Treating Thrush in Babies

Candida albicanis is a white yeast-like fungus. The yeast Candida can live quite happily anywhere on your body without causing trouble, but sometimes it grows out of control.

It’s this Candida overgrowth that’s known as thrush. When there’s an overgrowth, you’ll notice the telltale white patches in your baby’s mouth, around their diaper area, and — ugh — possibly on your nipples.

You might already be familiar with this fungus if you’ve ever had a vaginal yeast infection. Yes, that same culprit of burning and itching that drove you crazy has waged war on baby. But don’t worry — this is a war that’s usually easily won.

Thrush often appears in a baby’s mouth during the first few weeks or months of life. Researchers aren’t sure why, but it could happen because a newborn has a weaker immune system and can’t yet fight infections well.

That would explain why oral thrush often follows a course of antibiotics (just when you thought you were finally going to catch up on the sleep you missed because your baby wasn’t well). Antibiotics reduce the levels of healthy bacteria in our bodies, and this means fungi have an easier time growing. Oral thrush can also occur after the use of steroid medicines.

Here’s another possible cause: If you had to deal with a vaginal yeast infection when you were expecting (a less-often-talked-about-but-common pregnancy side effect that can be blamed on hormonal changes), your baby could have picked up Candida in the birth canal.

A peep into your baby’s mouth is all you need to spot the symptoms. Notice any white patches or sores on her tongue, gums, and/or the inside of her mouth? Are the corners of her mouth cracked? That’s thrush.

Before you skip to the treatment section, keep in mind that your baby’s tongue could be white from milk residue. But this milky tinge should disappear within an hour of a feeding. Still, if you’re not sure, try this quick and easy test: Wrap a piece of gauze around your finger and try to gently wipe away the marks. Gone? Rest easy. Still there? Is your baby’s tongue red and sore under the patch? Does it bleed easily? Now’s the time to treat thrush.

We’ve already mentioned that you can find thrush in other places, too. Your baby’s warm, moist diaper area is the perfect breeding ground for yeast infections. If you notice a stubborn rash with red dots, think thrush.

And here’s how you can tell if you have thrush on your nipples: Are your nipples burning and sore? Is the skin itchy and flaky? Add to these symptoms the sharp shooting pains that you feel in your breasts during or after feeding and you may have thrush.

Now that you have the diagnosis, you need to treat the culprit. Here’s the rundown on your options for oral thrush.

Medical treatment

For oral thrush, your doctor may prescribe antifungal medication (drops or a gel) containing nystatin, which must be spread on the tongue and inside the mouth a few times a day for 10 days. The easiest way to do this is to use a sponge applicator to paint on the solution.

Over-the-counter treatment

If thrush is affecting your baby’s diaper area or scalp, you may be able to use over-the-counter antifungals. That said, check with your healthcare provider first.

And if your baby is older, your doctor may suggest adding lactobacilli (a probiotic bacteria) to her diet. Lactobacilli act like “good” bacteria to help get rid of the fungus. You can purchase probiotics as a dietary supplement, but make sure to choose a reputable brand suitable for babies.

Home remedies

These home remedies for thrush are often touted as miracle cures, though many of them need to be approached with caution. In fact, you may want to consider them complementary, rather than primary, treatments.

• Baking soda. Add about half a teaspoon of baking soda to a cup of boiled, cooled water. Use a clean cotton bud to wipe the solution inside your baby’s mouth.
• Tea tree oil. Use 1 or 2 drops of tea tree oil to half a cup of boiled, cooled water. Apply with a clean cotton bud.
• Virgin coconut oil. One study suggested that coconut oil should be used to treat fungal infections, especially now that drug-resistant Candida species are emerging.
• Grapefruit seed extract (GSE). You may want to steer clear of this one, despite claims that GSE is a cure-all for infections. That’s because it’s pretty hard to trace how the product is made. One older study found benzalkonium chloride (an irritant) and triclosan (banned by the Food and Drug Administration in antibacterial soaps) in one extract even though these chemicals don’t appear in an extract of the seeds themselves.

Important bottom line, though: Check with your pediatrician before using any alternative treatment for your baby’s thrush, particularly thrush in the mouth. Remember that your little one will inevitably consume small amounts of whatever gets applied to the tongue.

Candida is really contagious. That’s because it’s a dimorphic fungus, meaning that it can switch between being a yeast or a mold depending on the temperature. Sneaky! This amazing ability helps Candida to oh-so-easily spread, survive, and cause disease.

Make sure that both you and baby are treated so that Candida doesn’t travel from your baby’s mouth to your nipple and back to their mouth.

Here’s a list of general prevention tips to help your baby:

• Take the time to wash your baby’s hands, toys, and pacifiers.
• Launder towels, clothing, and bras that may have come into contact with Candida. The best practice is to use a hot wash cycle.
• If you’re pumping your milk, keep it refrigerated until just before use to prevent the growth of yeast.
• Don’t skip sterilizing your breast pump and the parts — even if you’re ready to crawl into bed.

Here’s a list of general prevention tips to help you:

• Make sure your breasts are dry after every feeding.
• Avoid using disposable nursing pads with a plastic backing, and remember to change your nursing pads when they get wet.
• Think about reducing your sugar intake. A 2017 study suggests that higher glucose concentrations may promote Candida growth. (However, since this hasn’t been proven, we won’t tell if you choose to skip this advice, especially when your baby is crying and you need the comfort of chocolate. Perhaps just reach for the lower sugar, dark chocolate options.)

While thrush isn’t serious, it’s certainly unpleasant for your baby — and for you. Those shooting pains can take all the joy out of breastfeeding. So if the symptoms of thrush persist, pay your pediatrician a visit.

And don’t forget: This is just a passing discomfort in the big picture, and it’s common. You’re doing just fine, mom or dad.