How to Treat Oral Thrush in Newborns

Oral thrush is caused by the fungus Candida albicans and often appears after a mother or newborn has taken antibiotics. This is because the fungus typically grows when the bacteria in the body are eliminated. A breastfeeding mother with thrush or a fungal infection on her nipple may pass the condition to the infant, so it is crucial to treat both mother and baby. In most cases, oral thrush is not dangerous as it can be easily treated at home, typically without medication. However, severe thrush can lead to dehydration and fever (rarely), requiring immediate medical attention. Knowing how to identify the signs of oral thrush and treat mild cases at home will ensure your baby remains healthy and happy.

Consult with a pediatrician. Before using any natural or homemade remedies, it is important to consult a pediatrician. The doctor can confirm the diagnosis and provide professional advice on the best treatment for your child. While many home remedies are safe, remember that your baby's immune and digestive systems are still developing, so a pediatrician may advise caution when using such treatments.

Supplementing Acidophilus for Your Baby. Acidophilus is a powdered form of probiotics found in the digestive tract. The balance between fungi and gut bacteria is crucial for the body. However, antibiotics or oral thrush can cause fungal overgrowth. Adding Acidophilus probiotics can help control fungal growth and address the underlying cause of oral thrush in newborns.

• Mix the Acidophilus powder with clean water or breast milk.
• Apply the mixture to your baby's mouth until the thrush clears up.
• If your baby is bottle-fed, you can also add 1 teaspoon of Acidophilus powder to formula or breast milk. Add the powder once daily until the thrush resolves completely.

Feeding Yogurt to Your Baby. If your baby is able to swallow yogurt, a pediatrician may recommend giving them unsweetened yogurt. Yogurt functions similarly to Acidophilus by helping balance the amount of yeast in the digestive system.

• If your baby is too young to swallow yogurt, you can use a clean cotton swab to apply yogurt directly to the affected area. Use only a small amount of yogurt and closely monitor your baby to avoid choking.

Using Grapefruit Seed Extract. Grapefruit seed extract, when diluted with distilled water and used daily, may help treat oral thrush symptoms in some infants.

• Mix 10 drops of grapefruit seed extract with 30 ml of distilled water. Some doctors believe that tap water’s antibacterial process may reduce the effectiveness of grapefruit seed extract.
• Use a clean cotton swab to apply the grapefruit seed extract mixture to your baby’s mouth once every hour while they are awake.
• Wipe your baby’s mouth before feeding to help reduce the bitter taste associated with thrush while nursing and to ensure they follow their regular feeding schedule.
• If the thrush does not significantly improve after two days of treatment, you can increase the strength of the grapefruit seed extract mixture by adding 15-20 drops instead of 10 drops to 30 ml of distilled water.

Using Pure Coconut Oil. Coconut oil contains caprylic acid, which helps fight the fungal infection that causes thrush.

• Use a clean cotton swab to apply coconut oil directly to the affected thrush area.
• Consult with a pediatrician before use, as some babies may be allergic to coconut oil.

Using a Baking Soda Mixture. A baking soda mixture can help treat oral thrush and can also be used on the mother’s nipple (if breastfeeding) and the baby’s mouth.

• Mix 1 teaspoon of baking soda with 240 ml of water.
• Use a clean cotton swab to apply the mixture to your baby’s mouth.

Try using a saline solution. Mix 1/2 teaspoon of salt into a cup of warm water. Then, use a clean cotton swab to apply the solution to the affected thrush area.

Using Miconazole. Miconazole is often the first choice for pediatricians when treating oral thrush. Miconazole comes in gel form, which you apply directly to your baby's mouth.

• Wash your hands with antibacterial soap before applying the medication.
• Apply 1/4 teaspoon of Miconazole to the thrush area, up to 4 times a day. Use a clean finger or cotton swab to apply Miconazole directly to the affected area.
• Do not use too much gel to avoid choking. Also, avoid applying the gel to your baby’s throat as it may easily travel down.
• Continue using Miconazole until your pediatrician advises stopping.
• Miconazole is not recommended for babies under 6 months old due to a higher choking risk.

Try Using Nystatin. In some countries, like the U.S., Nystatin is commonly prescribed as an alternative to Miconazole. This liquid medication can be dripped directly onto the baby's mouth, squirted onto the thrush area, or applied using a clean cotton swab.

• Shake the Nystatin bottle before use to ensure the liquid is well-mixed.
• Your pharmacist will provide a dropper, syringe, or spoon to measure and administer the Nystatin. If not, follow the instructions on the bottle.
• For small babies, the pediatrician may recommend giving half a dose on each side of the baby’s tongue or using a cotton swab to apply it to both sides of the mouth.
• For older children who can follow directions, you may have them swish the Nystatin solution in their mouth to coat their entire tongue, cheeks, and gums.
• Wait 5-10 minutes after administering Nystatin before feeding your baby, especially if you are using it near feeding time.
• Use Nystatin up to 4 times a day, and continue treatment for up to 5 days after the thrush disappears to prevent recurrence.
• Rare side effects of Nystatin include diarrhea, nausea, vomiting, stomach pain, or allergic reactions in some children. Consult your pediatrician about potential side effects before starting the treatment.

Try Using Gentian Violet. If both Miconazole and Nystatin are ineffective, your pediatrician may recommend Gentian Violet. This antifungal solution is applied directly to the thrush area using a cotton swab. Gentian Violet is available over the counter at most pharmacies.

• Follow the dosing instructions on the bottle or as directed by your pediatrician.
• Use a clean cotton swab to apply Gentian Violet to the thrush area.
• Apply Gentian Violet 2-3 times a day for at least 3 days.
• Be aware that Gentian Violet may stain your baby’s skin and clothing. It can turn the skin purple, but this will fade after discontinuing use.
• Consult your pediatrician before using Gentian Violet, as some babies may be allergic to the medication, the dye, or the preservatives in it.

Consult with your pediatrician about using Fluconazole. If other treatments do not work, your doctor may prescribe Fluconazole for your baby. This antifungal medication is taken once daily for 7-14 days and will help slow the growth of the yeast causing thrush.

• Follow the pediatrician's instructions regarding the medication dosage.

Understand Oral Thrush. While thrush can cause discomfort for your baby and be concerning for parents, it is important to note that most cases are harmless. Some cases resolve without medication within 1-2 weeks, and more severe cases may take up to 8 weeks to clear on their own. With proper care, thrush can heal in about 4-5 days under a doctor’s supervision. However, sometimes thrush can be associated with more serious complications and may indicate an underlying issue. Take your baby to the pediatrician immediately if they show signs of:

• Fever
• Signs of bleeding
• Dehydration or drinking less than usual
• Difficulty swallowing or breathing
• Other concerning complications

Reduce bottle-feeding time. Prolonged sucking on a bottle nipple can irritate your baby’s mouth, making them more prone to oral yeast infections. Try limiting bottle-feeding to 20 minutes per session. If the thrush is severe, your baby may have difficulty drinking from the bottle due to mouth pain. In such cases, consider using a spoon or syringe to feed your baby. Consult your pediatrician for the best method to avoid further irritation.

Limit pacifier use. While pacifiers can be comforting for infants, prolonged use can irritate the mouth and increase the risk of a yeast infection.

• If your baby has or has had thrush, only offer a pacifier when there is no other way to soothe them.

Disinfect nipples, bottles, and pacifiers if your baby has thrush. To prevent the spread of thrush, store breast milk and bottles in the refrigerator to inhibit yeast growth. Additionally, make sure to clean the bottle nipples, bottles, and pacifiers thoroughly using hot water or by placing them in the dishwasher.

Consult with your doctor about stopping antibiotics. If the breastfeeding mother develops thrush due to taking antibiotics or steroids, she should stop or reduce the dosage of these medications until the thrush clears. However, only discontinue or reduce the dosage of antibiotics and steroids if it does not cause complications for the mother. Speak to your doctor if you suspect the medication is causing thrush.

• This approach also applies to any medications your baby may be taking.