Thrush is a very common infection in infants. It appears as white, thick, cheesy, irregularly shaped patches. It coats the inner surfaces of the mouth, including the gums, lips, and sometimes the tongue. Usually, it adheres to the mouth and cannot be washed away or wiped off easily like milk. (Note that a white film on the tongue is normal and does not usually indicate thrush infection). Thrush may cause mild discomfort to the child.
Thrush is caused by a common yeast called Candida. This yeast grows rapidly on the lining of the mouth in areas abraded by prolonged sucking (as when a child sleeps with a bottle or pacifier). A large pacifier or nipple can also injure the lining of the child’s mouth. Thrush may also occur when your child has recently been taking an antibiotic.
Thrush is not contagious since it does not invade normal tissue.
However, the fungus can also cause rashes, especially in the diaper area
What you should do
If your suspect your child has thrush, call your pediatrician, or contact our office
Treatment is most commonly with Nystatin, an oral suspension, and available by prescription. It comes in a bottle with a dropper. You can use 1 ml for each side of the mouth (a total of 2 ml per dose). Squirt it directly on the white patches 4 times a day. You can also rub the medication on the spots with a cotton swab, or with gauze wrapped around your finger. Apply it after meals, or at least do not feed your baby at least 30 minutes after the application, or as directed by your doctor.
If you are breastfeeding, also apply Nystatin on your nipples several times, as directed.
If your child has a diaper rash at the same time, it may be due to the same yeast. Request Nystatin cream and apply it to the area as directed.
It generally takes about a week to clear up. You should treat for at least 5-7 days, or for 2-3 days after all signs of infection are gone. Thrush commonly recurs at some point.
- Decrease sucking time to about 20 minutes per feeding. Prolonged sucking may make a child more prone to thrush. If sucking on a nipple is painful for your child, use a cup temporarily.
- Restrict pacifier use to bedtime.
- Sterilize any pacifiers and bottle nipples daily, appropriately.
Call your pediatrician if…
- Your child refuses to eat.
- The thrush is getting worse even though your child is undergoing treatment.
- The thrush lasts more than 10 days.
- You have other concerns or questions.