Is this your child's symptom?
- A yeast infection of the mouth in young babies
- White patches in the front of the mouth
Symptoms of Thrush
- White, odd shaped patches in the mouth
- Coats the inner cheeks or inner lips
- Sometimes also coats the tongue
- Sticks to the mouth. It can't be washed away or wiped off easily like milk curds.
- Sometimes causes a painful mouth, decreased sucking and reduced milk intake
- Mild discomfort or no symptoms in most newborns
- The infant is bottle-fed or breast-fed
Cause of Thrush
- Caused by a yeast (called Candida)
- Occurs on parts of the mouth involved with sucking
- Made worse by friction from too much time sucking on a pacifier
White Tongue Alone: Not Thrush
- If a white tongue is the only finding, it's not due to thrush.
- A milk diet often causes a white coated tongue.
- This is normal.
- It will go away after your baby starts eating solid foods.
- If white patches occur inside the lips or cheeks, call your child's doctor. It's safe to call during office hours.
When to Call for Thrush
Call Doctor or Seek Care Now
- Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
- Age less than 1 month old and looks or acts abnormal in any way
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- Fever occurs
- Bleeding in the mouth
- Drinking less than normal
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- Thrush, but none of the symptoms above. Reason: may need a prescription medicine to treat it.
- You have other questions or concerns
Care Advice for Thrush
- What You Should Know About Thrush:
- Thrush is common during the early months of life.
- It's caused by a yeast infection in the mouth. Most often, it's due to prolonged sucking.
- Thrush causes only mild discomfort. It's easy to treat at home.
- Here is some care advice that should help until you call your doctor.
- Anti-Yeast Medicine (Prescription):
- Your doctor will probably prescribe an anti-yeast liquid medicine. Use it as follows:
- Age Under 1 Month: Use 1 mL.
- Age Over 1 Month: Use 2 mLs.
- Place in the front of the mouth on each side. Also, put it wherever you see the thrush. It doesn't do any good once it's swallowed.
- Do this 4 times per day.
- If the thrush isn't getting better, rub the medicine directly on the thrush. Use a cotton swab to do this.
- Don't feed your baby anything for 30 minutes after the medicine.
- Keep this up for at least 7 days. Also, continue it until all thrush has been gone for 3 days.
- Decrease Sucking Time to 20 Minutes per Feeding:
- Reason: Too much sucking can irritate the lining of the mouth. This makes it more prone to a yeast infection. A common example of this is when a baby sleeps with a bottle.
- For severe mouth pain with bottle feeding, don't use a bottle. Reason: The nipple can make pain worse.
- Try giving fluids in a cup, spoon or syringe instead.
- Limit Pacifier Use:
- Too much sucking on a pacifier can irritate the mouth.
- Limit pacifier use to times when nothing else will calm your baby.
- If your infant is using an orthodontic pacifier, switch to a smaller, regular one. Reason: Bigger ones can cause more friction in the mouth.
- Special washing or boiling of pacifiers or bottle nipples is not needed or helpful.
- Special Washing of Pacifiers and Nipples - Not Helpful:
- Pacifiers and bottle nipples can be washed the usual way with soap and water.
- They do not need to be boiled or sterilized.
- They do not need to be thrown out.
- Yeast is a germ that is found in normal mouths.
- It only causes thrush if the lining of the mouth is irritated or damaged.
- Get better results by reducing nipple time and pacifier time.
- Note: Follow your doctor's advice if it is different.
- Breastfeeding and Yeast Symptoms:
- If the mother's nipples are red and sore, it's probably a yeast infection.
- Use an anti-yeast cream (such as Lotrimin) on the nipple area.
- No prescription is needed.
- Put it on 4 times per day after feedings.
- Wash the cream off the nipples before each nursing. Avoid soap which dries out the skin.
- Many mothers will need treatment with an oral anti-yeast medicine (such as Diflucan). Call your PCP or OB within 24 hours for advice.
- Diaper Rash Treatment:
- If there's a bad diaper rash, it can also be due to yeast.
- Use an anti-yeast cream (such as Lotrimin) on the diaper rash.
- No prescription is needed.
- Put it on 4 times per day.
- See Diaper Rash care guide.
- Return to Child Care:
- Thrush cannot be spread to others, since it does not invade normal skin.
- Your child can go to child care with thrush.
- What to Expect:
- With treatment, thrush usually clears up in 4 to 5 days.
- Without treatment, it clears up in 2-8 weeks.
- Call Your Doctor If:
- Starts drinking less than normal
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 09/17/2019
Last Revised: 03/14/2019
Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.