Oral Candida Infection (Thrush) in Your Child

Who’s at risk?

Thrush is common in babies and toddlers. Risk factors for infant thrush include:

• Very low birth weight

• Passing through the birth canal of a parent with a yeast infection

• Using antibiotics

• Using inhaled steroids, such as for asthma

• Using a pacifier often

• Weak immune system

Symptoms of thrush

Thrush causes creamy, white patches to form on the tongue or inner cheeks. These patches can be painful and may bleed. Babies with thrush are often fussy and may have trouble feeding.

Treatment for thrush

A healthy baby with mild thrush may not need any treatment. More severe cases are likely to be treated with a liquid antifungal medicine. Or the medicine may be given as lozenges or pills. Follow the healthcare provider's instructions for giving this medicine to your child.

Breastfeeding parents may develop thrush on their nipples. If you breastfeed, both you and your child will be treated. This is to prevent passing the infection back and forth.

It is also important to sterilize any bottle nipples, pacifiers, or toys your child may put in their mouth. This should be done repeatedly throughout the treatment course. This is to prevent reinfection through contact with contaminated surfaces.

Caring for your child at home

Make sure to do the following:

• Wash your hands well with clean, running water and soap before and after caring for your child. Have your child wash their hands often.

• If your child uses a pacifier, boil it for 5 to 10 minutes at least once a day.

• Wash drinking cups well using warm water and soap after each use.

• If your child takes inhaled corticosteroids, have your child rinse their mouth after taking the medicine. Also ask the child's healthcare provider about using a spacer. This can help lessen the risk for thrush.

Your child can likely go to school or daycare, unless the provider says otherwise.

When to call the healthcare provider

Call the healthcare provider right away if your child:

• Has a fever (see "Fever and children" below)

• Stops eating or drinking

• Has pain that doesn’t go away, or gets worse

• Has other symptoms that get worse

• Has repeated thrush infections

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider