What's That White Stuff in My Baby's Mouth?

If you see a white substance that looks like milk sticking to the inside of your baby's mouth and tongue, he may have oral thrush. Oral thrush is not usually a worrisome disease, but it does need attention. It is caused by a yeast, Candida albicans, which is normally found in the mouth and intestines. If your child has been on certain antibiotics, for example, the yeast can overgrow and cause thrush.

How will you know if your baby has thrush?

The best way to tell if the white patches you're seeing are milk or thrush is to take a tissue or cloth and wipe it. If it is easily removed, then you can be sure that it is only milk. However, if the white patches stick to the inside of the mouth despite your rubbing it, then it is probably thrush.

What should you do?

You will need a prescription from your baby's nurse practitioner or doctor to clear up the thrush. They may want to see the baby before prescribing a medicine. If a medicine is prescribed, it is usually the type (Nystatin) that you will paint onto the white patches with a cotton swab four times a day (after feedings). You can also rub 0.5 ml (half a dropper full) on each side of the tongue right after you use the Q-tip. Keep doing this until the white patches disappear. When you see that the white patches are gone, continue to use the medicine for two more days and then stop. If you stop too soon, the thrush may come back.

Is thrush painful for the baby?

For some infants, having thrush can be uncomfortable until it is treated. You may even notice that your baby isn't eating or sucking as much as she usually does. If feeding seems painful or uncomfortable, you may need to feed your infant more frequently for shorter periods. Remember that every child is different. You should only be concerned if your baby refuses to eat.

What if you are breast feeding?

There is no need to stop breast feeding when your baby has thrush. However, you may want to apply the medicine to any irritated areas on your nipples since the thrush can spread form the baby's mouth to your breast.

What if you are bottle-feeding?

Soak all nipples in hot tap water for 15 minutes after use or use a dishwasher. If your infant uses a pacifier, soak the pacifiers in hot water, too.

Call your doctor or nurse practitioner if:

• Your child refuses to eat
• The thrush lasts more than two weeks
• The thrush gets worse while using the medicine
• Your baby has a fever over 100 degrees (rectal) and is less than three months old

Adapted from Healthy Steps. Edited and Compiled by the Center for Promotion of Child Development Through Primary Care 2011