Oral Candida Infection (Thrush) in Your Child

Candida is a type of fungus. It's found naturally on the skin and in the mouth. If Candida grows out of control, it can cause mouth infection called thrush. Thrush is common in babies and children. Thrush is not a serious problem for a healthy child.

Who’s at risk?

Thrush is common in babies and toddlers. Risk factors for infant thrush include:

  • Very low birth weight

  • Passing through the birth canal of a mother with a yeast infection

  • Use of antibiotics

  • Use of inhaled steroids, such as for asthma

  • Frequent use of a pacifier

  • Weak immune system

Symptoms of thrush

Thrush causes creamy white patches to form on the tongue or inner cheeks. These patches can be painful and may bleed. Babies with thrush are often fussy and may have trouble feeding.

Treatment for thrush

A healthy baby with mild thrush may not need any treatment. More severe cases are likely to be treated with a liquid antifungal medicine. Or the medicine may be given as lozenges or pills. Follow the healthcare provider's instructions for giving this medicine to your child.

Breastfeeding mothers may develop thrush on their nipples. If you breastfeed, both you and your child will be treated. This is to prevent passing the infection back and forth.

Caring for your child at home

Make sure to do the following:

  • Wash your hands well with clean, running water and soap before and after caring for your child. Have your child wash his or her hands often.

  • If your child uses a pacifier, boil it for 5 to 10 minutes at least once a day.

  • Wash drinking cups well using warm water and soap after each use.

  • If your child takes inhaled corticosteroids, have your child rinse his or her mouth after taking the medicine. Also ask the child's healthcare provider about using a spacer. This can help lessen the risk for thrush.

Your child can likely go to school or daycare, unless the healthcare provider says otherwise.

When to call the healthcare provider

Call the healthcare provider right away if your child:

  • Has a fever (see Fever and children, below)

  • Stops eating or drinking

  • Has pain that doesn’t go away, or gets worse

  • Has other symptoms that get worse

  • Has repeated thrush infections

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4 or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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