Oral thrush in babies and children

Oral thrush is a type of fungus infection of the mouth. It's very common among babies. It appears as moist, milky-white patches in and around your child's mouth.

Usually, oral thrush is not serious and can sometimes even go unnoticed.

Thrush is a yeast infection caused by a fungus called candida albicans.

Around 1 in every 2 people have the fungus in their mouths normally. The yeast causes infection when it invades the mucosa (the lining of your mouth).

Who gets oral thrush?

Oral thrush occurs quite often in babies.

Newborn babies are more prone to infections such as thrush. This is because their immune systems are still maturing. Premature babies have an even greater risk of developing thrush.

Some medicines make it more likely that your child will get thrush. These include:

• broad-spectrum antibiotics
• inhaled corticosteroids — medicines used to treat asthma
• antihistamine medicines

Children who are immunocompromised (have a weak immune system), are also more likely to be infected with thrush. They may be immunocompromised due to illness or medical treatments.

Newborn babies can also get thrush from their mother's vagina during a vaginal birth. Candida albicans often lives in the vagina.

Read more about vaginal thrush during pregnancy and breastfeeding.

Is oral thrush contagious?

The candida albicans yeast is contagious, and can be passed from one person to another.

This can happen through contact with saliva from an infected child.

If you think your child may have oral thrush, it's a good idea to see your doctor.

Be sure to see your doctor if:

• your baby is under 4 months old and has signs of oral thrush
• the white patches do not improve after one week of treatment
• your child has difficulty swallowing
• your child has a fever or is feeling generally unwell

Your doctor will look in your child's mouth and ask you about their symptoms.

Most cases of oral thrush are very mild and will quickly clear up with treatment from the pharmacy. Ask your pharmacist for advice. Your doctor can also prescribe antifungal drops or gel to help manage the infection.

These treatments should be carefully put on your child's tongue and gums. In young babies, it is best to do this using your finger. A spoon or dropper should not be used to apply the gel as they are a potential choking risk.

If you follow the instructions on the packet, you should see an improvement within 1 to 2 days.

Wash your hands well after applying the drops or gel. This will help to stop the spread of thrush.

There are some things you can do to help prevent your child getting oral thrush:

• sterilise bottles after each use
• sterilise dummies regularly
• if your child has teeth, brush them twice a day
• take your child to the dentist for regular check-ups

Make sure that you wash your hands well after changing your baby's nappy.

You can read more about personal hygiene for children.

Breastfeeding babies can pass on oral thrush. This can cause nipple thrush in mothers.

Signs of nipple thrush are:

• your areola may be dry or flaky
• your nipple may be bright pink
• you may have a fine white rash
• your nipple may have sores (for example, a crack), which are slow to heal

However, there are often no obvious signs of nipple thrush.

Treatment while breastfeeding

If you are a breastfeeding mother with an infected child, your doctor might also prescribe an antifungal treatment for you. This is because you might be spreading the infection to your child when feeding.

Topical antifungal treatments are the most common treatment for nipple thrush.

You can continue to breastfeed as usual if your baby has oral thrush.

Speak to your doctor or child health nurse if you think your baby may have oral thrush.