Thrush in babies

Thrush can happen in and around the mouths (oral thrush) of babies, on their bottom and around their nappy area (nappy thrush). It’s a fungal infection caused by a yeast called Candida albicans that’s commonly found in everyone’s body, but normally balanced out with other healthy bacteria. If the balance gets upset (by a course of antibiotics, for example), the Candida albicans can outnumber the healthy bacteria and cause an infection.

Babies can be prone to thrush because their immune system is still developing. If a baby is being breastfed and has oral thrush, it’s possible for the infection to be passed on to their mother’s nipples. You or your baby will both need to be treated, even if only one of you has symptoms. Generally, thrush is not harmful and can be easily treated.

Signs and symptoms

Oral thrush

Babies may have a white or grey coating on their tongue and white or red spots on the inside of their cheeks. The coating is different to milk which can be wiped off their tongue easily. Their tongue and mouth may become red and sore and make it difficult for them to feed.

Nappy thrush

Nappy thrush looks like a bright red and shiny rash with clear patches on babies’ bottom and in their nappy area, it can be in their skin folds. Red dots or pus-like bumps (pustules) may happen around the edge of the rash.

Nappy rash is different because it happens from moisture on babies’ skin and is usually cleared in a couple of days. Thrush can take longer to clear and often comes back.

Treatment

If you treat thrush infections quickly it can prevent them getting worse.

There are a range of treatments available. It’s best to see a doctor before starting any treatment, so you’ve got the right plan for you and your baby.

Generally, nappy and nipple thrush is treated with antifungal creams or ointments which are available from a chemist without a prescription.

Treatments for oral thrush include gels and drops which you carefully measure and apply on your baby’s tongue and gums using your finger. They’re also available without a prescription.

Treatments are safe to use if you follow instructions carefully, you should see an improvement within 24 – 48 hours.

Make sure you also:

• wash your hands well after changing your baby’s nappy and before and after applying creams, ointments or gels
• sterilise dummies regularly, as well as any toys that your baby puts in their mouth
• sterilise bottles, feeding or expressing equipment after each use, especially the teats and nipple shields
• wash towels, bras and cloth nursing pads in hot soapy water, rinse well and air-dry outside if you are breastfeeding.

Key points

• Thrush is a fungal infection caused by a yeast called Candida albicans which happens when there is an imbalance in healthy bacteria in the body, which can be common after a course of antibiotics.
• Babies can develop oral thrush and pass it to their mother’s nipples if they are breastfeeding
• Nappy thrush looks like a bright red shiny rash with clear patches, and red dots with pus-like bumps. It’s different to nappy rash, which happens because of moisture on babies’ skin.
• Antifungal creams, ointments, gels and drops are commonly used to treat thrush. See your doctor, lactation nurse or child health nurse to choose the right treatment for your baby.

Commonly asked questions

Can thrush be prevented in babies?

It’s not clear whether thrush infections can be prevented in babies because it happens for a range of reasons. If your baby has thrush follow the advice from your doctor or healthcare professional and be consistent with good hygiene practices, such as washing your hands after changing your baby’s nappy, sterilising feeding aids and washing items that come into contact with you and your baby.

Is it safe to breastfeed while I’m being treated for thrush?

Yes. Your baby may be fussy during treatment of a thrush infection. Some mothers wipe the treatment off their nipples before feeding because their baby doesn’t like the taste. Creams or ointments mothers use to treat nipple thrush are safe for babies’ in small amounts.

Thrush is generally only a temporary problem, so you can continue breastfeeding.

What’s the difference between nappy rash and nappy thrush?

Nappy rash happens from moisture on babies’ skin and is usually cleared in a couple of days. It can be treated by keeping babies’ skin dry. Thrush is an infection caused by a healthy bacterial imbalance. It can be treated with antifungal creams and ointments which are available from your chemist.

When to seek help

See your GP if your child or you have any common symptoms of thrush.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by the Lactation Service, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS047. Reviewed: June 2021.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.