Family doctor

Overview:

• Oral thrush is caused by a yeast infection also known as candida albicans
• It causes white or cream to yellow coloured spots inside the month
• It is common among newborn babies but also occurs in adults
• The infection usually resolves by itself in about one month, but treatment with an antifungal medicine is often recommended
• The use of antibiotics can trigger another infection

What is it?

Oral (mouth) thrush is caused by an overgrowth of candida albicans. It is a yeast infection which mainly affects babies.

The condition produces white spots inside the mouth and on the tongue. It occurs in about five percent of babies.

Newborns usually get the infection when they pass through the birth canal during child birth. Candida is a naturally occurring organism in women, and babies come into contact with this during the birth process.

In most cases the infection does not cause any symptoms for the baby, but sometimes the spots are painful and this can lead to feeding difficulties.

Thrush can also pass through the baby's digestive system and cause a yeast infection nappy rash. But in most cases the condition spontaneously resolves without treatment in about four weeks.

The use of antibiotics during the first year of life can sometimes trigger oral thrush to return, and it can become persistent.

A baby can also get thrush from breastfeeding if the mother also has a yeast nipple infection.

Adults at risk of oral thrush include diabetics, those on antibiotics or having chemotherapy, those with weak immune systems, people who wear dentures, and drug users.

What are the symptoms?

The main sign is white spots occurring on the tongue, inside the mouth, roof of the mouth, and sometimes the lips.

The spots may be coloured white, cream, yellow or sometimes gray. They are usually painless but they may cause pain in some infants and problems with feeding.

Oral thrush usually develops about one week to 10 days following birth.

What can be done?

Even though oral thrush will normally resolve without treatment, medication is often recommended to ease any pain that may be caused, and to treat any accompanying nappy rash.

The main treatment is an antifungal antibiotic called nystatin. This can be applied directly to the spots in the mouth or given orally four times a day.

The medicine can also be applied to the mother's breasts if the infection persists or recurs. Nipple shields and dummies should also be sterilised if the condition returns.

In adults, treatment may involve having dentures refitted, adjusting diabetes treatment or the use of systemic fungicides.

Getting help

Babies and adults with oral thrush should be seen by a doctor who can confirm the diagnosis and recommend appropriate treatment.