Oral Thrush in Babies and Adults: Signs, Treatment and Breastfeeding Tips

Is it milk, or is it thrush? Parents ask this all the time. Oral thrush is a common yeast infection of the mouth. It’s harmless in most healthy babies and easy to treat, but in adults it can be a sign that something else needs attention.

Imagine your three-week-old suddenly fusses at every feed. Inside their cheeks you see creamy white patches. You try to wipe them away with a clean cloth, but they won’t budge, and the skin underneath looks red. At the same time, your nipples have become sore and shiny. Those two clues together often point to thrush passing back and forth during feeds.

Signs of oral thrush

• White patches on the tongue, gums, inner cheeks or roof of the mouth that don’t wipe off easily (milk usually does)
• Red, sore areas underneath the patches
• In babies: fussing or pulling off during feeds, and sometimes nappy rash
• In adults: a cotton-wool feeling in the mouth, loss of taste, cracks at the corners of the mouth, pain when eating

Who gets it?

• Babies in the first months of life
• People using steroid inhalers for asthma or COPD, especially without rinsing afterwards
• People who wear dentures, have a dry mouth, smoke, or have recently taken antibiotics
• People with diabetes or a weakened immune system, such as during chemotherapy or with untreated HIV

Treatment

• Babies: a nurse, doctor or pharmacist can advise on an antifungal gel or drops suitable for your baby’s age. Some products are not licensed for very young babies, so always ask first.
• Breastfeeding parents: if your nipples are sore, red or itchy, you may need treatment at the same time so the infection doesn’t pass back and forth. Keep breastfeeding.
• Adults: antifungal gels, lozenges or tablets are used. Rinse your mouth after steroid inhalers, clean dentures daily and take them out at night.
• Bottles and dummies: sterilise them, and anything else that goes in your baby’s mouth.

But when should an adult get checked?

Healthy adults rarely get oral thrush without a reason. See a doctor or nurse if it keeps coming back, doesn’t clear with treatment, makes swallowing painful, or appears with no obvious trigger. It can be a sign of undiagnosed diabetes or a problem with the immune system that is worth finding.

Sources: NHS (Oral thrush in adults; Oral thrush in babies), US Centers for Disease Control and Prevention (Candida infections of the mouth), American Academy of Pediatrics. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.