Thrush in a one year old

Oral Thrush (for Parents) - Nemours KidsHealth

Reviewed by: Michelle P. Tellado, MD

en español Muguet (candidiasis oral)

What Is Oral Thrush?

Oral thrush is a very common yeast infection in babies. It causes irritation in and around a baby's mouth.

What Are the Signs and Symptoms of Oral Thrush?

Oral thrush (also called oral candidiasis) can affect anyone, but is most common in babies younger than 6 months old and in older adults.

A baby with oral thrush might have cracked skin in the corners of the mouth or white patches on the lips, tongue, or inside the cheeks that look a little like cottage cheese but can't be wiped away.

Some babies may not feed well or are uncomfortable when sucking because their mouth feels sore, but many babies don't feel any pain or discomfort.

What Causes Oral Thrush?

Oral thrush is caused by the overgrowth of a yeast (a type of fungus) called Candida albicans.

Most people (including infants) naturally have Candida in their mouths and digestive tracts, which is considered normal growth. Usually, a healthy immune system and some "good" bacteria control the amount of this fungus in the body.

But if the immune system is weakened (from an illness or medicines like chemotherapy) or not fully developed (as in babies), Candida in the digestive tract can overgrow and lead to an infection. Candida overgrowth also causes diaper rash and vaginal yeast infections. Babies can have oral thrush and a diaper rash at the same time.

Candida overgrowth also can happen after a baby has been given antibiotics for a bacterial infection because antibiotics can kill off the "good" bacteria that keep the Candida from growing. Oral thrush also can happen after the use of steroid medicines.

How Is Oral Thrush Treated?

See your doctor if you think your baby may have thrush. Some cases go away without medical treatment within a week or two, but the doctor may prescribe an antifungal solution for your baby's mouth. This medicine is usually applied several times a day by "painting" it on the inside of the mouth and tongue with a sponge applicator.

Depending on your baby's age, the doctor also might suggest adding yogurt with lactobacilli to your baby's diet. The lactobacilli are "good" bacteria that can help get rid of the yeast in your child's mouth.

If your baby keeps getting oral thrush, especially if he or she is older than 9 months old, talk with your doctor because this might be a sign of another health issue.

Can Oral Thrush Be Prevented?

Oral thrush is a common infection in babies, but you can help prevent it:

• If you formula-feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. That way, if there's yeast on the bottle nipple or pacifier, your baby won't be reinfected. Store milk and prepared bottles in the refrigerator to prevent yeast from growing.
• If you breastfeed and your nipples are red and sore, you might have a yeast infection on your nipples, which you and your baby can pass back and forth. Talk to your doctor, who might recommend using an antifungal ointment on your nipples while your baby is treated with the antifungal solution.

To prevent diaper rash, change diapers often.

Reviewed by: Michelle P. Tellado, MD

Date reviewed: September 2019

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

Care Advice for Thrush

1. 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.
     
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
     
7. 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.
8. 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.
9. What to Expect:
   • With treatment, thrush usually clears up in 4 to 5 days.
   • Without treatment, it clears up in 2-8 weeks.
10. 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: 01/26/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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 rise. nine0003

Children of the first two years of life report their condition by refusing to eat, constant whims and crying for no reason. 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. nine0003

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; nine0003

• 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; nine0003

• 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. nine0003

Infection with Candida fungus in children over 2 years of age can occur as a result of eating 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. nine0003

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. nine0003

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. nine0003

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. nine0003

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 newborns: symptoms, complications, treatment

White plaque on the tongue, gums, cheeks in a small child may indicate damage by fungi of the genus Candida. The reproduction of a pathological microorganism occurs due to the imperfection of the baby's immune system. Most often, thrush occurs in newborns.

Causes of candidiasis

Thrush in the mouth of a child occurs due to the yeast-like fungi C. albicans. This fungus is normally found on the mucous membranes of the mouth and intestines. With reduced body resistance or weakened immunity, fungi actively multiply, causing candidiasis. nine0003

Risk factors are:

• prematurity;
• avitaminosis;
• alimentary dystrophy;
• anemia;
• rickets;
• SARS;
• oncology;
• metabolic disease;
• chemical, physical damage to the oral mucosa;
• antibiotic therapy. nine0030

Thrush in children under one year old is diagnosed in 20 percent of cases. The microflora in the oral cavity often changes, the epithelium is not yet fully formed. As a result, candida actively multiply.

Many parents prefer to treat this disease with alternative methods, but this approach can lead to a severe form of thrush in a child. When the first signs of pathology appear, it is necessary to consult a doctor.

Consult a pediatrician

Standard

Personal package for round -the -clock communication with Russian doctors by calling

1105 ₽/month

13 256 ₽

Read more

Family

Family package for round -the -clock doctors by phone

1819 ₽

21 830 ₽

Details

Premium

Maximum package of unlimited round-the-clock communication with Russian doctors by phone

2555 ₽/month

30 661 ₽

Details

Classification of pathology

The clinical classification of mycoses includes superficial candidiasis, chronic generalized, visceral.

According to the course of the pathological process, there are:

According to the localization of the pathological process: nine0003

According to the severity of the course of the disease: nine0003

The following stages of the development of the disease are distinguished:

Example
A mother with a 4-month-old baby turned to the local pediatrician. She complained that the baby sucks badly at the breast, a white coating appeared on the tongue, cheeks, gums, noted itching of the nipples. On examination, the pediatrician found white plaques, both single and merged on the cheeks and gums. According to the examination and anamnesis, the diagnosis was made: candidiasis of the oral cavity of moderate severity. Medical treatment was prescribed for the baby, mother - breast hygiene with drugs, it is advisable to treat all the toys of the baby in a soda solution. nine0003

Symptoms of thrush

The incubation period ranges from two days to several months, on average up to 6 days. Clinical manifestations depend on the severity of the disease. Most often there is a mild degree, which is manifested by a white curdled coating in the oral cavity, which is easy and effortlessly removed. The general state of health of the child remains within the normal range.

Symptoms of thrush in moderate and severe form are: nine0003

• mucosal hyperemia;
• diffusely diffuse pathological process;
• when you try to remove plaque, the mucous membranes are injured, blood appears.

The severe form is characterized by a total lesion of the mucous membranes of the oral cavity in a child. The plaque is tightly connected to the tissues, it is almost impossible to separate it. There is an unpleasant smell from the mouth. The child becomes restless, sleeps poorly, appetite is disturbed. nine0003

Book an online consultation at the first signs or suspicion of thrush. Our doctors will remotely assess the situation based on the clinical picture, suggest which doctors to contact, and select proven clinics for examination.

Diagnosis of pathology

An anamnesis and examination are sufficient to make a diagnosis. If necessary, the pediatrician may prescribe laboratory tests: nine0003

• sowing on Sabouraud's medium to identify the type of fungus;
• serological reactions: RSK, RP, RPHA, RA.

With the help of these studies, it becomes possible to exclude tonsillitis, diphtheria, acute herpetic stomatitis.

Complications of thrush in children

In the absence of treatment, the pathological process turns into an invasive form, which is very difficult to get rid of. Complications can be: nine0003

• fungal esophagitis;
• tracheitis;
• candidal sepsis;
• girls develop vulvovaginal candidiasis, which leads to fusion of the labia and vaginal walls.

Treatment of thrush in newborns

With a local lesion in the early stages of the disease, local therapy is indicated. Irrigation of the oral cavity of the baby is carried out with anticandidal, disinfectant preparations. The course of therapy is at least two weeks. nine0003

In severe cases, antimycotic drugs per os are prescribed. Since babies cannot rinse their mouths, plaque is removed mechanically:

• wash your hands thoroughly before the procedure;
• prepare gauze, bandages in advance;
• wrap a piece of bandage around your finger, moisten in medicine;
• gently wipe the affected areas;
• the bandage changes after each treatment area, that is, one cheek was treated, the gauze was changed, the second cheek was treated, and so on. nine0030

Important! The infant's mouth is cleaned after every feeding. Process all toys, nipples, pacifiers, bottles. When breastfeeding, the mother should carefully handle the breast before and after feeding.

FAQ

What does thrush look like on the tongue of a baby?

+

It usually appears as a white, thick, cheesy coating. Some mothers confuse it with plaque that appears after feeding. nine0003

Is it possible to treat thrush in a newborn with folk remedies?

+

No, such funds can be used as auxiliary, however, special antifungal drugs should be the main ones.

How to remove white plaque in the mouth of a monthly baby?

+

It is necessary to treat the oral cavity with special means. Such drugs are prescribed by a doctor based on the clinical picture and tests. nine0003

Expert opinion

Candidiasis in a child is caused by yeast-like fungi of the genus Candida.

Learn more

• 
  Do breastfed babies get constipated
• 
  What is cephalic version
• 
  Do gynecologist deliver babies
• 
  Diabetes in woman
• 
  How to make your child study without anyone telling them
• 
  What is the placenta for
• 
  How to deal with food aversion during pregnancy
• 
  Do gynos deliver babies
• 
  Vitamin k injection in infants
• 
  Ultrasound two months
• 
  How to increase your chance of having a boy