Thrush in Babies

It might come as a surprise to learn that babies can develop thrush. That's right – it's not an infection restricted to adults.

Thrush is what is known as an opportunistic infection. That means it tends to appear more frequently when the body is run down or, in the case of a baby, not quite up to full strength yet.

What is thrush?

A thrush infection develops when a single celled yeast organism on the surface of the skin is triggered into overdrive causing it to grow and multiply.

Anyone of any age and health condition can develop a thrush infection. Thrush can be restricted to the skin or be concentrated in the mouth, vagina or bowel.

Thrush thrives in warm, moist environments which is why it is more common in the mouth and nappy areas.

When does thrush develop?

Thrush can just appear one day without warning.

Unfortunately, it can be easily transmitted to a baby if a mother has thrush on her nipples or in her milk ducts and she is breastfeeding. Some adults find that a diet high in sugar and refined carbohydrates such as bread and yeast products also make them more prone to getting thrush.

What does thrush look like?

Thrush in the mouth:

• White patches or curds on the tongue, roof of the mouth and inner cheeks. These can easily be mistaken for milk residue. If you are unsure, use a clean cotton bud to try and wipe the milk away – if it is still there it may be thrush
• Fussing with feeds, not wanting to latch on as quickly on the breast or bottle teat

Thrush in the nappy area:

• Often appears a few days after oral thrush has been seen
• Red spots around the anus and surrounding skin. These can be in little satellites or clusters and look like pimples.
• A red, and sometimes shiny rash in the creases of the skin in the nappy area
• A quick flaring up of the rash, often between nappy changes
• Restlessness and irritability, especially when their nappy area is wet or dirty. The best way to cope with this is to keep it clean with wipes and allow air flow whenever possible.

Thrush on the neck:

Thrush can appear in the skin folds of the baby's neck. When the folds are separated, there can be a shiny red appearance and often an odour as well. This is more common in warmer weather and when the air is humid.

Treatment for this type of thrush is the same as for nappy thrush:

• Keep the area clean and dry with gentle wipes and towels
• Change clothing frequently
• Avoid using plastic backed bibs
• Use a cream with a specific anti-fungal agent

Monitor the area and watch for improvement. Sometimes babies develop a bacterial skin infection at the same time and this requires a different cream and occasionally, oral antibiotics as well.

What's the good news about thrush?

Thrush is not difficult to cure. It is easily recognised. If you're in doubt, check with your GP, pharmacist, or health care professional.

• Most thrush treatments are readily available and can be bought over the counter at pharmacies without a doctor's prescription.
• Although the symptoms of thrush can be irritating, it cannot hurt you or your baby. When a thrush infection is restricted to the skin or the mouth it is not considered to be dangerous.

Frequent nappy changing is important in the overall management of nappy thrush. This helps prevent the acid and bile salts in bub's dirty nappies from aggravating their skin.

How is thrush in babies treated?

The first step towards treatment is accurate diagnosis. Once you're clear that your baby has thrush then treatment options are relatively straightforward and very effective.

• Redness subsides quickly when cream with an anti-fungal agent are used
• The best strategy is to continue using the prescribed creams or drops until all signs of oral thrush have cleared
• It can be useful to apply a barrier cream as well as a specific thrush cream during episodes of thrush. However, rashes generally do not clear using barrier creams alone.

What's important to know about thrush treatment

• Adult thrush treatments are not suited for babies and children. Although the active ingredient may be the same, the concentrations vary.
• You should not share thrush creams and ointments between individuals.
• If your baby has thrush in their mouth and nappy area, you will need to treat both areas at the same time.

How can I prevent my baby from getting thrush?

Many health professionals believe that babies are initially exposed to thrush when they are born, particularly if they were born vaginally and their mother has a history of having had vaginal thrush.

However, like adults, some babies are just more prone to fungal infection than others. Here are some simple steps you can do which may help prevent it:

• Be mindful of your own hand washing and hygiene practices. Disposable paper towels are preferred over towels for hand drying.
• Be aware of how you and other people are handling your baby and how they may be sharing their germs. Kissing them around the mouth, blowing on your baby's food to cool it, tasting their food or milk before offering it your baby, putting your baby's dummy or teat in their mouth are all risky behaviours.
• Consider using an anti-fungal rinse solution when doing your baby's laundry – this can help to kill the fungal spores which lead to a thrush infection
• Change your baby's towels, bed linen, bibs and clothing frequently. When washing, aim to dry their items in the sun, rather than the clothes dryer.
• If possible, dress your baby in loose fitting clothing which allows for the air to circulate.
• Make sure you change your breast pads frequently and wear a clean bra every day.
• If you are bottle feeding, be very careful about bottle hygiene. Use very hot water or the dishwasher to wash your baby's bottles and air dry them.
• Wash any toys, dummies, and other equipment such as teething rings that they may put in their mouth every day in hot water and safe detergent. Rinse them well and place in the sun to dry.
• Avoid using alcohol based wipes to clean your baby's skin – low perfumed, hypo allergenic wipes are ideal and less irritating. You could also use cotton wool balls soaked in warm water at nappy changes.
• Air your baby's nappy area and let them kick freely without their nappy on for a short time each day.
• Use good quality disposable nappies which are more absorbent and keep the nappy area drier.

How long does it take to clear baby thrush?

Thrush symptoms usually respond within a few days of starting effective treatment – this is the case in both oral and skin treatments. If you find that your baby is not improving with treatment, then check with your health care practitioner.

Remember

Thrush is a common condition which generally responds very well to treatment. Thrush is not a sign of poor hygiene or that you are not caring well for your baby's health. It is impossible to completely rid the body of Candida Albicans as it is always present. Supporting your baby's healthy immune function and skin care will go a long way towards preventing a thrush infection.

For more information check

• With your pharmacist
• Your General Practitioner