Thrush Child

Causes

Thrush is caused by a fungus. There are many germs that normally live in the mouth. Sometimes fungus can start to grow too much and cause thrush. A health issue or medicine may let fungus grow more too much.

Risk Factors

Things that may raise a baby's chance of getting thrush include:

• Contamination from caregivers
• Contamination during breastfeeding
• Problems during birth, such as preterm birth, premature rupture of membranes, or perinatal asphyxia
• Having a very low birth weight and needing to be in neonatal intensive care
• Vaginal yeast infection in the mother at the time of birth

Things that may raise a child's chance of getting thrush include:

• Taking antibiotics
• Health issues that suppress the immune system, such as:
  • HIV infection
  • Cancer or medical treatments for cancer, such as chemotherapy
  • Immune system problems a child was born with
• Being ill for a long time
• Conditions that cause a dry mouth
• Taking medicines for psychiatric conditions
• Taking inhaled corticosteroids to treat asthma

Symptoms

Infants with thrush may have:

• Irritability
• Less interest in feeding
• White, lacy patches on the inside of the cheeks or tongue that do not come off when rubbed

Children with thrush may have:

• Sore mouth and throat
• Problems swallowing
• Differences in taste
• White or red patches on the inside of the cheeks or tongue that may or may not come off when rubbed
• Fissures or cracks in the mouth

Diagnosis

The doctor will ask about the child's symptoms and health history. A physical exam will be done, including an inspection of the mouth. Thrush can often be diagnosed after a physical exam.

A sample of cells may be taken from the mouth to be checked. This can confirm thrush or look for other infections.

Treatment

The goal of treatment is to restore the normal balance of bacteria and yeast in the mouth. If there are any underlying health issues that are helping cause thrush, they will also be treated.

Treatments include:

Medicines

In infants, antifungal medicine may be a gel or a rinse that is swished around their mouth. Other medicines may be used if:

• The baby is at risk for having a systemic infection
• The baby cannot take other treatments
• Other treatments have not helped the baby

Breastfeeding mothers of babies with thrush can use a topical antifungal medication on their nipples to reduce the baby's infection.

Antifungal medicines for kids may include oral tablets, rinses, or lozenges that dissolve in the mouth.

Oral Hygiene Steps

Things that may aid in healing include:

• Clean the baby's mouth with a clean, moist gauze pad as soon as baby teeth appear.
• Have the child rinse their mouth with warm salt water.
• Gently scrape patches off the child's mouth with a toothbrush.
• Gently brush any new teeth with a child-size toothbrush and water.
• Start to clean baby teeth regularly as soon as they come in. Use an amount of fluoride toothpaste that is about the size of a grain of rice. Progress to an amount that is about the size of a pea by the time the child is 3 years of age. This will reduce the risk of the child swallowing it.
• Start flossing children's teeth when they have two teeth that touch.

Prevention

To help reduce a child's chance of getting thrush:

• Keep up with advised oral hygiene after treatment.
• Fully clean the baby's pacifier and toothbrush.
• Use disposable nipples for babies who are prone to thrush and drink from a bottle.
• Avoid mouthwashes and mouth sprays. These can upset the normal balance of yeast and bacteria in the mouth.
• Children who use corticosteroid inhalers should rinse their mouths fully after using them.
• Talk to the child's doctor about antifungal medicine if a child is at risk.