By: Dr. Nazeli Gevorgyan - September 21, 2023 - 8 Minute Read
Have you ever noticed unusual white patches in your baby's mouth that left you puzzled and worried? These patches can be a sign of thrush, a common but often misunderstood condition in babies. If you're a parent wondering about thrush and how it can affect your little one, stick around. In this article, we're diving into the world of thrush in babies.
Thrush, or candidiasis is a common fungal infection caused by yeast Candida.
Most people, even babies, naturally have yeast in their mouths and digestive systems without problems. A strong immune system and ‘’good’ bacteria usually control its growth. When Candida grows too much, it causes an infection called candidiasis or thrush. Babies under 6 months and toddlers are more prone to this condition.
In babies, the infection often looks like patches in the mouth or on the tongue - oral thrush, irritating and making them uncomfortable. Sometimes babies can have both thrush and a diaper rash at once.
Candida albicans is commonly found yeast linked to thrush. Newborns can get these fungi when passing through the birth canal if their mother has vaginal thrush. According to the literature, babies born to mothers with vaginal thrush are eight times more likely to develop thrush.
Babies can also get yeast when a nursing mother has a breast and nipple thrush - particularly about 25% of babies get oral thrush before 18 months in such cases.
Corticosteroids, antidepressants, immunosuppressants, hormone problems, and pregnancy itself increase the risk of fungal infections in mothers including nipple thrush. Fungi thrive in warm, moist places, and breastfeeding provides this environment.
Candida can spread through not thoroughly cleaned milk bottles, breast pumps, pacifiers, and poor hygiene during breastfeeding such as dirty nipples and inadequate handwashing.
It’s worth remembering: Babies can transmit thrush to their mothers during breastfeeding, creating a cycle between the breast and the baby’s mouth.
Their immune system isn’t fully developed and even small problems in protective mechanisms can lead to thrush. These may include taking antibiotics, which can kill off the ‘’good’’ bacteria that control Candida growths, or steroids. Baby’s mouth tissue damage can also trigger the infection.
A baby with thrush doesn’t always need to have symptoms.
● However, oral thrush in infants usually appears as creamy white plaques on the tongue, inner cheeks, and sometimes on the gums, palate, and/or throat.
● These lesions are similar to cottage cheese, but they can’t be easily wiped away or removed.
● If the lesions are rubbed or scraped, they might cause light bleeding.
● Cracking and redness at the corners of your baby’s mouth can occur.
● Your baby may become picky and irritable. They may feel discomfort and pain during feeding due to a sore mouth.
● The infant may also have a rash in the diaper area.
It’s crucial for healthcare providers not to confuse milk coating from breastfeeding (milk tongue) with oral thrush, as their appearances might look similar. Milk coating includes the tongue and is characterized by easy removal upon wiping and might suggest issues with tongue movement or other factors.
In case you have breast and nipple thrush, you may experience:
1. Nipples that are unusually red, sensitive, cracked, or itchy.
2. The nipple’s darker area (areola) appears shiny or flaky.
3. Pain during nursing or between feedings, which can sometimes feel like stabbing pains in the breast.
Remember, not all nipple pain is caused by thrush; it could be due to your baby’s positioning or latch during breastfeeding. Your midwife, health visitor, or breastfeeding specialist should see you while you breastfeed and offer help if required.
If you think your baby and/or you have thrush, see a doctor. If you both have thrush, getting treatment together is important to avoid passing the infection back and forth.
In some babies’ signs and symptoms may go away on their own in a week or two, but the doctor might offer a gel or liquid against fungi that you gently apply to your baby’s mouth and tongue several times a day using a sponge. The doctor might also recommend giving them yogurt with beneficial bacteria called lactobacilli, which can help clear the yeast from their mouth.
If you have thrush too, it may be treated with an antifungal cream, or tablets in some cases. For the cream, you need to apply it to your nipples after each feeding with properly washed hands.
Usually, oral thrush becomes less of a problem as your baby’s immune system gets stronger. But if your baby continues to get it, especially after 9 months of age, contact a doctor because it could indicate another health issue.
If your baby keeps getting oral thrush, especially if he or she is older than 9 months old, talk with your doctor because this might be a sign of another health issue.
Breastfeeding with thrush can be tough both for you and your baby. Continue breastfeeding if possible. If it becomes too uncomfortable, consider using a breast pump to express your milk instead.
While receiving treatment for the infection, healthcare providers suggest using fresh or frozen expressed milk for the baby. Yet, it’s not recommended to use milk expressed during the infection period after treatment because freezing doesn't get rid of yeast spores. This helps lower the risk of infection coming back.
Additionally, you can consider using baby formulas. European formulas are well-known for their clean ingredients and high-quality standards. One notable ingredient often found in these formulas is probiotics, which can naturally help manage thrush. Probiotics are ‘’good’’ bacteria that promote a healthy balance in your little one’s body. By doing so, they can prevent the overgrowth of yeast. This can make things easier for you and ensure your baby still gets good nutrition.
To prevent oral thrush in your little one, if you nurse, prioritize personal hygiene, including:
● Keeping your hands and nipples clean
● Changing underwear (bras) regularly and nursing pads when they get moist.
● Ensuring breasts are dry after feeding.
● Sterilizing breast pumps and their parts systematically.
According to a study by Rahmadiayni et al., mothers who practiced personal hygiene 5.167 times were less likely to experience oral thrush in their babies aged 0-6 months.
1. Promptly treat breast and nipple thrush if you notice any signs and symptoms to prevent the infection from spreading to your baby.
2. Treat your vaginal thrush, if you have it, too.
3. Use a hot wash cycle for towels, clothing, and bras that may have had contact with Candida.
4. Wash your baby’s hands and toys regularly.
5. Clean the nipples of feeding bottles and pacifiers in hot water or a dishwasher after each use if your formula-feed your baby or use pacifiers.
6. Limit sucking during feedings to 20 minutes or less, and only use a pacifier at bedtime for up to one hour a day to prevent thrush from coming back, as they can irritate your little one’s mouth.
7. Change diapers frequently to prevent diaper rash.
When it comes to parenting, the journey is filled with ups and downs, joys, and challenges. Dealing with thrush in a baby can be challenging, but it’s heartwarming to know that with patience, care, and proper treatment, you can help your baby overcome this common infant ailment.
Consult with a medical professional for proper diagnosis and treatment.
For more information on European baby formulas, baby nutrition, breastfeeding, and for other valuable resources, be sure to visit “The Milky Box’’ website - it’s there to support you in your parenting journey.
1. Rahmadiyanti, R., & Halimatussadiah, H. (2023). Relationship Between Personal Hygiene During Breastfeeding and Oral Thrush in Infants 0-6 Months. International Journal of Health and Pharmaceutical (IJHP), 3(4), 769–774.
2. Jameel K, Al-Ruaby KJW. Breast and Nipple Thrush in Lactating Mothers. ResearchGate
3. Moerman A-F. Development of a protocol to question healthcare workers considering oral thrush in infants.
4. Vainionpää, A., Tuomi, J., Kantola, S., & Anttonen, V. (2019). Neonatal thrush of newborns: Oral candidiasis? Clinical and Experimental Dental Research, 5(5), 580-582. https://doi.org/10.1002/cre2.213
5. Oral Thrush - Johns Hopkins All Children’s Hospital https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Oral-Thrush-(1)
6. Oral thrush - Symptoms and causes - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533
7. Thrush: Symptoms, Causes & Treatment. https://my.clevelandclinic.org/health/diseases/10956-thrush
8. Thrush - Breastfeeding challenges - Start for Life - NHS. https://www.nhs.uk/start-for-life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/thrush/
9. Breastfeeding and thrush - NHS.
https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/thrush/
10. What You Need to Know About Thrush in Babies - American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/what-you-need-to-know-about-thrush-in-babies/
11. What Is Thrush? | St. Louis Children’s Hospital. https://www.stlouischildrens.org/health-resources/pulse/what-thrush
Disclaimer:
Please be aware that this information is based on general trends in babies, and it is not medical advice. Your doctor should be your first source of information and advice when considering any changes to your child’s formula and when choosing your child’s formula. Always consult your pediatrician before making any decisions about your child’s diet or if you notice any changes in your child.
Breastfeeding is the best nutrition for your baby because breast milk provides your child with all the essential nutrients they need for growth and development. Please consult your pediatrician if your child requires supplemental feeding.
Nazeli Gevorgyan is a medical doctor from Armenia, and is a researcher in the fields of Obstetrics and Gynecology, among others. Dr. Nazeli is passionate with providing women and parents with reliable and high-quality information on healthy options for infant nutrition, breastfeeding, infant formula, and food. In her free time, she enjoys swimming, traveling, and pottery.
Reviewed by Suzanne Renee',
Infant Nutrition Expert
Suzanne Renee' is an accomplished professional with extensive expertise in the area of infant nutrition, dedicated to promoting the health and wellbeing of children. She started this journey as a foster parent.
Suzanne has emerged as a strong proponent of the European baby formula and has become a full-time writer on the subject.
In her free time, she enjoys camping, hiking, and going to church.
