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 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 yeast called Candida albicans.

Around 1 in every 2 people have the fungus in their mouths normally. It’s usually harmless, but 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 higher chance of developing thrush.

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

• broad-spectrum antibiotics (Opens in new tab)
• inhaled corticosteroids — medicines used to treat asthma
• antihistamine (Opens in new tab) 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 — it can easily spread from one person to another.

If your breastfed baby has oral thrush, the infection can be passed on to your nipples. Both you and your baby need treatment for thrush, even if only one of you shows symptoms.

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
• your baby is not improving within 48 hours
• your baby has recurrent thrush (thrush that comes back again)
• your baby is not feeding
• your baby has a very dry mouth and has no tears or any wet nappies in 8 hours
• your child has difficulty swallowing
• your child has a fever or is feeling generally unwell

You should also see your doctor if the patches inside your baby’s mouth:

• bleed when wiped gently
• spread to the skin outside their mouth
• do not go away after treatment

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

If your child’s thrush continues, your doctor might suggest tests, such as a skin swab (Opens in new tab).

Most cases of oral thrush are mild and will quickly clear up with treatment from the pharmacy. Ask your pharmacist for advice. Your doctor can also prescribe antifungal (Opens in new tab) 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. Avoid using a spoon or dropper 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.

Should I get treatment if my baby has oral thrush and I am breastfeeding?

If you are breastfeeding and your baby has been diagnosed with oral thrush, both you and your baby will need to be treated. This will stop you passing the infection back and forth when breastfeeding.

Antifungal treatment, in the form of a cream or gel, is the most common treatment for nipple thrush. You can put this cream or gel on your nipple after a feed.

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 (Opens in new tab) well after changing your baby's nappy.

You can read more about personal hygiene for children (Opens in new tab). 

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

You may have a nipple infection if your nipples:

• have cracks which are slow to heal
• are red
• have shiny areas
• have flaky or white spots
• have pus-like fluid or clear fluid

Or there may be no visible signs, but you might have:

• sore nipples that are very sensitive to touch
• an itchy breast or nipple
• nipple pain that is sharp, burning, deep or throbbing
• pain that spreads, such as pain in your arm or back
• pain that starts during a feed and continues for some time afterwards

Read more about nipple thrush and thrush during pregnancy and breastfeeding.

Treatment while breastfeeding

If you are a breastfeeding mother your doctor may prescribe you an antifungal treatment if your baby has thrush. 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. You can also ask your pharmacist for advice.