Thrush in Babies: Signs, Symptoms and Treatment

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. Tissue damage to an infant’s mouth can also increase susceptibility. 

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 qualified health provider because this might be a sign of another health issue.

In more persistent and/or severe cases, it may be worth considering various supplements and potential prescriptions such as Nystatin to help this clear more fully. Talking with your licensed prescriber first is of course essential.

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.

HiPP is an organic baby formula company that takes great care in designing their powdered formula to provide the best possible nutrition for babies. Their formula contains natural probiotic L. fermentum hereditum®, which is known to support a baby's digestive system and immune function.

Research has shown that probiotics can help reduce the risk of various health issues in infants, including irritable bowel syndrome, constipation, colic, ulcerative colitis, and stomach inflammation. They work by adding more beneficial bacteria to the gut, promoting a healthy gut environment.

Additionally, probiotics can prevent or reduce the risk of diarrhea and atopic eczema in babies. They also control the growth of undesirable bacteria that may lead to thrush and can cause inflammation and damage the infant's GI tract.

Finally, probiotics have been studied as a potential preventative against necrotizing enterocolitis, a rare and severe infection that can damage the infant's gut.

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

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https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/thrush/

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