Thrush

A very common rash for babies is called thrush.  The weird thing with this rash is that it does not occur on the skin, but rather in the mouth of the baby.  It will look like white flakey curds on the tongue and cheeks.  It is often confused with dried milk or milk color changes to baby’s tongue.  I like to differentiate the two in a couple of ways.  The first is, in clinic, if I take a tongue depressor or cue tip and I can easily scrape the white flakes off (often in a sheet) and the tongue underneath is beefy red-looking, it is most likely thrush.  If I can’t scrape it off, or the tongue is not super irritated underneath, it is most likely dried milk. 

Another way to know if it is thrush or not is if the baby is breastfeeding and mom starts to notice rashes around her/their nipple and experiences pain/burning both during feeding and when not feeding.  This rash loves to be transferred back and forth from baby’s mouth to the breast. To fully treat thrush, we prescribe the baby mouth drops, as well as a topical ointment for mom’s nipples, to prevent the infection from travelling back and forth and back and forth.

If baby is taking a bottle when they have thrush, then it becomes extra important to clean the bottles, nipples, and pacifiers extra well to prevent the same back and forth spread of the infection.

For kiddos with lighter versions of this rash, we can sometimes use acidophilus probiotic drops to help treat the infection.  But if it lingers or causes more discomfort for mom and/or baby, then we will use drops and creams with nystatin - a baby safe antifungal medicine.

Once treated, it is very common for it to come back; no biggie-we just treat the same way.  Once a kiddo starts solid foods, we see a dramatic decrease in thrush due to maturing of saliva to help combat thrush.