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Thrush

Oropharyngeal candidiasis (Latin name)

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Thrush is an infection in the oral cavity caused by fungi. The disease is very common during the first months following the birth. Thrush appears as milk white spots on the tongue, on the palate and on the inside of the cheeks. Thrush is contagious. Contact the doctor if the spots do not disappear after a few days treatment with soda water. A doctor can make a prescription for a fungicide remedy.

Thrush is an infection in the mouth caused by a fungus (Candida albicans). The mother often infects the child at birth since many women have the fungus in their vagina. Having fungi in the mouth does not have to cause problems for the child. Almost half of all children have fungi in the mouth, without it causes any problems. Only in those cases where the fungi spread, thrush can break out. It is not precisely known why some children develop thrush, although it is known that thrush can break out if the child is treated with antibiotics or asthma medication. However, many children get thrush even though they are not medicated.

Thrush is a comparatively harmless infection. Some children are not bothered at all while others have difficulty sucking or eating. Thrush appears as milk white, overlapping spots or huddles on a crimson mucous membrane. The spots appear on the inside of the cheeks, on the tongue and on the palate. When the white spots are removed the underlying mucous membrane appears very red and bleeding may occur.

The white spots of the thrush can be mistaken for left over milk in the oral cavity. It is not thrush if the spots disappear entirely after the child has drunk, for example some water. The white spots that appear with thrush cannot be flushed away like left over milk.

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Contamination

Thrush infects from the child’s mouth to hands, bottle, pacifier and nipple shield. Careful hygiene of hands is important when you clean the mouth. You should wash your hands both before and after treatment. If you use a nipple shield when breastfeeding you should be careful with the cleaning and boiling of it. The child should have a clean pacifier every day and you must avoid putting it into your own mouth. It can be a good idea to buy new pacifiers when the treatment of the fungi has commenced.

Day care:
There are no special rules for attending day care. However, the rules mentioned above should be adhered.

Medication

The child can be treated with a fungicide which is only available on prescription.

What can you do?

Light thrush (few white spots that does not bother the child) will disappear in the course of a few days. If there are many white spots or the child seems bothered when it sucks or eats you can use soda water to remove the thrush. Use a cotton bud or the corner of a diaper/wash cloth that you dip in soda water. Try scraping off the spots. You should make an effort to be careful getting around the entire oral cavity, the tongue and the palate. Previously people were advised to remove thrush with chlorhexidine, but that is not advisable. Chlorhexidine kills the normal bacteria in the child’s mouth, which provides the fungus with better conditions for getting ahead.

Contact the doctor tomorrow

If the thrush does not disappear after own treatment with soda water.

Contact the doctor immediately

This is never necessary.