Cause

You get thrush when a yeast called Candida grows out of control. Candida is normally found in small amounts in the mouth and other mucous membranes. It usually causes no harm. But when the yeast is able to grow uncontrolled, it invades surrounding tissues and becomes an infection.

• Babies get thrush because their immune systems aren't yet strong enough to control the growth of the yeast.
• Older people get thrush because their immune systems can weaken with age.
• Some people get thrush when they take certain medicines, such as antibiotics, inhaled corticosteroids, or medicines that weaken the immune system (like chemotherapy).
• People who have certain health problems, such as diabetes or HIV, are also more likely to get thrush.

Prevention

In babies

Here are some tips for how to help prevent thrush in infants.

• Treat vaginal yeast infections, especially during the last 3 months of pregnancy. This will decrease your baby's risk of getting thrush during delivery.
• Wash bottle nipples and pacifiers daily. And keep all prepared bottles and nipples in the refrigerator to decrease the likelihood of yeast growth.
• Do not reuse a bottle more than an hour after the baby has drunk from it. Yeast may have had time to grow on the nipple.
• Change your baby's diaper soon after it is wet. A wet diaper area provides a good environment for the yeast that causes thrush to grow.
• Breastfeed your baby if possible. Breast milk contains antibodies that will help build your baby's natural defense system (immune system) so your baby can resist infection.
• Contact your doctor with concerns about breastfeeding. If your nipples become red and sore, or you have breast pain during or after feeding, it may be a sign that a thrush infection in your baby has spread to your nipples.

If your baby needs medicine to treat thrush, don't put the medicine dropper in the baby's mouth. Drop the medicine on a cotton swab and swab it on the affected area. Throw away the swab, and don't put anything back into the medicine bottle that could be contaminated with the yeast.

In adults

Here are some tips for preventing thrush.

• Practice good oral hygiene. This includes brushing your teeth twice a day and flossing once a day.
  • If you have had a previous thrush infection, replace your toothbrush to help prevent another infection.
• Take care of your dentures if you wear them. Talk with your doctor about soaking your dentures in chlorhexidine solution. If this is recommended, follow your doctor's or pharmacist's specific instructions.
• Practice good hand-washing.
• Rinse your mouth with water soon after you take a liquid antibiotic. Antibiotics can throw off the balance of bacteria in the mouth and can allow the growth of the yeast that causes thrush.
• Get treatment for conditions that increase your risk for thrush. These include diabetes, human immunodeficiency virus (HIV), or cancer.
• Use a spacer when taking inhaled corticosteroids. Rinse your mouth after you inhale the dose.

Symptoms

In babies

Thrush can be a mild infection that causes no symptoms. If a baby has symptoms, they may include:

• White patches inside the mouth and on the tongue. The white patches look like cottage cheese or milk curds. Thrush is often mistaken for milk or formula. The patches stick to the mouth and tongue and can't be easily wiped away. When rubbed, the patches may bleed.
• A sore mouth and tongue and trouble swallowing. If the infant can't eat because of a sore mouth or throat, the infant may act fussy.
• Poor appetite. The infant may refuse to eat, which can be mistaken for lack of hunger or poor milk supply.
• Diaper rash. This may occur because the yeast that causes thrush also will be in the baby's stool.

In adults

Thrush can be a mild infection that causes no symptoms. If an adult has symptoms, they may include:

• A burning feeling in the mouth and throat. This occurs at the start of a thrush infection.
• White patches that stick to the mouth and tongue. The patches look like cottage cheese or milk curds. The tissue around the patches may be red, raw, and painful. If rubbed (during tooth brushing, for example), the patches and the tissue of the mouth may bleed easily.
• A bad taste in the mouth or trouble tasting foods. Some adults say they feel like they have cotton in their mouth.

If you breastfeed, you may get a yeast infection of your nipples if your baby has thrush. This can cause sore, red nipples. You may also have a severe burning pain in your nipples during and after breastfeeding.

When to Call a Doctor

Contact your doctor today if you or your child has been diagnosed with thrush and:

• You have symptoms that show the infection may be spreading, such as white patches on the skin outside of the mouth.
• Your symptoms are getting worse or have not improved within 7 days of starting treatment.
• Your symptoms come back often.
• You have HIV infection, cancer, or another condition that weakens your immune system.
• You are breastfeeding and develop redness or pain in your nipples.

Watchful waiting

If you have been diagnosed with thrush before and you believe you may have it again, home treatment may help. Very mild cases of thrush may clear up without medical treatment.

Treatment Overview

In babies

In healthy infants, thrush usually isn't a serious problem and is easily treated and cured. Except for the mildest cases, you should treat thrush to keep the infection from spreading.

Thrush is usually treated with prescribed antifungal medicine such as nystatin liquid. In most cases, you will put the medicine right on the white patches.

The yeast can cause a diaper rash at the same time as thrush. Your doctor may prescribe nystatin cream or ointment for your baby's diaper area.

Mild thrush is usually treated until at least 48 hours after the symptoms have gone away. For some severe infections, a longer treatment period may be needed.

In adults

Thrush is usually treated with antifungal medicines. These are either applied directly to the affected area (topical) or swallowed (oral).

Mild thrush

You will probably use antifungal medicine that goes directly on the white patches, such as a mouth rinse or a lozenge. Treatment usually lasts about 14 days.

Moderate to severe thrush

Thrush that spreads to the esophagus can cause a more severe infection. This is treated with antifungal pills. A topical antifungal medicine may also be used.

For some severe infections, treatment may last longer than 14 days.

Persistent or recurrent thrush

Persistent or recurrent cases of thrush may:

• Need to be treated twice as long as the symptoms last.
• Require treatment with both oral and topical medicines.

People with weakened immune systems may need to keep taking antifungal medicine to prevent thrush.

Self-Care

Caring for your child

• If your child is eating solid foods, you can massage plain, unflavored yogurt around the inside of your child's mouth. Check the label to make sure that the yogurt contains live cultures. Yogurt may help healthy bacteria grow in the mouth. These bacteria can stop yeast growth.
• Be safe with medicines. Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with any medicines.
• Clean pacifiers, bottle nipples, and other bottle or pumping supplies as usual with warm, soapy water. Talk to your doctor about whether you need to sanitize these items.
• If you are breastfeeding, talk to your doctor about whether you need treatment.

Caring for yourself

Here are some tips for managing thrush at home.

• Drink cold liquids. Examples include water or iced tea. You can also eat flavored ice treats or frozen juices.
• Eat foods that are easy to swallow. Examples include gelatin, ice cream, or custard.
• If the thrush patches are painful, try drinking from a straw.
• Rinse your mouth several times a day with a warm saltwater rinse. You can make the saltwater mixture with 1 tsp salt in 8 fl oz (236.6 mL) of warm water.