Everything you need to know about your baby's oral thrush

A yeast called candida grows naturally in the body, including the mouth. Some babies get an overgrowth of this yeast because their immune systems aren’t mature yet, says pediatric dentist Dr. Liel Grinbaum, DMD.

“Oral thrush is a condition of an overgrowth of Candida Albicans, which is a fungus that naturally grows on our skin and in our stomachs,” explains Dr. Grinbaum. “Typically, C. Albicans are a natural inhabitant of our body but when there is an uncontrollable overgrowth, it has a detrimental effect.”

According to cosmetic dentist Dr. Lauren Becker, DDS, PC, common signs of oral thrush in babies include the presence of white patches in the baby’s mouth that can coat the inner cheeks, lips, and tongue. It can also cause discomfort for the baby and result in feeding challenges. Dr. Grinbaum also suggests watching for cracked red areas around the corners of your baby’s mouth.

“Thrush looks like thick, white, cheesy clumps on the tongue, inside of the mouth and gums,” says Kerry Harris, a midwife based in Vancouver. She adds that thrush can sometimes be confused with ordinary milk residue on your baby’s tongue, but thrush doesn’t wipe away as easily as milk does. Your baby may also have a red rash in their diaper area and be generally fussy, especially when it’s time to eat. It shouldn’t be painful for babies, but it can be for moms.

Breastfeeding mothers may notice red, shiny, irritated and peeling skin on their nipples. “Often, thrush is a burning or stabbing pain that goes from the front of the breast toward the chest,” says Harris. “The pain can happen during or between feedings.”

“Thrush can be persistent and usually lasts for a week or two,” says Harris. “If it persists beyond that with treatment, talk to your healthcare provider.”

A yeast called candida grows naturally in the body, including the mouth. Some babies get an overgrowth of this yeast because their immune systems aren’t mature yet. Your baby can pass it on to you during breastfeeding, especially if you have cracked or irritated nipples.

Your baby can pass it on to you during breastfeeding, especially if you have cracked or irritated nipples. Therefore, Dr. Grinbaum recommends feeding your baby formula via bottles for the duration of the infection.

“Oral thrush is highly contagious and can spread from an infant's mouth to the mother's nipples, areolas and breasts via direct oral to skin contact and indirect contact,” notes Dr. Grinbaum. “I would recommend pumping or using formula via bottles for the time of infection. Thrush spread to the mother will cause very itchy and white areas around the nipples with a burning and painful sensation.”

According to Dr. Scott W. Cashion, D.D.S., M.S., president of the American Academy of Pediatric Dentistry, oral thrush is contagious and can be passed along to other babies and children. To prevent the transmission of oral thrush, he suggests refraining from sharing bottles, cups, or toys that the infected child has used, and not allowing other children to use your child’s pacifier.

The first step is a thorough assessment by a healthcare provider so that you know what you’re dealing with, says Harris. Your healthcare provider may recommend some of the following remedies, which are safe for both babies and breastfeeding moms.

• Nystatin, a prescription liquid antifungal medication, can be administered with a dropper in your baby’s mouth after nursing. You can also use a prescription cream that contains nystatin or an over-the-counter antifungal cream, similar to one used to treat vaginal yeast infections, on the nipples after nursing, says Harris.
• An all-purpose nipple ointment like Dr. Jack Newman’s All Purpose Nipple Ointment, a compound cream that includes anti-inflammatory, antifungal and antibiotic ingredients, can be applied after nursing.
• Gentian violet, an antiseptic dye in a water-based solution, can be applied to your baby’s mouth and your nipples with a cotton swab before nursing. (This is messy purple stuff and can stain fabric and skin.)
• Lanolin ointment can be applied to the nipples before breastfeeding as a barrier to yeast.
• An over-the-counter pain medication, such as acetaminophen or ibuprofen, can be taken to help relieve pain in new moms.
• Boiling bottle nipples, pacifiers, breast pump parts and medication droppers for 20 minutes daily will sterilize them.
• Changing breast pads and bras frequently if you’re breastfeeding and going topless whenever possible can help. “Yeast really likes warm, dark environments, so get light and air on your breasts,” advises Harris. iStock

In the event that your baby’s thrush comes back, pediatric dentist Dr. Sonia Gutierrez, DDS, recommends consulting a pediatrician or pediatric dentist for a thorough assessment. “We will examine the baby's mouth, ask about symptoms, and recommend appropriate treatment,” says Dr. Guiterrez. “Recurrent oral thrush may be indicative of an underlying issue that needs to be addressed.”

To prevent oral thrush from returning, Dr. Cashion recommends ensuring that your baby’s pacifiers and bottle nipples are meticulously cleaned in hot water or a dishwasher after every use. However, he says that it is still vital to consult with your pediatric dentist before implementing any changes.

Dr. Cashion suggests that parents can make adjustments to their child’s diet to help prevent oral thrush. One approach is to reduce the intake of sugar in the child’s diet. Additionally, depending on the child’s age, including yogurt with lactobacilli in their diet can also be a viable method for treating oral thrush.

Experts:

• Pediatric dentist Dr. Liel Grinbaum, DMD
• Cosmetic dentist Dr. Lauren Becker, DDS, PC
• Dr. Scott W. Cashion, D.D.S., M.S., president of the American Academy of Pediatric Dentistry
• Pediatric dentist Dr. Sonia Gutierrez, DDS