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Up to seven percent of all babies develop a yeast infection known as oral thrush in their first month of life. How can you recognize thrush in babies, and how is oral candidiasis treated in infants?

Have you noticed a white film on your baby's tongue that doesn't easily rub off? Does your baby have white patches in their mouth that seem to make them uncomfortable? Your baby may have oral thrush. 

What Do You Need To Know About Thrush In Babies?

Thrush, medically referred to as oropharyngeal candidiasis, is a yeast infection in the mouth and throat. It is most commonly caused by the fungal species Candida albicans, though more than 20 different species can be responsible. These species are naturally present in the human body, and it is an overgrowth, rather than the mere presence, of Candida species that causes candidiasis. Around five to seven percent of all babies are believed to develop thrush within their first month of life, with some showing symptoms of thrush as soon as the first week of life. [1, 2]

Signs of thrush in newborns and young infants may include:

  • White patches in the baby's mouth and a white, curd-like coating on the baby's tongue that doesn't wipe off easily.
  • A red and sore looking mouth
  • A fussy baby that is resistant to breastfeeding — due to possible pain in the baby's mouth. 
  • A diaper rash caused by the same infection. [3, 4]

Untreated oral thrush in your baby can also lead to nipple thrush for you, if you're breastfeeding. This is particularly likely to happen if your nipples were cracked, and may lead to:

  • Pain while breastfeeding. 
  • Shiny, red, and sore looking areolae (the darker patches around your nipples)
  • Flaking skin around the nipples and areolae. [5]

Thrush In Infants: What Are The Risk Factors?

Research shows that mothers who were exposed to antibiotics during their labors and births are more likely to develop breast candidiasis (nipple thrush), a condition that can then be passed onto the baby while nursing. Infants whose mothers were exposed to antibiotics during labor and birth are, themselves, also a little more likely to develop oral thrush. [6] This is due to the fact that antibiotics disturb the normal microbial balance, giving Candida species the chance to proliferate. 

HIV-positive infants are much more likely than others to develop both oral thrush and the associated Candida diaper dermatitis — between 50 and 85 percent of HIV-infected babies will fall victim to these infections, and they are also more likely to develop an invasive form of candidiasis that can be deadly. [7]

Parents of prematurely born, extremely low birth weight, babies also need to pay special attention to the signs of thrush and Candida diaper dermatitis as they, too, are at a much higher risk of developing invasive candidiasis — especially if they were exposed to antibiotics, or had a central catheter or an endotracheal tube. [8]

The simple fact that your baby is a baby, and as such possesses a still developing immune system, is another risk factor for thrush.

Nonetheless, we would like to make it clear that oral thrush in healthy, term, and normal birth weight, babies is more of a nuisance than a danger, so do not worry too much if your baby does not face any medical challenges and you notice the signs of oral thrush in your infant. Nonetheless, any parent who recognizes the signs of oropharyngeal candidiasis in their baby should seek medical attention. [9]

Oral Thrush In Babies: What Treatment Can You Expect?

When you take your baby to your pediatrician with suspected thrush, your doctor is most likely to make the diagnosis simply by performing a physical examination. Lab tests are available, but often not needed. Research shows that your doctor is less likely to look at you, too, if you suspect you have nipple thrush. If you'd like to be looked at as well, you will be better off seeing a family physician than a pediatrician. [10]

The treatment your doctor will offer your infant for uncomplicated oral thrush consists of nothing more than antifungal medications, which will clear the yeast infection right up most of the time:
  • Oral Nystatin is the most commonly prescribed drug to treat infant thrush. This treatment cures half of all infants of thrush within the first week, and 80 percent within a fortnight. It is well-tolerated and should be offered after you've fed your baby. [11]
  • Imidazole members of the azole antifungal medication family, like Miconazole and Clotrimazole, are even more effective and are especially good options if your infant has been suffering from recurrent episodes of oral thrush. [12]
  • Should the above treatments fail to treat your infant's oral thrush, your doctor may consider prescribing newer-generation Imidazoles such as Fluconazole and Itraconazole (also the drugs you're most likely to be recommended if you have nipple thrush). Since these drugs have not been widely studied in infants, they are not the first choice. However, they're especially likely to be used in immunocompromised babies. [13]
Note that the use of an infant pacifier (or dummy, or infant soother, depending on where you're from) may both increase your baby's risk of developing thrush in the first place, and make the medications your doctor suggests less effective — the Candida species responsible for your baby's oral thrush can live on on the surface of the pacifier. If your baby does use a paci, make sure to clean it well after use! [14]

Yeast Infection Treatment At Home: Can You Safely DIY The Treatment Of Oral Thrush In Your Baby?

If you're interested in yeast infection treatment at home, you may want to know that the following have been shown to fight species of Candida fungi:

  • Oregano oil of the  Origanum vulgare species [15]
  • Coconut oil [16]
  • Garlic [17]
  • Probiotics [18]
Nonetheless, it is important to see your child's pediatrician any time you suspect an oral yeast infection in your infant, and to consult with them regarding the possible use of natural treatments of oral thrush.

Even with natural treatments that have been shown to be effective in combating candidiasis, the dosage and form for the treatment of oral thrush in infants will not have been determined scientifically. By using the wrong treatment, you could prolong your baby's episode of thrush and potentially cause unwanted side effects.