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What is thrush?
Thrush is a fungal infection that occurs in the mouth and throat. You know if your baby has thrush if you notice white patches on your baby's mouth, tongue or throat. Other signs include fussiness or refusal to nurse or cracking or redness on the corners of your baby's mouth.
Under normal conditions, the body contains millions of yeast and fungi. They usually cause no harm and can be beneficial and help fight disease. A particular type of yeast, called candida albicans normally lives in your baby's body without causing any problems. Other beneficial bacteria keep it from causing problems.
Thrush is a fungal infection that occurs in the mouth and throat. When the conditions inside the body change, possibly because of antibiotics or an undeveloped immune system, it can lead to the yeast growing out of control and causing thrush. Infants don't have a fully developed immune system, so thrush is the most common fungal infection in babies.
Symptoms of thrush in babies
Thrush infections can have any of the following symptoms:
- White patches in your baby's mouth, tongue, or throat
- Fussiness or refusal to nurse or bottle-feed
- Cracking and redness at the corners of your baby's mouth
Causes of thrush in babies
Thrush occurs when there is an overgrowth of the yeast candida albicans. Candida is always present on the skin and inside the body in the mouth, throat, gut, and vagina. It normally does not cause any problems since the beneficial bacteria in your baby's body keeps it from growing out of control.
However, if the environment in your baby's mouth changes for any reason, it can lead to fungal overgrowth. Some things that can lead to this include:
Medicine
If your baby has been on antibiotics recently, they may be more likely to develop thrush. Antibiotics kill off bacteria that cause infections, but they can also kill off beneficial bacteria that prevent candida from growing out of control. Inhaled corticosteroid can also cause thrush if your child's mouth is not rinsed thoroughly afterward.
Pregnancy and birth
Because of hormonal changes, women are more likely to get yeast infections during pregnancy. These infections generally result from the same type of yeast that causes thrush. Babies may get thrush from their mothers, either during pregnancy or during vaginal birth.
Medical issues
Babies who were born prematurely or had a low birth weight are at a higher risk for developing thrush. Children with a weakened immune system because of cancer or other medical problems are also at a higher risk. Repeated thrush infections or thrush in the mouths of older children can be a sign of an underlying health issue such as childhood diabetes.
When to see a doctor for thrush in babies
If your baby has any of the symptoms of thrush, particularly white patches in the mouth, see the pediatrician. Thrush may sometimes go away on its own, but your doctor can prescribe antifungal medication to help.
Diagnosing thrush in babies
Your child's doctor will ask about their medical history and do a physical exam. You will be asked about any medical conditions your child has and any medications your child is currently taking.
It's likely that your doctor can make a diagnosis with only an exam. However, your child's doctor may do a biopsy by taking a small sample from your child's mouth or throat.
Treatments for thrush in babies
Antifungal medications are the standard treatment for thrush. Your pediatrician may prescribe a liquid or gel that contains nystatin. Here is the best way to give nystatin to your baby:
- Wash your hands thoroughly.
- Place your baby on their back with one cheek turned to the side.
- Gently open your baby's mouth and drop half of the medicine onto the white patches on that side.
- Turn your baby's head to the other side and repeat with the other half of the medicine.
- Using a cotton swab, gently rub the medication around your baby's gums and tongue.
- If your child is older, have them swish the medicine around their mouth for 30 seconds and then swallow.
- Do not give your child anything to eat or drink for 30 minutes.
Fluconazole is another medicine for thrush. It’s taken orally, and your prescription will include dosage instructions like how much and how often to take it.
The following advice will help your baby heal faster and may prevent thrush from recurring:
- Wash your hands thoroughly after touching your child's mouth.
- Offer your child extra fluids such as breast milk or formula to prevent dehydration.
- Sterilize bottle nipples and pacifiers after use.
- If you are breastfeeding, clean your nipples with water and let air dry after feeding.
- If your child has been diagnosed, regardless of whether your breasts show signs of infection, your doctor will likely start you on a prescription at the same time.
- Limit sucking to 20 minutes per feeding and limit pacifier use to bedtime. Vigorous and prolonged sucking may cause irritation.