Oral Trush

Nadirah 3-m0nth-young:
1. Started to suck her thumb and index finger last week (right hand only). Shussshh. She loves doing it, especially when she's sleepy and about to sleep. Layan gilerrr. Kalo tarik tgn dy, menjerit mcm kene dera. Arghh. She's loud! Super-loud. Tho we're not planning to send her to TKC for high school, she definitely qualified if they have to audition her voice for form 1 intake.

2. Last night she just discovered that she has another thumb (left!) and started to suck the other hand pulak. Adoi.

3. Last Tuesday Ibu noticed that she has oral thrush. Mummy thot it's milk residue. But nope. Confirmed, there are fungus growing happily in her mouth. Pity pity baby HnyB. What we do, we clean her mouth using soda bicarb diluted in boiled water. Alhamdulillah, the condition is improving.

Thrush in babies

Written for BabyCenter Malaysia
Approved by the BabyCenter Malaysia Medical Advisory Board

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• My baby has white patches on the insides of her cheeks. What could it be?
  
• How can I be certain that it's thrush?
  
• How can I treat thrush?
  
• Is there anything I can do to prevent my baby from getting thrush?
  
• Is thrush dangerous?
  

My baby has white patches on the insides of her cheeks. What could it be?

It could be a yeast infection known as thrush which resembles cottage cheese or milk curds on the sides, roof and sometimes, the tongue of a baby's mouth. It's most common in babies two months and younger, but it can appear in older babies, too.

Everyone has yeast in their bodies - it's a normal part of the digestive system - but when there's an imbalance, an infection sets in. The main factors that can tip the balance are hormonal changes and the use of antibiotics - either in a breastfeeding mother or in a baby.

How can I be certain that it's thrush?

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If you notice a white coating on your baby's tongue but nowhere else, it's probably just milk residue. Thrush, on the other hand, can be found on the tongue, but is most often on the sides of the mouth, causing it to be very sore. You may first suspect it if your baby starts crying when breastfeeding, sucking on a pacifier or a bottle.

If you think your baby has thrush, look for the characteristic white patches. Then gently touch a patch with a gauze-covered finger. It probably won't come off very easily, but if it does, you'll find a raw, red area underneath that may bleed.

How can I treat thrush?

Consult your paediatrician if you suspect your baby has it. She may prescribe an oral fungal cream called Nystatin or Mycostatin. It may take a week to clear up the infection. Sometimes doctors will recommend a mother apply Nystatin to her nipples if she's breastfeeding so that she and her baby don't pass the infection to each other. It's important to treat both mother and baby concurrently so that they don't reinfect one another.

Is there anything I can do to prevent my baby from getting thrush?

Not if, like many babies, she got the infection from you in the first place - picking up the yeasty bacteria as she passed through the birth canal during labour.

However, some babies are simply more susceptible than others to the fungus. Some people think it can also be caused by prolonged sucking on a bottle or pacifier; others think poor hygiene of bottle teats is to blame; still others blame a pacifier or bottle teat that's too large for the baby. However, babies who exclusively breastfeed and don't use pacifiers can also get it.

Some experts recommend giving a baby sterilised water to drink after breastfeeding or bottle feeding to rinse the milk residue away. Cleaning and sterilising pacifiers may also help. Some doctors advise breastfeeding mothers to let their nipples air dry between feedings to prevent thrush, and this is especially important if you do have thrush - damp nipples are a good breeding ground for yeasts.

Take care if your baby is placed on a course of antibiotics or if you're breastfeeding and take them to treat an infection. Antiobiotics kill off good, infection-fighting bacteria as well as bad bacteria; either can trigger a case of thrush in the baby, especially if you contract a vaginal yeast infection in the process.

Is thrush dangerous?

Not really. The biggest problem occurs if your baby's mouth is too sore to suck - she may get dehydrated. Your doctor may prescribe paracetamol suspension for the pain. You should alert your doctor if the thrush doesn't seem to clear up with treatment or if the baby also has a fever over 101 degrees F / 38.2 degrees C, which could indicate a different infection.

A bout of thrush can be very trying for all of you - a hungry baby who finds it painful to feed is a very sad sight - but is usually short-lived. Give your baby all the comfort she needs, follow your doctor's instructions for pain relief and medicine, and this infection, too, will pass.