Dr Phil Kieran: Does my baby have oral thrush?
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We often see oral thrush in young babies at the surgery, which can be a significant source of distress for new parents. It’s understandable — you look into your child’s mouth and see a thick white coating on their tongue, perhaps spreading onto the inside of their cheeks.
Any woman who has experienced vaginal thrush, or worse, nipple thrush when breastfeeding will know that these conditions can be incredibly uncomfortable and will likely want to save their baby the suffering caused by oral thrush.
The three most common causes of a white coating in the mouth are milk protein, oral candida, and oral thrush. Milk protein deposition is by far the most frequent reason a parent attends the surgery with their baby asking about oral thrush. The transient nature of the white coating in the mouth means it is present at times and not at others.
It’s usually worst after a feed, but can be present later as when the baby refluxes milk into their mouth and the proteins stick again.
If you think your baby may have thrush, the first thing to do is to wipe the tongue with a clean cotton cloth and if the white colour goes away there is no thrush. Also, I wouldn’t be worried if the white area disappears in less than two weeks.
The next cause is oral candida, and this is where confusion can start. Candida is the yeast that causes thrush and can form a coating on the tongue or cheeks in infants. This yeast is present all over the body and is frequently found in the mouth. You can identify it because it tends to form a more stable coating and can have yellowish patches to it.
Thrush occurs when too much candida is present and starts getting under the skin’s surface, causing problems. In most instances, this will result in pain and severe itch. Your baby obviously can’t tell you about their itchy mouth but will likely get upset with feeding and feed less.
If the baby is struggling to feed, a doctor needs to intervene. For breastfed babies, the GP would first need to check for candida in the mother’s breast. If this is present, the mum is treated, ensuring the medication passing through her milk is enough to treat the baby.
The liquid antifungal medication nystatin can be used from one month on prescription.
As all medications have potential side effects, doctors are reluctant to suggest treatment unless the thrush is causing symptoms.
If there are persistent signs after two weeks, it is a good idea to ask your GP to take a look — if there are problems with feeding, you will need to go sooner.
- If you have a question for Dr Phil, please send it to parenting@examiner.ie
