What are commonly known as yeast infections are caused by various species of a yeast-like fungus called Candida. Yeast organisms are part of the germs (including bacteria) that are normally found on various parts of the body and which ordinarily cause no symptoms. This article discusses oral thrush in babies. You can read our article about oral thrush in adults here.
Thrush is a common infection in the mouth of babies, on rashes (especially nappy/diaper rashes and rashes in moist places such as under the chin of a dribbling baby), on the nipples of breast feeding mothers and in the vagina of women. It can be very irritating but it is treatable.
Babies get candida in their bodies at birth or soon after. Many babies get thrush in the mouth in the first few weeks or months of life. There is no clear reason why for some babies the candida which is normally in their mouth without causing problems becomes thrush.
Oral thrush is a yeast infection of the mouth that is caused by a fungal microorganism called Candida albicans. Oral thrust is most common in infants and is generally not a serious condition in itself. However, it can be uncomfortable and lead to difficulties with eating or infant feeding if it does not resolve or is not treated.
50% of the population has candida in their mouths. Under normal circumstances candida albicans is kept under control by bacteria. However, some factors or conditions may result in an overgrowth of Candida albicans. Candida albicans can also cause a yeast or thrush infection in the vagina, resulting in the exposure of an infant to the infection during the vaginal birthing process. It can also cause an infection in a woman's nipples, which can then be transmitted to an infant's mouth during breastfeeding.
People at risk for oral thrush include those taking strong antibiotics, especially for a long period of time. Antibiotics kill bacteria, which can alter the balance of microorganisms in the mouth and result in a proliferation of yeast.
Causes of oral thrush in babies
Again, thrush is caused by forms of a fungus called Candida. A small amount of this fungus lives in the mouth most of the time. It is usually kept in check by the immune system and other types of germs that also normally live in the mouth.
However, when the immune system is weaker, the fungus can grow, leading to sores and lesions in the mouth and on the tongue.
Oral thrush may occur in babies because their immune systems take time to mature, making them less able to resist infection.
Oral thrush infections can also happen after treatment with antibiotics. This is because antibiotics reduce the levels of healthy bacteria in a baby's mouth, which allows fungus levels to increase.
Symptoms of oral thrush in babies
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Thrush appears as whitish, velvety lesions in the mouth and on the tongue. Underneath the whitish material, there is red tissue that may bleed easily. The lesions can slowly increase in number and size.
The first sign may be that the baby is unsettled, especially when feeding (his mouth is sore). However, many babies are not bothered by thrush.
Thrush shows as white patches on the roof of the mouth, inside the cheeks and on the tongue. There may be redness around the patches, and they might look like ulcers. Unlike bits of milk, the patches do not wash or rub off easily.
If an older child or adult gets thrush in the mouth, or ulcers that look like they may be thrush, it may be a sign of another disease, so have a doctor check.
Signs of thrush can occur suddenly. Thrush can also be difficult to get rid of, especially in infants. Lesions will begin to appear within the mouth, and one may have pain associated with lesion development. The corners of the mouth may crack when one opens the mouth.
Other symptoms can include a loss of taste, or feeling as if swallowed a cotton ball. The thrush can become severe enough that one may have difficulty swallowing food.
Diagnosing oral thrush
A doctor may take a swab or sample of infected tissue and look at it under a microscope. If there is evidence of Candida infection, the sample will be cultured to confirm the diagnosis.
Treating babies for oral thrush
If you think your child may have thrush in the mouth, one needs to go to a doctor or child health nurse to be sure, and to get advice about treatment.
The treatment may be drops or a gel which needs to be spread around the inside of the mouth, not just put on the tongue. If the baby is breastfeeding, the mother's nipples may need to be treated at the same time as the baby to prevent the infection passing back and forth.
In many cases, oral thrush in infants can disappear within two weeks and may need no treatment other than watching the progress of the mouth lesions. Because oral thrush may affect feedings, the pediatrician should still be notified if symptoms appear in an infant.
Treatment of older children and adults with oral thrush includes diagnosing any underlying diseases that may increase the risk for the infection. These include HIV/AIDS and diabetes. Treating the high blood sugar levels of diabetes may resolve a current infection and is key to minimizing the risk of developing recurrent infections of oral thrush.
A treatment plan may also include medications, including prescription topical or oral antifungal medications, such as fluconazole.
Therapy may also include eating yogurt or taking acidophilus supplements, which can help to correct the abnormal balance of microorganisms in the mouth, which leads to oral thrush. Using antiseptic mouth washes may also be recommended.
Preventing oral thrush
To prevent transmission of a yeast infection to a newborn infant, pregnant women should consult with their licensed health care provider if they have symptoms of a vaginal yeast infection, such as vaginal itching and a cheesy white discharge.
Nursing women who have nipple discharge or pain should also notify their provider so they can be examined for a thrush infection in the nipples, which could be transmitted to the mouth of a nursing infant.