Oral thrush in babies

Signs of oral thrush in babies

• the main sign of oral thrush is a white coating on your baby's tongue - there may also be white patches elsewhere in the mouth
• this coating may look like curd or cottage cheese - it usually can't be rubbed off easily
• if the coating does rub off easily, it's more likely to be milk coating the tongue and not thrush
• babies may not seem bothered by the patches - they may be reluctant to feed – or keep detaching from the breast during feeds, if they're sore
• there may also be nappy rash caused by the same infection that needs to be treated as well

When to seek medical advice

Oral thrush in babies isn't usually serious, but you should see your GP if your child is under two years of age. If your child is older your pharmacist may be able to help if you think your child may have the condition.

You can also ask your health visitor for advice. If you need advice from a GP when your doctor is not available, you can contact the GP out of hours services.

If there's any doubt about the diagnosis, your GP may take a swab from your baby's mouth. This will be sent to a lab to be tested.

Although babies and young children are particularly at risk from oral thrush, the condition can also affect adults. Read about oral thrush in adults.

Causes of oral thrush in babies

Oral thrush is caused by a group of yeasts called Candida.

Healthy people have the spores of this fungus in their mouths. It doesn't normally cause problems.

Babies are at an increased risk of oral thrush. This is because their immune systems haven't yet fully developed and are less able to resist infection.

This is particularly the case with babies born prematurely (before 37 weeks of pregnancy).

Oral thrush can also affect babies if they've recently been treated with antibiotics.

If you're breastfeeding and have been taking antibiotics for an infection, your own levels of healthy bacteria in your body can be affected.

This can also lead to a thrush infection. This infection may then be passed to your baby during breastfeeding.

Treating oral thrush in babies

If your GP or health visitor feels your baby needs treatment, your GP will probably prescribe an antifungal medicine.

If treatment hasn't fully cleared the thrush after treatment, speak to your GP or health visitor again for advice.

Advice for breastfeeding mothers

If your baby has oral thrush and you're breastfeeding, it's possible for your baby to pass a thrush infection to you. The resistance to infection may be reduced by breastfeeding. This can affect your nipples or breasts and cause nipple thrush.

Symptoms of nipple thrush can include:

• pain while you're feeding your baby, which may continue after the feed is finished
• cracked, flaky or sensitive nipples and areolas (the darker area around your nipple)
• changes in the colour of your nipples or areolas

If you have nipple thrush, or there's a risk of your baby passing thrush on to you, you'll normally be advised to continue breastfeeding while using an antifungal cream to treat the infection.

You should apply the cream to your nipples after every feed. You should remove any that's left before the next feed.

In severe cases of nipple thrush, antifungal tablets may be recommended.

Preventing oral thrush in babies

It's not clear whether it's possible to prevent oral thrush in babies. Some doctors suggest the following advice may help:

• sterilise dummies regularly, as well as any toys that your baby puts in their mouth
• sterilise bottles and other feeding equipment regularly, especially the teats

Washing your hands thoroughly after changing your baby's nappy can also be helpful in stopping thrush spreading. 

More useful links

• How to use your health services