Thrush is one of those conditions most women never hear about until they become a mom—and even then, it may not be on your radar until your pediatrician explains why baby’s mouth is sore and spotted with a thick, white coating. But while thrush doesn’t typically pop up in adults, it’s a relatively common infection among infants. Here’s how to detect thrush in babies and how to effectively treat it.
What Is Thrush?
Thrush is a fungal infection of the mouth caused by a type of yeast called candida, says Daniel Ganjian, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California. It’s characterized by white patches on the tongue, inside of the cheeks, roof of the mouth and lips. Thrush doesn’t commonly appear in healthy adults, but those with weakened immune systems—especially babies younger than 6 months old—are particularly susceptible to the infection. While it doesn’t pose any significant danger for little ones, thrush in babies can make sucking and swallowing painful, so it’s important to treat the infection promptly.
What Causes Thrush in Babies?
Yeast naturally exists on the body and in the mouth, but it can sometimes grow out of control, leading to thrush in babies, says Gina Posner, MD, a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California. A healthy immune system usually keeps candida in check, but babies don’t have fully developed immune responses, making it more likely for the yeast to proliferate.
In other cases, yeast may develop on a nursing mother’s nipples and on bottle nipples or pacifiers that haven’t been thoroughly rinsed. The fungus is then transferred to baby’s mouth and can develop into thrush, says Ashanti Woods, MD, a pediatrician at Baltimore's Mercy Medical Center.
So how can you tell whether baby has developed a mouth infection? There are several thrush symptoms to look out for, including:
• White, cottage cheese–like patches in the mouth. This thick film usually coats the tongue and inside of the cheeks and is the classic sign of thrush in babies. Note that infants often have a whitish tongue from drinking breast milk or formula, but that white buildup can easily be rubbed off, Woods says, whereas thrush is harder to remove.
• Dry, cracked lips. Cracking and redness at the corners of the mouth is another sign of thrush.
• Fussiness. While some babies are largely unaffected by thrush, others may experience pain while eating and become more fussy than usual, Posner says.
• A diaper rash. Babies can sometimes swallow the fungus and excrete it through bowel movements, which can lead to a yeast diaper rash, Ganjian says. The rash alone isn’t usually a tip-off that you’re dealing with thrush, but if your child has white patches in her mouth and a diaper rash that won’t quit, together they could be telltale thrush symptoms.
• Irritated nipples on mom. Breastfeeding moms can pass yeast from their nipples to their babies, but it’s also possible for infected babies to transfer thrush to their mothers through nursing, Woods says. Thrush symptoms in mom can include red, itchy or sore nipples.
If you spot any signs of thrush, give your pediatrician a call. Doctors can usually make a diagnosis based on the thrush symptoms baby may be exhibiting; taking a quick peek into your child’s mouth to confirm the presence of white patches is often all they need to do. Other times doctors will take a small sample from baby’s mouth and send it off to a lab for testing.
There are a few ways you can treat thrush in babies. “Some cases of thrush go away on their own with natural and oral care,” Woods says, “but most cases require an oral antifungal medicine.” Doctors generally recommend Nystatin, a medication that’s squirted onto the inside of baby’s cheeks four times a day for a week or two to keep the yeast in check.
To treat a yeast diaper rash that develops as a result of thrush, monitor the diaper area closely and use an over-the-counter diaper rash cream to ease baby’s discomfort, Woods says. If the rash doesn’t clear up, alert your pediatrician.
If you’re breastfeeding, your doctor may also recommend you use an antifungal cream, such as Clotrimazole, on your nipples twice daily to prevent you and baby from exchanging thrush.
Natural remedies for thrush
While medication is generally doctors’ prefered thrush treatment, there are a few natural remedies for thrush in babies that you can try as well:
• Wipe the inside of baby’s cheeks. This can help physically remove the thrush, Woods says.
• Sterilize feeding supplies. Pacifiers, bottles and niplpes should all be sterilized after each use until the thrush is resolved, Ganjian says.
• Give baby probiotics. Probiotics can help keep a bacterial balance in baby, Posner says, but talk to your pediatrician before offering them to baby.
How to Prevent Thrush in Babies
It’s not always possible to prevent thrush in babies, but there are a few ways to help lower your and baby’s risk:
• Keep your breasts dry. During nursing sessions, breasts are warm and moist—two things yeast thrives on. Ganjian recommends keeping your breasts dry between feedings to help prevent thrush.
• Sterilize bottles and pacifiers. Preemptively sterilizing items that find their way into baby’s mouth will kill off any fungus that could be gathering on those surfaces, Woods says.
Updated January 2018
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