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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Thrush On Tongue. Given Nilstat. Has Black Particles In Stools. What Could It Be?

My baby is 4 and a half month old.she had cow s milk protein allergy . but got settled after I omitted all dairy.she is mainly breast fed and takes iron fortified cereal once or twice daily of about 40ml.she has got thrush on tongue since 3rd week of life. I am using Nilstat drop for 3 months. It has got better but still some in there. my concern is, today I noticed plenty of black particles in her poo.What it could be?
Mon, 25 Feb 2013
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Pediatrician 's  Response
Hello mishudmc,

Thank you for your query. It is most likely that the black flakes you are seeing in your baby's stool is a result of the iron supplementation in her cereal. This is a common side effect of taking iron and is nothing to worry about. Some children develop constipation with iron supplementation, but as long as she is opening her bowels regularly and comfortably I would not worry.

Very dark tar like stools can be the result of blood loss somewhere in the digestive tract. This is very uncommon in babies. So if you notice your child has episodes of severe distress, is pale, lethargic or not growing as expected I would suggest that she is reviewed by a pediatrician.

I also wish to add that her treatment with oral thrush seems particularly prolonged. It is worth getting her seen by a pediatrician to confirm that she does indeed still have thrush and not persistent milk residue (which is really common). If so, I would suggest changing her medication to a miconazole gel. There are also other things you can do to prevent the thrush from recurring. You can sterilize all bottles and cutlery she uses. If she uses a pacifier, change it to a new fresh one. Since you are breastfeeding it is worth you taking some treatment for thrush as well.

I wish you all the best and hope you find this information useful.
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Child Has Thrush On Tongue. Given Nilstat. Has Black Particles In Stools. What Could It Be?

Hello mishudmc, Thank you for your query. It is most likely that the black flakes you are seeing in your baby s stool is a result of the iron supplementation in her cereal. This is a common side effect of taking iron and is nothing to worry about. Some children develop constipation with iron supplementation, but as long as she is opening her bowels regularly and comfortably I would not worry. Very dark tar like stools can be the result of blood loss somewhere in the digestive tract. This is very uncommon in babies. So if you notice your child has episodes of severe distress, is pale, lethargic or not growing as expected I would suggest that she is reviewed by a pediatrician. I also wish to add that her treatment with oral thrush seems particularly prolonged. It is worth getting her seen by a pediatrician to confirm that she does indeed still have thrush and not persistent milk residue (which is really common). If so, I would suggest changing her medication to a miconazole gel. There are also other things you can do to prevent the thrush from recurring. You can sterilize all bottles and cutlery she uses. If she uses a pacifier, change it to a new fresh one. Since you are breastfeeding it is worth you taking some treatment for thrush as well. I wish you all the best and hope you find this information useful.