Thrush is an infection in a baby’s mouth caused by the fungus Candida albicans. It’s most common in babies under 6 months old because their immune system is still developing, but it can affect babies at any age. It usually causes small white dots or patches on the tongue that may look similar to leftover milk.
A newborn can develop thrush, also known as oral candidiasis or moniliasis, during birth through contact with the mother’s vaginal canal or by coming into contact with poorly cleaned items, such as bottles or pacifiers. Thrush may also develop after antibiotic use, since antibiotics can change the natural balance of microorganisms in the mouth.
Whenever thrush is suspected, it’s important to see a pediatrician to confirm the diagnosis and start treatment. Treatment typically involves applying a liquid antifungal medication.
Common symptoms
The main symptoms of thrush in babies include:
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Small white dots or cottage cheese-like patches on the lips, tongue, roof of the mouth, gums, tonsils, or inner cheeks
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Cracked skin at the corners of the mouth
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Redness in the mouth
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Bleeding when trying to wipe away the white patches
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Frequent crying
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Irritability or fussiness
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Trouble swallowing
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Decreased appetite
A baby may also have difficulty breastfeeding or may refuse to nurse, which can lead to dehydration. Signs of dehydration include fewer wet diapers, dry skin, a dry mouth or tongue, a sunken soft spot, or excessive sleepiness.
In some cases, thrush may also cause white dots to appear on the nails or in skin folds.
Confirming a diagnosis
A pediatrician can diagnose thrush by examining the baby’s mouth, and additional tests are usually not needed.
Possible causes
Thrush in babies is caused by the fungus Candida albicans, which can be transmitted during birth as the baby passes through the vaginal canal.
However, the most common cause is exposure to the fungus through contaminated bottles or pacifiers.
If a baby is breastfed and the breastfeeding parent has a Candida infection on the nipple, called nipple candidiasis, the fungus can also be passed to the baby and lead to thrush.
Treatment with antibiotics, whether taken by the breastfeeding parent or the baby, also increases the risk of fungal growth and the development of thrush.
Treatment options
Thrush treatment should be guided by a pediatrician, but it’s usually managed with an antifungal liquid, cream, or gel applied directly to the infected areas in the mouth.
If the thrush is linked to nipple candidiasis in the breastfeeding parent, both parent and baby need treatment at the same time to prevent reinfection.
In this situation, the breastfeeding parent’s treatment is typically guided by an obstetrician and usually involves antifungal creams or tablets.
Care during treatment
During treatment, certain care measures can help prevent reinfection, such as:
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Washing hands thoroughly with mild soap and drying them well before handling the baby
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Avoiding kissing the baby
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Sterilizing pacifiers, bottles, and toys the baby puts in the mouth by boiling them for at least 20 minutes after each use
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Washing burp cloths, clothing, or diapers that come into contact with the baby’s mouth in 140ºF water or boiling water
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Boiling breast pump parts for 20 minutes after each use
It’s also important to keep the nipples clean and dry. Nursing pads can help absorb moisture but should be replaced as soon as they become damp to reduce fungal growth.
Natural remedy for thrush
While undergoing treatment, a natural remedy may help ease discomfort. One option is to apply gauze soaked in pomegranate tea, which has antiseptic properties that may help cleanse the baby’s mouth.
To prepare pomegranate tea, boil the peel of one pomegranate in 250 ml of water. Once cooled, apply it to the white patches in the baby’s mouth using gauze soaked in the tea. Leave it on for 10 minutes and rinse the mouth afterward with clean water. This can be repeated 3 to 4 times a day for about a week.
It’s important to remember that pomegranate tea, like any home remedy, should only complement the treatment prescribed by the pediatrician and should never replace prescribed medications.