CHILD’S DISORDERS: ORAL THRUSH (ORAL CANDIDIASIS, MONILIASIS)
Cause
Thrush of the throat, tongue and lining of the mouth is caused by a fungus, or yeast, called Candida albicans, which normally lives in the body. If there is a disruption in the balance of organisms, the thrush organisms begin to multiply, and produce an infection. This may be a result of treatment with antibiotics, which destroys normal bacteria in the bowel, and allows the thrush organisms to flourish. Thrush can also be picked up during passage down the mother’s vagina at birth. If thrush organisms are present on anything that the baby sucks, such as a teat or pacifier, the baby may develop an oral infection. Children who have a weak immune system for whatever reasons are also more prone to developing thrush infections. But if your baby has thrush it does not necessarily mean he has poor immunity. Thrush is not contagious.
Clinical features
Usually babies and young children with oral thrush are unaware of it, as it generally does not irritate them unless the areas involved become severely inflamed. If this does occur, babies may be reluctant to feed and toddlers may play with or refuse their meals. Parents may notice that their child has white patches or plaques on the inside of the cheeks, lips and tongue.
When to see your doctor
• if you see white patches on the inside of your child’s mouth;
• if your child is generally unwell or has a fever for no apparent reason;
• if despite appropriate treatment, your child suffers from recurrent or persistent thrush infections.
Your doctor will usually prescribe special drops to be used after each feed or meal for 10 days. All teats and pacifiers should be sterilised to kill the thrush organisms. Sometimes oral thrush is accompanied by thrush in the nappy region, which needs treatment at the same time. Thrush is not a reason to stop breastfeeding. Your doctor may advise you to apply some anti-fungal cream to your nipples as well.
Prevention
Teats and bottles should be sterilised to prevent recurrent thrush.
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