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 Oral Thrush 

Infant Oral Candidiasis

How to Treat and

Prevent infant Oral Thrust?

   Signs of oral thrush in babies

  • The main sign of oral thrush is a white coating on your baby's tongue,  there may be white patches in the mouth.

  • This coating may look like curd or cottage cheese, usually can't be rubbed off easily and it does not disappear.​

  • Babies are normally not bothered by the patches, but they may be reluctant to feed or keep detaching from the breast / bottle during feeds. 

  • There may also be associated nappy rash caused by the same infection, which also needs to be treated.

    When to seek GP advice

  • your baby is under 4 months and has signs of oral thrush

  • you do not see any improvement after 1 week of treatment with a mouth gel

  • you have difficulty or pain swallowing


    Causes of oral thrush in babies

  • Oral thrush is caused by a yeast fungus called Candida albicans.

  • Healthy people have this fungus in their mouths and it doesn't normally cause problems. But it can overgrow and infect the membranes in the mouth.

  • Babies are at an increased risk of oral thrush because their immune systems haven't fully developed yet and are less able to resist infection.

  • This is particularly the case with babies born prematurely (before 37 weeks of pregnancy).

  • Oral thrush can also affect babies if they have recently been treated with antibiotics.

  • Antibiotics reduce the levels of healthy bacteria in your baby's mouth, which can allow fungus levels to increase.

  • If you're breastfeeding and have been taking antibiotics for an infection, the levels of healthy bacteria in your body can be affected.

  • This can also make you prone to a thrush infection that may then be passed to your baby during breastfeeding.


   Treating oral thrush in babies

  • Your Local Prescriber Health Visitor or GP would prescribe topical antifungal treatment for 7 days: 

         1. Miconazole oral gel first-line

             2. If Miconazole oral gel is unsuitable, offer oral Nystatin suspension.

             3. Treatment with a mouth gel usually lasts at least 7 days. Always follow the instructions on the medicine packet.

  • If you don't see any improvement after 1 week of treatment with the mouth gel, speak to your GP or Health Visitor. They may suggest an alternative medicines. 


     Advice for breastfeeding mothers

    If your baby has oral thrush and you're breastfeeding, it's possible for your baby to pass a thrush infection to you.

  • This can affect your nipples or breasts and cause nipple thrush.

  • Symptoms of nipple thrush can include:

  • pain while you're feeding your baby, which may continue after the feed is finished

  • cracked, flaky or sensitive nipples and areolas (the darker area around your nipple)

  • changes in the colour of your nipples or areolas

  • If you have nipple thrush or there's a risk of your baby passing thrush on to you, you'll normally be advised to continue breastfeeding while using an antifungal cream such as miconazole to treat the infection.

  • You should apply the cream to your nipples after every feed and remove any that's left before the next feed. 

  • In severe cases of nipple thrush, antifungal tablets may be recommended.


   Preventing oral thrush in babies

  • It's not clear whether it's possible to prevent oral thrush in babies.

  • Some doctors suggest the following advice may help:

  • Sterilise dummies regularly, as well as any toys that your baby puts in their mouth.

  • Sterilise bottles and other feeding equipment after each use, especially the teats.

  • Washing your hands thoroughly after changing your baby's nappy can also be helpful in stopping thrush spreading because the infection can be passed through their digestive system.

Institute for Excellence in Health and Care (NICE 2023 Guidelines : Seborrhoeic dermatitis - infants 

National Health Service: Choices 2023

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