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Thrush  
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Symptom
Description
Should I
Call?
Care at
Home
Does this describe your child's symptoms?

Definition
  • A superficial yeast infection of the mouth of young babies
  • Causes white patches in the front of the mouth

Symptoms

  • White, irregularly shaped patches in the mouth
  • Coats the inside cheeks or inner lips
  • Sometimes coats the tongue (if the only symptom is a uniformly white tongue, it's due to a milk diet, not thrush)
  • Adherent to the mouth (cannot be washed away or wiped off easily like milk curds)
  • Occasionally causes a painful mouth, reluctance to suck 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
  • Accentuated by friction from frequent pacifier use

Return to Day Care

  • Thrush is not contagious, since it does not invade normal tissue. Your child can go to day care with thrush.

If not, see these topics
  • It doesn't look like thrush, see MOUTH ULCERS


Should I
Call?
Care at
Home
When to Call Your Doctor

Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Signs of dehydration (very dry mouth, no tears and no urine in more than 8 hours)
  • Age under 1 month old and looks or acts sick in any way
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Fever occurs
  • Bleeding is present
  • Drinking less than normal
Call Your Doctor During Weekday Office Hours If
  • Thrush, but none of the symptoms described above (Reason: may need prescription medicine to treat it)
Symptom
Description
Care at
Home
HOME CARE ADVICE FOR THRUSH (Pending Talking With Your Doctor)

  1. Anti-Yeast Medicine: Your doctor will probably prescribe an anti-yeast liquid medicine. Use it as follows:
    • Place 1 ml (2 ml if over age 1 month) in the front of the mouth on each side or where ever 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 responding, rub the medicine directly on the affected areas with a cotton swab.
    • Don't feed your baby anything for 30 minutes after application.
    • Keep this up for at least 7 days, or until all thrush has been gone for 3 days.
  2. Decrease Sucking Time to 20 Minutes per Feeding:  Reason: prolonged sucking (as when a baby sleeps with a bottle) can irritate the lining of the mouth and make it more prone to yeast infection.  For severe mouth pain with bottle feeding, offer fluids in a cup, spoon or syringe rather than a bottle (Reason: The nipple increases pain).
  3. Limit Pacifier Use:  
    • Again, prolonged 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 irritate the mouth more).
    • Special washing of pacifiers or bottle nipples is not necessary or helpful.
  4. Breastfeeding:  If the mother's nipples are red and sore, apply Lotrimin Cream (no prescription needed) 4 times per day AFTER feedings.
  5. Diaper Rash:  If there's a bad diaper rash, it's also probably due to yeast. Apply Lotrimin cream (no prescription needed) 4 times per day (see DIAPER RASH topic).
  6. Contagiousness: Thrush is not contagious, since it does not invade normal tissue. Your child can go to day care with thrush.
  7. Expected Course:  With treatment, thrush usually clears up in 4 to 5 days. Without treatment, it clears up in 2-8 weeks.
  8. Call Your Doctor If:
    • Drinking becomes less than normal
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Symptom
Description
Should I
Call?

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: 1/19/2009

Last Revised: 8/6/2007

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.

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