Oral thrush in babies is caused by a yeast infection (candida albicans). While it is not harmful, it can sometimes cause discomfort in baby and can make breastfeeding very painful. For this reason it is important to identify it early and treat both baby and mum. Yeast infections love warm, moist environments, so a baby’s mouth and a mother’s nipples provide the perfect conditions for it to grow.
What does oral thrush look like?
Oral thrush looks like white patches (plaques) in the mouth. It may be on the tongue, gums, cheeks or roof of the mouth. Sometimes this is confused with a white covered milk tongue. If you are able to scrape away the milk residue on the tongue after a feed, then this is not oral thrush.
What does oral thrush feel like?
Incorrect positioning and latch are the most common cause of nipple or breast pain. When this is ok you might suspect you have thrush if your nipple/areola is discoloured, shiny, itchy, burning or flaky. You may also feel deep nipple/breast pain during and after a feed.
Sometimes women describe the pain as a ‘, shooting, stabbing or burning pain’ or ‘feeling like the baby is sucking on broken glass’. OUCH!
Treatment of oral thrush in babies
To treat thrush an anti-fungal medication is needed. For babies a gel ointment such as daktarin oral gel (Miconazole) can be very effective. But some no longer recommend this for babies under 6 months of age, or those with an undeveloped gag reflex, due to some cases of babies choking when gel was applied inappropriately (too much was given). An oral suspension such as nystatin drops is also available, but it said to be less effective. The mother should also treat herself with similar anti-fungal gels/creams directly on the nipple and/or oral antifungals. The treatment should continue for up to two weeks after all the symptoms have disappeared. A really clear guideline by the Royal Women’s Hospital lists the medications available and the dosage to be taken. You should speak to your health professional or pharmacist for advice on the latest up-to-date information.
Sterilising dummies/teats by boiling and replacing often, cleaning toys that go in the mouth, washing maternity bras/pads with hot water, decreasing sugar in the diet and acidophilus supplements may also be required to get rid of a thrush infection. Good handwashing between nappy changes is also important.
If in any doubt whether you have thrush, or you feel the pain is not improving after treatment, it is important to seek further medical advice. There can be other causes of nipple/breast pain, such as a bacterial infection, which would require a different course of treatment. Pain while feeding is a common reason why women discontinue to breastfeed. So it’s important to get any thrush treated early so the breastfeeding experience for you and baby is a pleasant one!