Thrush (Oral Candida Infection) in Children

What is thrush in children?

Thrush is a mouth infection that is common in babies and children. Symptoms include white or yellow velvety patches in the mouth. Thrush is caused by a type of fungus called Candida. Candida is found naturally on the skin and in the mouth. But if Candida grows out of control, it can cause thrush.

Thrush is not a serious problem for a healthy child. It can be treated with antifungal medicine.

What causes thrush in a child?

Candida yeast is common in the everyday environment. It only causes a problem when it grows out of control. This can happen if a child:

• Has taken antibiotics

• Uses inhaled corticosteroids, such as for asthma

• Uses a pacifier often

• Has a weak immune system

Which children are at risk for thrush?

A child is more at risk for thrush if they:

• Had a very low birth weight

• Passed through the birth canal of a mother with a yeast infection

• Has taken antibiotics

• Uses inhaled corticosteroids, such as for asthma

• Uses a pacifier often

• Has a weak immune system

What are the symptoms of thrush in a child?

Thrush causes milky white or yellow patches to form on the tongue or inner cheeks. These patches can be painful and may bleed. Some babies have no pain from thrush. Others may have pain and be fussy and refuse to feed. It may hurt when your child swallows. Thrush can also cause cracked skin in the corners of the mouth. Symptoms can occur a bit differently in each child.

The symptoms of thrush can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is thrush diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. This will include looking in your child’s mouth.

How is thrush treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is.

A healthy baby with mild thrush may not need any treatment. More severe cases are likely to be treated with a liquid antifungal medicine. This is given through a dropper into your child’s mouth. Or the medicine may be given as pills in an older child. Follow the healthcare provider's instructions for giving this medicine to your child.

Breastfeeding mothers may develop thrush on their nipples. If you breastfeed, both you and your child will be treated. This is to prevent passing the infection back and forth. You may be given an ointment to apply to your skin or an oral antifungal medicine.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

It's also important to boil (sterilize) and disinfect any pacifiers, bottle nipples, or toys that your child may put in their mouth after each use. This will prevent your child from being infected again.

To care for your child at home:

• Wash your hands well with warm water and soap before and after caring for your child. Have your child wash their hands often.

• If your child uses a bottle or a pacifier, boil it for 5 to 10 minutes after each use.

• Wash drinking cups using warm water and soap after each use.

How can I help prevent thrush in my child?

If your child takes inhaled corticosteroids, have your child rinse their mouth after taking the medicine. Also ask the healthcare provider about using a spacer on the inhaler. This can help reduce the risk for thrush.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child:

• Has symptoms that don’t get better, or get worse

• Has new symptoms

• Stops eating or drinking

Get medical care right away if your child is under 3 months old and has a fever of 100.4°F (38°C) or higher. Fever in a young baby can be a sign of a dangerous infection.

Key points about thrush in children

• Thrush is a common mouth infection in babies and children. It’s not a serious problem for a healthy child. It can be treated with antifungal medicine.

• Thrush is caused by a type of fungus called Candida. Candida is found naturally on the skin and in the mouth. But if Candida grows out of control, it can cause thrush.

• Thrush causes milky white or yellow patches to form on the tongue or inner cheeks. These patches can be painful and may bleed. Some babies have no pain from thrush. Others may have pain and be fussy and refuse to feed. It may hurt when your child swallows.

• A healthy baby with mild thrush may not need any treatment. More severe cases are likely to be treated with a liquid antifungal medicine.

• Breastfeeding mothers may develop thrush on their nipples. If you breastfeed, both you and your child will be treated.

• It's also important to boil (sterilize) any pacifiers, bottle nipples, or toys that your child may put in their mouth after each use.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.