Ever noticed a white coating in your child’s mouth? What is that white stuff anyways? It’s called oral candidiasis, better known as thrush. Thrush is an infection that is caused by a fungus called candida albicans. Tiny amounts of candida are normal in the mouth, but when it continues to multiply it causes thrush. Thrush can occur at any age, but it is most common in babies, those with weak immune systems or from certain medications. Babies are at increased risk for thrush because their immune systems are still developing so they are less likely to resist infections.
Oral thrush presents as a creamy white coating on your baby’s tongue, inner cheeks, gums, tonsils or on the roof of the mouth. The creamy white coating or patches looks similar to cottage cheese. Babies with thrush are sometimes fussier than normal, or may not want to feed. This is because thrush can cause soreness in the mouth.
Thrush can also cause discomfort in the breastfeeding mother. Thrush can be passed from the baby to their mother during breastfeeding. Nipples can become dry, red, itchy and sensitive, and they may experience pain when nursing.
Thrush can be diagnosed simply by examining the mouth. Lightly scraping the lesions can help to distinguish thrush from milk. Generally if you try to scrape off thrush in the mouth, it will not come off, or it may bleed. Milk on the tongue after feeding leaves a similar white coating, but milk rubs off quite easily with no bleeding.
Once diagnosed by your doctor, thrush may be treated using anti-fungal medications, like nystatin or miconazole. Another treatment option may be gentian violet, an antiseptic dye that coats the mouth.
Breastfeeding mothers can also use anti-fungal creams to treat the symptoms of thrush. This cream should be applied after feeding and should be removed before the baby’s next feed.
Thrush can also occur in children who use inhalers to treat conditions such as asthma. Children should be reminded to rinse their mouths after using their inhalers to help reduce the chances of infection.
In an otherwise healthy child, thrush is not a serious condition. If you think your child has thrush, make an appointment to see your doctor or nurse practitioner.
– Dr. Christina Cesareo and Dr. G Paul Dempsey
[Featured image: James Heilman, MD]