Thrush is a type of fungal infection that is caused by yeast. This yeast is called Candida Albicans. It appears as white or sometimes yellow patches that are irregular in shape.
These lesions are slightly raised, which gives a cottage cheese-like appearance. The lesions can also appear as sores. These lesions can coat your baby’s gums and tongue along with the sides as well as the roof of the mouth. Thrush in the baby mouth is quite a common condition, although it is not usually serious.
Therefore, it can be treated easily. If your baby is healthy oral Thrush is not a big issue. However, if your baby’s immune system is weak, symptoms can get severe and will be challenging to control.
As Thrush is highly contagious, the infection can pass back and forth between the baby’s mouth and the mother’s breast. Therefore treatment should aim at treating both nursing mother and baby.
How does Thrush affect your baby?
Since the lesions coat your baby’s gums and tongue, the baby becomes irritable. It makes sucking and feeding uncomfortable. The baby becomes fussy during feeding. Even though you try to nurse, your baby will turn away due to pain.
Although it is a mild infection most of the time, it can sometimes be painful for your baby.
The lesions can spread to the roof of your baby’s mouth, back of the throat, and even tonsils. If the Thrush is severe, corners of your baby’s mouth can get cracked with redness. Babies are more affected than adults, although it is an infection that can occur in anyone.
Babies suffer more because of their reduced immunity. For the immune system to develop entirely, it takes time.
If the baby can communicate, he or she will refuse milk as they cannot feel the taste. Besides burning, sensation and soreness will make the baby irritable and will cry when milk or food is offered as it is difficult to swallow with all the lesions in the mouth.
Sometimes your baby with Thrush may also develop Candida infection in the groins due to the spread of the fungus. This diaper rash will make the affected skin red and elevated with red dots.
Thrush can also affect the nursing mother as infection can pass from your baby to you while feeding. Nipple thrush can be identified by soreness of nipples along with burning sensation or sometimes itchiness. Nipples may appear shiny, flaky or crusty. Feeding may give rise to sharp shooting pains in your breast.
What causes Thrush in your baby’s mouth?
Candida is a form of yeast that can colonize the vagina (the birth canal). You, as a mother, would have experienced yeast infection at least once in your life. This happens when Candida (yeast), which is kept in check by other microorganisms, starts to grow and cause infection.
If you get sick, your immunity can go down. If you use antibiotics frequently or there are hormonal changes (as in you getting pregnant), the Candida, which was lying low within your vagina, can multiply rapidly and start the infection. The causes mentioned above are known to disrupt the balance between microbes in the body.
Your baby can pick up this fungal or yeast infection at birth while passing down the birth canal. Therefore Thrush is most commonly seen in newborns and babies less than 3 months of age.
If an older baby gets Thrush, it can be due to your baby being on an antibiotic for another infection. It also kills the friendly bacteria, which keeps Candida in check, or else your baby’s immune system is not strong enough to fight infections.
If your baby is using pacifiers or feeding bottles, they can make your baby’s mouth extra moist. A moist environment is perfect for yeast to thrive, thus causing Thrush in your baby’s mouth.
If your baby is on inhaled corticosteroids (baby with wheeze), he or she will be more prone to develop Thrush. Corticosteroids can get absorbed through the oral lining and cause reduced immunity in the baby.
Thrush is easily passed back and forth from baby to mother. An infected mother can give the infection to the baby while nursing and an infected baby can pass the infection easily to the mother’s breast. Therefore it is best to get treatment for both you and your baby.
How do you correctly identify Thrush in the baby mouth?
Candida is a normal organism that lives in the lining of the mouth (oral mucosa). When it overgrows, symptoms can arise. Oral Thrush causes lesions that are creamy white. Baby can develop these lesions not only in tongue and gums but also in inner cheeks.
If the lesions are scraped off, the underlying sore can give rise to slight bleeding.
Residues of breast milk or formula can cause white patches on your baby’s mouth. These residues can stay on your baby’s mouth after a feed but commonly dissolves within an hour or two. These milk residues may be mistaken for Thrush.
If your baby’s gums and tongue have white patches, try to wipe them off gently with your finger covered by using a piece of gauze or a soft damp cloth. The milk residues will be wiped away easily, and your baby’s tongue will be pink and healthy.
However, if white patches are due to yeast infection, they cannot be wiped off easily. If it comes out, the underlying surface of the patch will be red and raw. If this is so, the condition is most likely Thrush, and it is better to contact your pediatrician or a dentist.
How do you prevent Thrush in the baby mouth?
If you deliver your baby by normal vaginal delivery, there is no way you can prevent your baby from encountering the yeast infection as the baby has to pass down the birth canal.
However, having a caesarian section can prevent your baby from encountering the yeast. But caesarian sections are not indicated purely for such reasons.
- Clean and sterilize the pacifiers, feeding bottles, and parts of breast pumps to kill the yeast, which was contaminated.
- Allow your breasts to dry completely between feeds. When the breasts are dry, it will prevent the growth of yeast or other microbes.
- Wear cotton bras that do not trap moisture as moisture helps the yeast to grow rapidly.
- Change nursing pads after breastfeeding.
- Wash your bras frequently with hot water and dry them well before wearing them again. Sun-drying helps as it destroys the microbes.
- Do not use antibiotics unless they are essential. Antibiotics can trigger the development of yeast infection in both you and your baby.
What are the complications of Thrush?
Complications occur only in babies who have suppressed immunity. They can develop serious systemic Candida infections if left untreated.
Thrush can spread to your baby’s esophagus or other areas of the body when the infection is severe. In severe Thrush, your baby can even develop fever, mainly if it spreads beyond the esophagus.
Long-standing Thrush can lead to weight loss as it interferes with feeding.
What are the home remedies which you can try to treat Thrush in your baby’s mouth?
Mild cases of oral Thrush can go away on its own. Following home remedies can help to control and relieve some of the symptoms of Thrush in your baby’s mouth.
Treat the underlying cause
If your baby is on inhaled steroids for Asthma or wheezing, wash your baby’s mouth region after each inhalation. Inhaled corticosteroids can get absorbed and lead to reduced immunity in your baby, leading to Thrush. Make sure you take a damp cloth and clean the baby’s gums and tongue after inhaler use.
Inform the pediatrician regarding inhaler use, if your baby develops Thrush, as there is a possibility of reducing the dosage or frequency of inhaled steroids by your doctor.
Warm salt water rinse
Wrap your finger with a piece of gauze and dip it in a cup of warm salt water. Then clean your baby’s mouth with your finger wrapped with salt water-soaked gauze. However, too much salt, if swallowed, can lead to electrolyte imbalances in your baby.
Therefore take precautions not to do this too frequently and soak the gauze just enough for cleaning the insides of the baby’s mouth.
Apply lemon juice over the lesions
Applying a little lemon juice over lesions can help to suppress Candida infection as it has both antiseptic and antifungal properties.
However, acidity in lemon can cause burning and irritation in your baby’s mouth. Therefore make sure that you do not try this home remedy too often.
Application of coconut oil
Coconut oil is a well-known healing agent as it has both antiseptic and soothing properties. Apply a little coconut oil in gums and tongue along with sides twice a day.
Use a piece of gauze wrapped around your finger to soak the coconut oil and applying. This can be done twice a day, and you will notice that your baby will be less irritable.
Clove oil application over the lesions
Clove oil can be applied with a swab over the Candida lesions. This remedy can help as it is known to be an antiseptic, as well as a pain reliever.
Make sure you touch only the lesions with the clove oil soaked swab as it can irritate the mucosal lining of your baby’s mouth.
Application of baking soda
Dilute baking soda with a little water into a paste and apply this over the lesions. Baking soda (sodium bicarbonate) is a weak base that neutralizes acidity. This method can be tried in older babies.
Although this remedy helps in treating Thrush, it may cause burning and should be used cautiously.
Applying apple cider vinegar
Antifungal properties in apple cider vinegar can fight with Candida yeast. As it can cause a burning sensation, you have to be cautious when applying inside your baby’s mouth.
Tea tree oil
Applying tea tree oil with a cotton swab over the lesions may help to control the yeast lesions.
If the lesions are scraped or rubbed off, slight bleeding can occur. Therefore make sure not to rub the lesions when applying medications.
These home remedies can help to reduce symptoms and control the spread, but it will not cure the Candida infection. Since you are trying these home remedies on your baby, you have to do it cautiously as too much of these natural chemicals can irritate the mucosal lining of your baby’s mouth.
Remember that home remedies are to support and not to replace antifungal medications in the treatment of Thrush in your baby’s mouth.
When you notice that your baby has developed oral Thrush, using these preventive techniques can also help in controlling the Thrush.
Use nursing pads
If you are a mother who breastfeeds your baby, it is better to use nursing pads. These will prevent the yeast from spreading to your clothes. Make sure you change the nursing pads after each nursing session.
Use breast pads without plastic liners as they can trap in moisture, which makes you more susceptible to Thrush.
Wear clean and dry bras
When your bra is moist, Candida can grow and multiply as fungus thrives in moist environments.
If you live in a hot and humid climate, you will experience more sweating, which can make your bra moist. Change them often as necessary.
- If you use a breast pump, make sure you clean all the detachable parts which touch your skin.
- Clean the bottle nipples and pacifiers well before using it. Sterilizing helps to get rid of the germs.
- As Thrush is highly contagious, whatever your baby puts inside the mouth can spread the Candida infection. Therefore it is essential to sterilize teething rings too.
- Make sure that your breast nipples are clean and dry before you nurse your baby. As nipples need to be dry in-between feeds, try to remain topless for a few minutes if possible which allow your nipples to air dry.
- Maintaining good oral hygiene in your baby can control and even prevent developing Thrush. Babies who are more than 6 months of age start getting milk teeth. You should start brushing your baby’s teeth from the start, which means the eruption of the first tooth itself.
- Wash your hands often, especially after nursing, and after each diaper change.
- If your baby is taking solids, increasing yogurt intake helps, as yogurt contains lactobacillus, which is a good bacteria that keeps Candida in check.
What are the over the counter medications which can be used for Thrush?
Gentian violet has antifungal properties, and this can be obtained over the counter. Apply Gentian violet to the affected regions with a cotton swab twice a day.
Over the counter antifungal creams to apply to a nursing mother’s breasts include Miconazole cream (Lotrimin, Crurex). Some topical antifungal medications are appropriate for oral use.
But others need to be wiped off your breast before nursing. Always ask your doctor or pharmacist whether a certain topical product is safe for your baby.
When should you seek help from your doctor?
If you notice Thrush in your baby, it is better to seek help from your pediatrician before it spreads. Treatment is necessary, especially if your baby is refusing feeds and becomes increasingly irritable. Early treatment is helpful in preventing complications.
Feeding problems can lead to dehydration and nutritional deficiencies in your baby. It is best not to wait until complications develop because both you and your baby will unnecessarily suffer if treatment is started late.
As natural home remedies also contain chemicals, it is best to discuss with your doctor before trying them on your baby.
How will your doctor manage Thrush in the baby mouth?
To diagnose oral Thrush in your baby’s mouth, your doctor will examine the mouth to visualize the lesions. Diagnosis is usually clinical. Sometimes a small scraping will be taken from the lesions to examine under a microscope.
If necessary, your doctor will do a physical examination of your baby and order certain blood tests if he suspects a possible underlying medical condition.
When Thrush is diagnosed, it should be treated appropriately. The goal of treatment should be to stop the spread of infection and complete cure. Once treated, the aim should be to prevent a recurrence.
Your doctor will prescribe a suitable antifungal gel or drops, which has to be applied inside of your baby’s mouth several times a day for at least 10 days.
Ex: Nystatin oral drops, Candid mouth paint. Nystatin (Mycostatin) is a commonly used anti-yeast and antifungal medication to treat oral Thrush. It should be applied directly over the lesions for proper control.
If the Candida infection is severe, your doctor may prescribe an oral antifungal medication such as Flucanazole. This may be given by a dropper as it is easier to give orally.
Oral antifungal medications also come in syrup form. Ex: Flucanazole (Diflucan) or Itraconazole (Sporonox). Oral Antifungal medications are usually prescribed for 10 to 14 days.
Antifungal medications are needed to get rid of Candida infection entirely.
Sometimes your baby with Thrush may also develop Candida infection in the groins. Your doctor will specifically look for these diaper rashes and treat them with a different antifungal medication.
Since infection passes back and forth from you and your baby, it is best to treat both. An antifungal cream will be prescribed to you, which has to be applied regularly (twice a day) to your nipples and areola region (dark area around your nipple).
Ex: Miconazole cream, Nystatin cream, Clotrimazole cream, Ketoconazole cream, etc. Treatment should be continued for at least 6 weeks if not infection might recur.
If your nipples are infected with visible Candida rash, your doctor will prescribe an oral antifungal like Flucanazole.
Breastfeeding need not be stopped, as most medications are compatible with nursing.
Even after successful treatment, Thrush can recur if the underlying cause is not addressed. That is why your doctor will actively look for a cause.
- If it is due to unnecessary use of antibiotics, they may be omitted.
- If it is due to inhaled corticosteroid use, your doctor will teach you the inhalation technique and how to clean the mouth region after each inhalation.
- If it is due to a medical condition, further investigations have to be done to manage such conditions.
In immunosuppressed babies, Thrush can spread towards the esophagus. If your doctor suspects spread beyond the esophagus, an endoscopy will be arranged to visualize the lesions. (An endoscopy is a procedure where a lighted, flexible tube with a camera is used to visualize the inside of your esophagus and stomach).
As esophageal Thrush is uncommon, a thorough physical examination and investigations are done to exclude the cause of immunosuppression.
Mothers who have uncontrolled diabetes can develop Thrush, as yeast feeds on sugar. If you are a nursing mother having high blood sugar levels, you are prone to Candida infection as well as pass it to your baby.
Your doctor will treat you for diabetes, and it is your responsibility to get it controlled by adhering to the treatment plan as well as by proper diet and regular exercise. Reduce your sugar and intake of refined carbohydrates.
Diabetes control needs a lifestyle change. If you suspect any infection around your breast region, get medical help, because you can pass the infection to your little one while nursing.
It will take up to 2 weeks for oral Thrush to dissipate completely. Make sure you comply with the treatment plan given to you by the doctor about the treatment of both you and your baby. Following strict hygienic practices and contacting your doctor at the early stages and getting treated will allow you to continue breastfeeding without any hassle.
Therefore, do not worry if your little one gets Thrush in the mouth as it can be easily controlled. It needs patience and compliance with treatment as well as preventing your baby from getting re-infected.