Thrush

Main Symptoms

• White, irregularly shaped patches in the mouth
• Coats the inside cheeks or inner lips.
• Sometimes coats the tongue. (If the only symptom is a uniformly white tongue, it’s due to a milk diet, not thrush.)
• Adherent to the mouth (cannot be washed away or wiped off easily like milk curds)
• Causes mild discomfort or no symptoms
• The child is bottle-fed or breast-fed
• Caused by a yeast (called Candida)

See More Appropriate Topic If

• If it doesn’t look like thrush, see Mouth Ulcers

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Signs of dehydration (very dry mouth, no tears and no urine in > 8 hours)
• Newborn (< 1 month old) looks or acts sick at all

Call Your Doctor Within 24 Hours (between 9 and 4) If

• You think your child needs to be seen
• Fever occurs
• Bleeding is present

Call Your Doctor During Weekday Office Hours For

• Thrush, but none of the symptoms described above (Reason: may need prescription medicine to treat it)

Home Care Advice for Thrush (Pending Talking With Your Doctor)

1. Decrease Sucking Time to 20 Minutes per Feeding. Reason: prolonged sucking (as when a baby sleeps with a bottle or pacifier) can irritate the lining of the mouth and make it more prone to yeast infection. For severe mouth pain with bottle feeding, offer fluids in a cup rather than a bottle (Reason: the nipple increases pain).
2. Limit Pacifier Use to Bedtime: Again, prolonged sucking on a pacifier can irritate the mouth. If your infant is using an orthodontic pacifier, switch to a smaller, regular one. (Reason: bigger ones can irritate the mouth more)
3. Breastfeeding: If mothers nipples are red and sore, apply Lotrimin Cream (no prescription needed).
4. Diaper Rash: If there’s a bad diaper rash, it’s also probably due to yeast. Apply Lotrimin cream (no prescription needed) 4 times per day. (See Diaper Rash guideline)
5. Contagiousness: Thrush is not contagious, since it does not invade normal tissue. Your child can go to day care with thrush.
6. Expected Course: With treatment, thrush usually clears up in 4 to 5 days. Without treatment, it clears up in 2-8 weeks.
7. Call Your Doctor If
   • Your child becomes worse or develops any of the “Call Your Doctor Now” symptoms