Oral thrush is a term used to describe a fungal infection in the mouth caused by the yeast fungus Candida albicans. This fungus is present in everyone’s mouth and it doesn’t normally cause problems but if it gets the better of your immune system it can overgrow and cause symptomatic infection. Babies are more at risk of this than adults because their immune systems are not as strong or developed and are therefore more susceptible to infection. Another cause of oral thrush is antibiotic use by either your baby or yourself (if you are breastfeeding). Using antibiotics can kill some of the good bacteria in your mouth – these good bacteria are what normally keep the yeast levels under control! Probiotics are handy for this reason – they replenish your body’s levels of good bacteria which keeps the balance nice and even! For kids, I like this probiotic: Bio Kult Infantis
Symptoms of oral thrush
- White coating or patches on your baby’s tongue which do not rub off easily. Patches which do rub off easily could just be milk deposits.
- White patches elsewhere in your baby’s mouth such as their gums or palate (roof of the mouth)
- When rubbed the patches may be red underneath or bleed a little. Don’t rub these patches if you can help it – see the GP if you suspect thrush.
- Lack of interest in bottle feeding or latching onto the breast – most likely caused by pain in the mouth.
- Your baby may appear hungry and look for a feed but stop as soon as they start due to the discomfort.
- Clicking noises when your baby is trying to suckle.
- Poor feeding can result in slow weight gain.
- Nappy rash – particularly in the creases of your baby’s skin.
Treating oral thrush
If you suspect oral thrush you should bring your baby to their GP to confirm the diagnosis and discuss treatment. Medication is usually required and the choice can depend on a few factors, especially your baby’s age.
If your baby is over four months of age the doctor may recommend Daktarin oral gel. This is available over the counter from your local pharmacy. It is a pleasant-tasting gel (orange flavour!) which should be applied according to the manufacturer’s recommendation as follows:
Your doctor may also choose to prescribe a medication which is not currently available without a prescription in Ireland called Mycostatin. The dosage instructions for Mycostatin which are recommended by the manufacturer are:
“For thrush of the mouth or throat: The recommended dose for newborns (from birth to 1 month) is 1ml four times a day dropped into the mouth. The recommended dose for infants (1 month to 2 years) is 2 ml four times a day dropped into the mouth (1 ml for each side of the mouth). The recommended dose for children (over 2 years) and adults is 4 to 6ml four times a day dropped into the mouth (half dose in each side of the mouth).”
Both Daktarin and Mycostatin should be applied just after feeds or meals to maximise the contact time they will have with the mucous membranes and reduce the risk of them being washed away prematurely. Both medicines should be used for at least a couple of days after all of the symptoms have disappeared to ensure thorough treatment.
As a compliment to the medical treatment of thrush, you should try to wash all of your baby’s bottles, teats, soothers, toys, toothbrushes and teethers in hot soapy water to help to clear the infection.
Breastfeeding and Oral Thrush
If your baby has oral thrush and you are breastfeeding you must let your doctor know. You may require treatment for thrush yourself as it can also affect the breasts as a condition known as ductal candidiasis. Thrush infections are easily passed from mother to baby and back again so it’s very important to coordinate treatment for a quick resolution of the problem. Ductal thrush can be painful and can go on to affect the breastfeeding relationship so I would urge you to read my article all about its management here – https://wonderbaba.ie/2016/11/23/candida-thrush-infection-of-breasts-symptoms-and-treatment/
As always if you have any questions please don’t hesitate to get in touch through the WonderCare Facebook page by private message – http://www.facebook.com/wonderbabacare or phone me at Milltown totalhealth Pharmacy in Dublin 6 on 012600262!
References:
http://www.medicines.ie/medicine/9525/PIL
http://www.medicines.ie/medicine/1960/SPC
http://www.medicines.ie/medicine/14652/PIL/Mycostatin+Oral+Suspension+(Ready-Mixed)/
http://www.hse.ie/eng/health/az/C/Candidiasis,-oral-babies-/Treating-oral-thrush-in-babies.html