Who’s at risk?

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

• A very low birth weight.

• Passing through a birth canal with a yeast infection.

• Using antibiotics.

• Using inhaled steroids, such as for asthma.

• Using a pacifier often.

• A 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 doctor's instructions for giving this medicine to your child.

If you breastfeed, you may develop thrush on your nipples. Both you and your child will need to 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 their hands often.

• Clean or sterilize all pacifiers, bottles, and other items that go in your child's mouth. Follow your doctor's instructions. Some doctors recommend boiling while others recommend washing with soap and water.

• If your child takes inhaled corticosteroids, have your child rinse their mouth after taking the medicine. Also ask the child's doctor about using a spacer. This can help reduce the risk for thrush.

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

When to contact the doctor

Contact your child's doctor 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 doctor 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 doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a 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 okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to call a doctor about your child’s fever

For a baby under 3 months old:

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

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

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

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

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

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

• A fever of ___________ as advised by the doctor