Key takeaways: Thrush is a common yeast infection that causes white patches on the tongue, cheeks, or gums that don’t wipe off easily. It’s treated with antifungal medicine. Breastfeeding parents may need treatment too. Milk residue, which wipes off easily, isn’t thrush.
Thrush is a yeast infection caused by Candida, a fungus that normally lives in the mouth and gut. In babies, whose immune systems are still developing, it can overgrow.
Signs of Thrush in Babies
- White or creamy patches on the tongue, inner cheeks, gums, or roof of the mouth.
- Patches that don’t wipe away easily, or leave a red, sometimes bleeding, area when wiped.
- Fussiness during feeds or refusing to feed (some babies aren’t bothered).
- A yeast diaper rash: bright red with small red spots at the edges.
Thrush vs. Milk Residue
Milk can leave a white coating on the tongue. Milk residue:
- Wipes off easily with a soft cloth.
- Usually only on the tongue.
- Disappears shortly after feeds.
Thrush patches are on the cheeks and gums too and don’t wipe off easily.
Who Gets Thrush?
- Babies under 6 months.
- Babies who’ve taken antibiotics, or whose breastfeeding parent has.
- Babies who use pacifiers or bottles that aren’t cleaned well.
Treatment for Babies
Your doctor may prescribe an oral antifungal medicine, such as nystatin suspension, applied to the inside of the mouth several times a day, or another antifungal. Continue treatment as directed, often for a few days after the patches go away.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. If you want feeding help you can flip to in the middle of the night, my book walks you through feeding month by month, from the very first latch to the first birthday.
Thrush and Breastfeeding
Yeast can pass between a baby’s mouth and the breastfeeding parent’s nipples. Signs on the nipples may include:
- Shiny, flaky, or red nipples or areolas.
- Itching or burning.
Important: burning or shooting breast pain is often attributed to yeast, but research shows it’s frequently caused by other things, such as nipple damage, vasospasm, or bacterial infection. Experts now urge caution about diagnosing “breast thrush” without clear signs. Talk to your provider for an evaluation.
If thrush is confirmed, your provider may treat both you and your baby at the same time to prevent passing it back and forth.
Preventing Reinfection
- Wash bottle nipples, pacifiers, and pump parts that touch milk after each use, and sanitize them daily during treatment.
- Wash your hands after diaper changes and before feeds.
- Change nursing pads often.
- Replace pacifiers and bottle nipples after treatment if recommended.
Call your baby’s doctor if your baby: has white patches that don’t wipe away, is feeding poorly, has fewer wet diapers, or has a persistent diaper rash. Call your provider if you have: nipple or breast pain, especially with redness, fever, or cracked skin.
The Bottom Line
Thrush is common and treatable. White patches that don’t wipe away are the key sign. Treat promptly, clean feeding items well, and get an evaluation for nipple pain rather than assuming it’s yeast.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
Sources
- American Academy of Pediatrics. Red Book: 2024-2027 Report of the Committee on Infectious Diseases. 33rd ed. American Academy of Pediatrics; 2024. Candidiasis.
- Berens P, Eglash A, Malloy M, Steube AM; Academy of Breastfeeding Medicine. ABM Clinical Protocol #26: Persistent pain with breastfeeding. Breastfeed Med. 2016;11(2):46-53.
- Mitchell KB, Johnson HM, Rodríguez JM, et al; Academy of Breastfeeding Medicine. Academy of Breastfeeding Medicine Clinical Protocol #36: The mastitis spectrum, revised 2022. Breastfeed Med. 2022;17(5):360-376.
- Amir LH, Donath SM, Garland SM, et al. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open. 2013;3(3):e002351.
- Centers for Disease Control and Prevention. How to clean, sanitize, and store infant feeding items. https://www.cdc.gov/hygiene
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
