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If your baby has a faint white color on her tongue, it's probably just breast milk or formula. But if your baby has thick white patches or a sticky plaque on her tongue, gums, lips, or the inside of her cheeks, then it's probably thrush, a type of yeast infection. Watch the video to learn more about thrush and what doctors usually prescribe to treat it.
Dr. Dawn Rosenberg, M.D., FAAP, is a board-certified general pediatrician in San Francisco. She is very committed to teaching and is actively involved in medical student and resident education as an Associate Clinical Professor in the Department of Pediatrics at University of California, San Francisco.
Thrush is a yeast infection of your baby's mouth. It's really common in infants and usually painless. If you notice white raised patches on your baby's tongue, on the roof of her mouth, insides of her gums and lips, it's probably thrush. It will look like a thick, sticky, white plaque on her tongue. In contrast, sometimes you'll notice a faint whitish color on your baby's tongue, which is entirely normal. This is just breast milk or formula that sticks to her tongue.
Thrush is caused by an overgrowth of yeast called candida in the mouth. Yeast is a normal part of our digestive system, but if there's an imbalance it may cause an infection. Thrush can be triggered by a mom taking antibiotics, either during delivery or breastfeeding, or a baby taking antibiotics. Antibiotics kill off the bad bacteria but also kill good bacteria that keep yeast in check, and sometimes moms and babies will pass this infection back and forth to each other through breastfeeding. For example, your baby may have thrush and may cause an infection of your nipples through breastfeeding. Or you may have a nipple infection and pass the yeast back to your baby through breastfeeding.
Yeast thrive in warm, moist, sugary environments, which exactly describes your baby's mouth and your nipples.
First-line treatment for thrush is a liquid medicine called nystatin. This is prescribed by a doctor. You will apply it to your baby's gums and tongue multiple times a day. The nystatin can also be applied to your nipples. Often we'll treat both at the same time so the infection doesn't continue to go back and forth. I'd recommend sterilizing all your pacifiers, bottle nipples, and nipple shields to make sure that we really get rid of all of the yeast.
If nystatin doesn't work, there are a few other options we might try. One is gentian violet, a topical liquid also applied to your baby's mouth. And the other is an oral antifungal medicine called fluconazole. Sometimes thrush will actually resolve on its own, as your baby's immune system matures.
When moms have yeast it can cause an itchy, sometimes painful rash on their nipples. The good news is thrush really doesn't cause many symptoms in your baby, and it's usually harmless and very easily treated.
Video production by Paige Bierma.