Causes And Treatment For Oral Thrush In Babies

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Candidiasis is a yeast infection of the mucus membrane lining the mouth and tongue. The alternative name for candidiasis is oral thrush.

Causes, incidence, and risk factors

The body normally hosts a variety of germs, including bacteria and fungi. Some of these are useful to the body, some produce no harm or benefit, and some can cause harmful infections.

Thrush occurs when a fungus called Candida overgrows in your mouth. A small amount of this fungus lives in your mouth most of the time. It is usually kept in check by your immune system and other germs that also normally live in your mouth.

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However, when your immune system is weak or when the other normal bacteria die, the fungus can overgrow. The following factors can increase your chances of getting thrush:

The following factors can increase your chances of getting thrush:

• Being in poor health
• Being very old or very young
• Having an HIV infection or AIDS
• Long-term use or high dose antibiotics
• Receiving chemotherapy or drugs that weaken the immune system
• Taking steroid medications

Thrush is commonly seen in infants. It is not considered abnormal in infants unless it lasts longer than a couple of weeks.

People who have diabetes and have high blood sugar levels are more likely to get thrush in the mouth (oral thrush). This is due to fact that the extra sugar in their saliva acts as food for Candida.

Taking high doses of antibiotics or taking antibiotics for a long time also increases the risk of oral thrush. When antibiotics are overused, some of the healthy bacteria that help keep Candida from growing too much are killed .

People with poorly fitting dentures are also more likely to get thrush.

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Symptoms
Thrush appears as whitish, velvety sores in the mouth and on the tongue. Underneath the whitish material, there is red tissue that may bleed easily. The sores can slowly increase in number and size.

Signs and tests
Your doctor or dentist can almost always diagnose thrush by looking at your mouth and tongue. The sores have a distinct appearance.

If the diagnosis is not clear, one of the following tests may be performed to look for Candida:

• Culture of mouth lesions
• Microscopic examination of mouth scrapings

Treatment
For thrush in infants, treatment is often NOT needed. It usually gets better on its own within 2 weeks.

Your doctor may prescribe an antifungal drug if you have a severe case of thrush or a weakened immune system. These products are usually to be used for 5 to 10 days. If they don't work, other medication may be prescribed.

Expectations
Thrush in infants may be painful, but it is rarely serious. Because of discomfort, it can interfere with eating. If it does not get better on its own within 2 weeks, call your pediatrician.

In adults, thrush that occurs in the mouth can be cured. However, the long-term outlook depends on your immune system and the cause of the immune problem.

Calling your doctor

Call your doctor if:

• Your infant has had thrush-like sores in the mouth for at least 2 weeks.
• Your infant is eating poorly due to the sores.
• You are a teen or an adult with thrush-like sores.
• You have pain or difficulty swallowing.
• You have symptoms of thrush and you are HIV positive, receiving chemotherapy, or you take medications to suppress your immune system.

Prevention

If you get thrush often, your doctor may recommend taking antifungal medication on a regular basis to avoid repeat infections.

If an infant with thrush is breastfeeding, talk to your doctor about ways to prevent future infections, such as an antifungal medication. Sterilize or throw out any pacifiers. For bottle-fed babies with thrush, throw out the nipples and buy new ones as the baby's mouth begins to clear.

N Chandra KumarNeonatology

MBBS, MD (JIPMER), DNB, DM (Neonatology), AIIMS, DNB (Neonatology)

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