The couple was very nervous and came to the clinic because the child had something like white goose feathers in her mouth and indicated that she always cried and was very anxious about drinking milk recently. Through a careful oral examination, combined with the medical history, thrush was diagnosed. Medication and oral hygiene education were given, and the child’s symptoms subsided with good treatment results.
Basic information】Female, 3 months old
Disease Type】Cushings
Hospital】Nei Mongol Autonomous Region Maternal and Child Health Hospital
Date of consultation】April 2021
Treatment plan】Medication (2% sodium bicarbonate solution + mycophenolate solution) + oral care
[Treatment Period] 12 days of outpatient treatment, followed by regular checkups on the 3rd and 12th
Treatment effect] Good treatment effect
I. Initial consultation
A couple came to the oral clinic with their 3-month-old baby girl in their arms. The couple asked the child about the white goose feather-like things in her mouth, and she always cried when she drank milk recently. The mother of the child was very anxious as she did not know what was wrong with her. Through a careful oral examination, combined with the medical history, the results of the exfoliative cytology examination returned positive for Candida, and the diagnosis was thrush.
II. Treatment
After oral examination of the child, medical records were taken: scattered soft spots as white as snow were seen on the mucosa of the upper and lower lips, cheeks, and soft palate, as well as large white velvety patches, and some of the mucosa was congested and reddened, which could be wiped off with slight force, exposing the red mucosal erosion surface. The child was then treated with local medication: 2% sodium bicarbonate solution was wiped on the oral mucosal lesion area before and after breastfeeding, mycophenolate solution was wiped on the oral mucosal lesion area, the breast was cleaned and wiped with 2% sodium bicarbonate solution before and after each feeding, and the bottle teat was disinfected at high temperature and dried daily.
III. Treatment effect
Through medication and oral hygiene education, the child’s condition improved at the follow-up visit after 3 days, and the symptoms of thrush with large white velvety patches improved significantly. Before treatment, the child’s symptoms of irritability and crying when drinking milk were obvious, but after treatment, he did not refuse to drink milk when feeding and his irritability improved; after treatment, the child’s parents gave him daily oral care and fed him a small amount of warm water every day; the treatment effect is now good and there is no recurrence. 12 days later, the oral mucosa healed well and the re-examination was normal.
Precautions
It is understandable that the new parents are a little frazzled at the beginning with their child. It is recommended that the parents of this child should insist on daily bottle boiling and sterilization, and that the mother should wash and wipe her nipples before breastfeeding every day. Even if the child is exclusively breastfed, she should drink a small amount of warm boiled water before and after each feeding, or wipe the oral mucosa with warm boiled water, and perform routine oral care to clean the curds and sugars left in the mouth. Also, newborns have an oral period and need to sterilize toys and other items that may be in their mouths on a regular basis.
V. Personal insight
Thrush is common in newborns because of their low immunity, and Candida albicans is the main pathogenic fungus of thrush. There are many normal flora in the oral cavity, and Candida is among them. When the defenses within the oral mucosa are reduced, it will provide an opportunity for Candida to take advantage of it, and Candida albicans takes advantage of this opportunity to cause thrush. But Candida albicans is not easy to grow and reproduce in an alkaline environment, so use 2% sodium bicarbonate solution for oral wiping and nipple disinfection, which can inhibit the growth and reproduction of Candida, and mycoplasma solution also has an antibacterial effect. Oral care of newborns is not easy to do, like the case of the child’s new parents are busy, so parents need to be more patient, cleaning the mouth can be distracted by the child’s favorite toys, gentle action, do not violently wipe, to prevent scratching the mucosa.