Thrush  

This Care Guide Covers:

  • An infection of the mouth in young babies
  • White patches in the front of the mouth
  • Caused by yeast

If not, see these topics
When to Call Your Doctor

Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
  • Age under 1 month old and looks or acts abnormal in any way
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Fever occurs
  • Bleeding in the mouth
  • Drinking less than normal
Call Your Doctor During Weekday Office Hours If
  • Thrush, but none of the symptoms above. (Reason: May need a prescription medicine to treat it)
Causes & Health Information

Symptoms

  • 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

  • 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.

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.
CARE ADVICE FOR THRUSH (Use this until you talk with your doctor)

  1. What You Should Know:
    • 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.
  2. Anti-Yeast Medicine:
    • Your doctor will probably prescribe an anti-yeast liquid medicine. Use it as follows:
    • Use 1 ml (2 ml if over age 1 month). 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.
  3. 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.
  4. 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 nor helpful.
  5. Breastfeeding:
    • If the mother's nipples are red and sore, it's probably a yeast infection.
    • Use Lotrimin cream on the nipple area.
    • No prescription is needed.
    • Put it on 4 times per day AFTER feedings.
  6. Diaper Rash:
    • If there's a bad diaper rash, it can also be due to yeast.
    • Use Lotrimin cream on the diaper rash.
    • No prescription is needed.
    • Put it on 4 times per day.
    • See DIAPER RASH care guide.
  7. 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.
  8. What to Expect:  
    • With treatment, thrush usually clears up in 4 to 5 days.
    • Without treatment, it clears up in 2-8 weeks.
  9. Call Your Doctor If:
    • Starts drinking less than normal
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.