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Marlton Pediatrics

Thrush

Definition

  • Thrush is a yeast infection of the mouth in young babies
  • White patches in the front of the mouth are the hallmark

 

Call or Return If

  • Starts drinking less than normal
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • 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

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.

Cause

  • 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

After Care Advice

Overview:
  • Thrush is common during the early months of life.
  • It's caused by a yeast infection in the mouth. Also, it's often triggered by prolonged sucking.
  • Thrush causes only mild discomfort. It's easy to treat at home.
  • Here is some care advice that should help.
Anti-Yeast Medicine:
  • Treatment requires a prescription anti-yeast medicine. It's a liquid. Use it as follows:
  • Use 1 ml (2 ml if over age 1 month). 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. Avoid touching the dropper to the mouth.
  • 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 nor helpful.
Breastfeeding:
  • If the mother's nipples are red and sore, it's probably a yeast infection.
  • Use Lotrimin cream on the nipple area.
  • No prescription is needed.
  • Put it on 4 times per day AFTER feedings.
  • Wash off the nipples with warm water before applying the cream. Also, wash the cream off the nipples before each nursing. Avoid soap which dries out the skin.
  • If your nipple infection becomes worse, call your OB. You may need an oral anti-yeast medicine.
Diaper Rash:
  • If there's a bad diaper rash, it can also be due to yeast.
  • Use Lotrimin cream on the diaper rash.
  • No prescription is needed.
  • Put it on 4 times per day.
What to Expect:
  • With treatment, thrush usually clears up in 4 to 5 days.
  • Without treatment, it clears up in 2-8 weeks.
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.
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