Mild baby thrush

Thrush in newborns Information | Mount Sinai

Candidiasis - oral - newborn; Oral thrush - newborn; Fungal infection - mouth - newborn; Candida - oral - newborn

Thrush is a yeast infection of the tongue and mouth. This common infection can be passed between a mother and baby during breastfeeding.

Causes

Certain germs normally live in our bodies. While most germs are harmless, some can cause infection.

Thrush occurs when too much of a yeast called Candida albicans grows in a baby's mouth. Germs called bacteria and fungi naturally grow in our bodies. Our immune system helps keep these germs in check. But babies do not have fully-formed immune systems. That makes it easier for too much yeast (a type of fungus) to grow.

Thrush often occurs when mother or baby has taken antibiotics. Antibiotics treat infections from bacteria. They can also kill "good" bacteria, and this allows yeast to grow.

The yeast thrives in warm, moist areas. The baby's mouth and the mother's nipples are perfect places for a yeast infection.

Babies can also get a yeast infection on the diaper area at the same time. The yeast gets in the baby's stool and can cause a diaper rash.

Symptoms

Symptoms of thrush in the baby include:

White, velvety sores in the mouth and on the tongue
Wiping the sores may cause bleeding
Redness in the mouth
Diaper rash
Mood changes, such as being very fussy
Refusing to nurse because of soreness

Some babies may not feel anything at all.

Symptoms of thrush in the mother include:

Deep-pink, cracked, and sore nipples
Tenderness and pain during and after nursing

Exams and Tests

Your health care provider can often diagnose thrush by looking at your baby's mouth and tongue. The sores are easy to recognize.

Treatment

Your baby might not need any treatment. Thrush often goes away on its own in a few days.

Your provider may prescribe antifungal medicine to treat thrush. You paint this medicine on your baby's mouth and tongue.

If you have a yeast infection on your nipples, your provider may recommend an over-the-counter or prescription antifungal cream. You put this on your nipples to treat the infection.

If both you and your baby have the infection, you both need to be treated at the same time. Otherwise, you can pass the infection back and forth.

Outlook (Prognosis)

Thrush in babies is very common and can easily be treated. Let your provider know if thrush keeps coming back. It may be a sign of another health issue.

When to Contact a Medical Professional

Contact your provider if:

Your baby has symptoms of thrush
Your baby refuses to eat
You have symptoms of a yeast infection on your nipples

Prevention

You may not be able to prevent thrush, but these steps may help:

If you bottle feed your baby, clean and sterilize all equipment, including nipples.
Clean and sterilize pacifiers and other toys that go in baby's mouth.
Change diapers often to help prevent yeast from causing diaper rash.
Be sure to treat your nipples if you have a yeast infection.

Balest AL, Riley MM, O'Donnell B, Zarit JS. Neonatology. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 2.

Harrison GJ. Approach to infections in the fetus and newborn. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 66.

Last reviewed on: 12/12/2021

Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Thrush

Is this your child's symptom?

A yeast infection of the mouth in young babies
White patches in the front of the mouth

Symptoms of Thrush

White, odd shaped patches in the mouth
Coats the inner cheeks or inner lips
Sometimes also coats the tongue
Sticks to the mouth. It can't be washed away or wiped off easily like milk curds.
Sometimes causes a painful mouth, decreased sucking and reduced milk intake
Mild discomfort or no symptoms in most newborns
The infant is bottle-fed or breast-fed

Cause of Thrush

Caused by a yeast (called Candida)
Occurs on parts of the mouth involved with sucking
Made worse by friction from too much time sucking on a pacifier

White Tongue Alone: Not Thrush

If a white tongue is the only finding, it's not due to thrush.
A milk diet often causes a white coated tongue.
This is normal.
It will go away after your baby starts eating solid foods.
If white patches occur inside the lips or cheeks, call your child's doctor. It's safe to call during office hours.

When to Call for Thrush

Call Doctor or Seek Care Now

Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
Age less than 1 month old and looks or acts abnormal in any way
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Fever occurs
Bleeding in the mouth
Drinking less than normal
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Thrush, but none of the symptoms above. Reason: may need a prescription medicine to treat it.
You have other questions or concerns

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle
Virtual Urgent Care

Care Advice for Thrush

What You Should Know About Thrush:
- Thrush is common during the early months of life.
- It's caused by a yeast infection in the mouth. Most often, it's due to prolonged sucking.
- Thrush causes only mild discomfort. It's easy to treat at home.
- Here is some care advice that should help until you call your doctor.
Anti-Yeast Medicine (Prescription):
- Your doctor will probably prescribe an anti-yeast liquid medicine. Use it as follows:
- Age Under 1 Month: Use 1 mL.
- Age Over 1 Month: Use 2 mLs.
- Place in the front of the mouth on each side. Also, put it wherever you see the thrush. It doesn't do any good once it's swallowed.
- Do this 4 times per day.
- If the thrush isn't getting better, rub the medicine directly on the thrush. Use a cotton swab to do this.
- Don't feed your baby anything for 30 minutes after the medicine.
- Keep this up for at least 7 days. Also, continue it until all thrush has been gone for 3 days.
Decrease Sucking Time to 20 Minutes per Feeding:
- Reason: Too much sucking can irritate the lining of the mouth. This makes it more prone to a yeast infection. A common example of this is when a baby sleeps with a bottle.
- For severe mouth pain with bottle feeding, don't use a bottle. Reason: The nipple can make pain worse.
- Try giving fluids in a cup, spoon or syringe instead.
Limit Pacifier Use:
- Too much sucking on a pacifier can irritate the mouth.
- Limit pacifier use to times when nothing else will calm your baby.
- If your infant is using an orthodontic pacifier, switch to a smaller, regular one. Reason: Bigger ones can cause more friction in the mouth.
- Special washing or boiling of pacifiers or bottle nipples is not needed or helpful.
Special Washing of Pacifiers and Nipples - Not Helpful:
- Pacifiers and bottle nipples can be washed the usual way with soap and water.
- They do not need to be boiled or sterilized.
- They do not need to be thrown out.
- Yeast is a germ that is found in normal mouths.
- It only causes thrush if the lining of the mouth is irritated or damaged.
- Get better results by reducing nipple time and pacifier time.
- Note: Follow your doctor's advice if it is different.
Breastfeeding and Yeast Symptoms:
- If the mother's nipples are red and sore, it's probably a yeast infection.
- Use an anti-yeast cream (such as Lotrimin) on the nipple area.
- No prescription is needed.
- Put it on 4 times per day after feedings.
- Wash the cream off the nipples before each nursing. Avoid soap which dries out the skin.
- Many mothers will need treatment with an oral anti-yeast medicine (such as Diflucan). Call your PCP or OB within 24 hours for advice.
Diaper Rash Treatment:
- If there's a bad diaper rash, it can also be due to yeast.
- Use an anti-yeast cream (such as Lotrimin) on the diaper rash.
- No prescription is needed.
- Put it on 4 times per day.
- See Diaper Rash care guide.
Return to Child Care:
- Thrush cannot be spread to others, since it does not invade normal skin.
- Your child can go to child care with thrush.
What to Expect:
- With treatment, thrush usually clears up in 4 to 5 days.
- Without treatment, it clears up in 2-8 weeks.
Call Your Doctor If:
- Starts drinking less than normal
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 02/28/2023

Last Revised: 12/30/2022

Candidiasis in the mouth of a child

Contents

What kind of disease is candidiasisSymptomsCausesTreatmentMethods of therapyPreventive measures

Many parents are aware of such a common problem in children as thrush, which is characterized by the appearance of white plaque on the tissues of the oral cavity. In medicine, this pathological condition has the term "candidiasis" and refers to fungal diseases.

Most often, candidiasis develops in the mouth of a child in the first year of life. Symptoms of thrush greatly disturb the baby, but timely treatment allows you to quickly and without consequences get rid of the fungus.

What kind of disease is candidiasis

According to statistics, about 30% of infants are faced with candidiasis. The causative agent of the disease is the Candida fungus. These specific microorganisms are normally present in the body of every person, even in the absence of health problems, but only in small quantities.

Oral candidiasis in children is much more common, since the immune system of babies is not yet formed and is not able to withstand pathogenic microorganisms and the effects of negative external factors.

With a weakened immune system and the concomitant effect of provoking factors, the fungus begins to actively multiply, affecting the mucous membranes. Without therapeutic treatment, candidiasis is eliminated in exceptional cases. If thrush is not treated, complications arise, and the infection itself spreads throughout the body.

Symptoms

Oral candidiasis in children can have a different form of manifestation and severity of symptoms: mild, moderate and severe. As a rule, each form corresponds to the stage of development of the disease. If therapy is not carried out in a timely manner, then the signs of a fungal infection become more intense and the number of symptoms increases.

With a mild form of the disease, a red rash appears on the oral mucosa, which is covered with a white coating on top. At the next stage, the child has swelling of the tissues and the formation of localized white spots with a touch of curd consistency. Gradually, these spots merge into a large affected area. When plaque is removed, bleeding sores open. If the thrush starts, then the fungus already spreads to the entire oral cavity, including the lips, tongue and throat. All fabrics are completely covered with cheesy bloom.

Common symptoms of candidiasis in children include:

burning sensation and itching in the mouth;
discomfort and pain when eating;
frequent spitting up in babies;
the formation of cracks in the corners of the lips;
temperature increase.

Children of the first two years of life report their condition with refusal to eat, constant whims and causeless crying. It is not difficult to see signs of candidiasis, so if a child has a sharp rise in temperature or refuses to eat, pediatricians and dentists recommend checking the oral cavity for white plaque. If you suspect thrush, it is undesirable to delay a visit to a specialist, since the fungal infection progresses rapidly.

Reasons

The main reason for the development of candidiasis of the oral mucosa in children is a weakened immune system. If a child is born prematurely, then the likelihood of having thrush is very high. Children who are breastfed or have congenital pathologies are also often exposed to fungal infection.

Provoking factors include:

the presence of vaginal candidiasis in the mother during pregnancy - the child can become infected when passing through the birth canal;
insufficient hygiene of the female breast during breastfeeding - the fungus is often localized precisely on the nipples because of the favorable environment for it;
poor processing of the child's initial things - bottles, nipples, and so on;
the habit of parents to lick the nipples - even if the adult does not have signs of thrush, a fungus may be present in the mouth, which will be transmitted to the child;
long-term use of drugs of the "antibiotics" group - drugs help to reduce one's own immunity;
frequent regurgitation in infants - after regurgitation, an increased acidic environment, favorable for the fungus, remains inside the oral cavity;
excessive and frequent dry mouth - the absence of saliva, as a protective agent against the activity of pathological microorganisms.

Infection with Candida fungus in children older than 2 years can occur as a result of unwashed foods, raw milk or running water. If a child over 3 years of age has suddenly developed signs of thrush, one should be examined not only for a fungal infection, but also for other possible diseases that may be accompanied by a “fading” of the immune system.

Treatment

Children's fungal diseases can be dealt with by a pediatrician, infectious disease specialist or dermatologist. If we are talking about the treatment of thrush of the oral cavity, then the dentist can also carry out therapy.

The diagnosis of "candidiasis" is determined in most cases on the basis of a specialist examination of the oral cavity. If there is any doubt, the doctor directs the patient for additional examinations. To confirm the disease, a laboratory method is used to study a smear taken from the mouth for the presence of a fungus.

Treatment of thrush in children involves an integrated approach. If the disease is not advanced, then local therapy is carried out in combination with the adoption of measures to strengthen the immune system. In severe form, oral candidiasis in children is treated with systemic drugs, local remedies and compliance with preventive recommendations.

Methods of therapy

Treatment of candidiasis begins with the treatment of the oral cavity. The first procedure is already performed at the reception. Antiseptic agents are used to remove plaque. The doctor may then apply an antifungal agent.

The parent should carefully monitor the actions of the dentist, as in the future they will have to independently process the oral cavity at home. The necessary drugs will be prescribed by a specialist. Local antifungal agents are dangerous in case of overdose, especially for the child's body, so you must strictly follow the doctor's recommendations.

In advanced cases, medications are prescribed in the form of solutions, drops or tablets. There are only a few drugs for the treatment of candidiasis in children. Replacing them with adult counterparts is dangerous. The dosage must be strictly observed.

A mandatory addition to the main therapy is hygiene, good sleep, proper nutrition and taking measures to strengthen immunity (eating healthy foods, if necessary, pharmacy vitamins, walking.

Preventive measures

In order to prevent and even shorten the course of therapy, it is recommended to rinse the mouth (if the child is older than 3-4 years), or use antiseptic sprays several times a day.

It is not difficult to prevent oral candidiasis in children. The responsible approach of parents to the health of the child from the moment of planning conception and pregnancy will help to avoid fungal infections in babies.

Thrush in the mouth of a baby

0-6 months

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Thrush in infants is a common phenomenon caused by microorganisms of the genus Candida. We will look at the causes of candidiasis and ways to prevent the disease.

3 min. for reading Feb. 17, 2022

80% of people around the world have Candida in their bodies. They are present on the skin and mucous membranes in small quantities and make themselves felt only under certain circumstances. For a newborn, such a circumstance may be a weak immune system. The microflora of the baby is not yet formed, and pathogenic cells have more freedom to spread and multiply. A baby can get an infection even when passing through the birth canal - fungi are transmitted from mother to child through the mucous membrane.

Premature and bottle-fed babies are more likely to get candidiasis than full-term breastfed babies

Now you know what thrush is in babies. Now let's look at the causes of candidiasis.

5 causes of thrush in babies

Weak immunity at birth. All babies have a weak immune system. But at risk are premature babies. Breast milk helps a small body get stronger

Infectious disease. Allergies, colds - all this increases the risk of developing thrush in infants
Taking medication. It doesn’t matter if the child drinks them himself or if they enter his body through mother’s milk. Antibiotics and other drugs reduce immunity by suppressing both harmful and beneficial bacteria
Infection with fungi from the mother's vagina. During childbirth, a mother can infect her baby with Candida fungi from her body
Cracks in the oral mucosa and frequent regurgitation is another reason for the appearance of thrush on the tongue in a child under the age of

Sometimes a white coating in the mouth of an infant is due to inadequate care in the hospital or at home. For example, due to a poorly sterilized bottle, dirty nipple or unwashed hands in adults

Symptoms of candidiasis in newborns

Oral thrush manifests itself as follows:

In the mouth - on the inside of the cheeks, on the tongue, gums and palate - white plaque and / or small white pellets. This is the initial and easiest stage of candidiasis
The second stage is an increase in white plaque and the gradual development of an inflammatory process, which manifests itself in the form of red spots under the milk film
Third stage - violation of the mucous membrane, the appearance of wounds on the lips and mouth, bleeding
A neglected case - when a white film tightens not only the mouth, but also the child's throat. It is difficult for the baby to swallow, he screams and refuses to suckle, his temperature rises. Then the disease spreads through the intestines, disrupting the microflora of the gastrointestinal tract and further reducing the immunity of the crumbs

With a long course of the disease without proper treatment, the negative process spreads to the skin, nails, internal and genital organs of the child

How to cure thrush in an infant

Treatment of thrush in newborns involves contacting a pediatrician for examination and consultation. Additionally, the doctor may prescribe taking tests from the affected areas to detect Candida fungi.

Please note that not only the baby, but also the mother should undergo appropriate treatment. This will help to avoid re-infection of the infant while breastfeeding

With proper and timely treatment, the symptoms disappear in a few days or a week. Therefore, the sooner you seek help from a doctor, the sooner you solve the problem.

The best treatment is prevention

You can solve the problem, or you can prevent it. Here are four ways to avoid candidiasis in your newborn:

Thoroughly clean and sterilize bottles and teats
Treat all objects that your child touches during the day while playing or feeding. If the item is not sterilizable, use baking soda
When breastfeeding, the mother should keep her breasts clean and carefully treat all cracks in the nipples