Are you starting to see small whitish spots appearing in your baby's mouth? He refuses to breastfeed? Maybe it's just sour milk, but it can also be oral thrush. How to recognize it? What are the treatments ? And can we prevent it? A dermatologist answers us.
No, it's not a flower, it's a mushroom. Oral thrush in babies is mucosal pathology caused by the presence of a fungal infection (Candida Albicans). You may have heard of it before, it is indeed the same fungus responsible for vaginal yeast infection in women. This is probably how a baby can get it, coming into contact with the mother's contaminated genitalia during childbirth. This mild infection affects between 5 and 7% of infants and is usually caught in the first few months of life, when the baby's immunity is not yet sufficiently developed.
What are the symptoms ?
Although the comparison may make you smile, the appearance of an oral lily of the valley is somewhat reminiscent of the proliferation of small white flowers. In reality, it is whitish deposits, which is often confused with curd residue.
How to differentiate them? After washing your hands properly or with a glove, gently scratch your baby's oral mucosa (without the fingernails) and see if the material comes off. In the case of pieces of curdled milk, these will go away on their own, while lily of the valley is a little adherent. For Catherine Gaucher, dermatologist, "This is a simple and effective way to get a first impression. The “old” doctors did this during their clinical examination. Today we will be more inclined to realize in first intention a sample and at send it to a lab to be fixed. However, the results can be falsified and appear negative even though the fungus is there … "
For babies, oral thrush can be very bothersome and prevent them from feeding properly or be painful. In doubt, see a doctor.
Is it serious ?
In principle, it is a disease completely benign and not serious. It usually responds quite well to treatment and goes away within a few days. On the other hand, if oral thrush recurs frequently in a baby, then it is important to look for other possible causes for this regular presence of Candida Albicans. Indeed, even if this infection does not represent a danger in itself, it can nevertheless be the warning sign of another disease, if contracted repeatedly.
How do you treat oral thrush?
Just like with vaginal yeast infection, the doctor will prescribe antifungals to fight against the overgrowth of the yeast infection. In babies, this treatment will be given in gel form (DAKTARIN type) to put in the mouth. This product can of course be swallowed, but it is important to Line it well on the mucous membranes so that it can take effect before going into the intestines.
To facilitate this operation, Catherine Gaucher recommends positioning the gel on what the baby is going to suck. “Before feeding, you can apply a small dab on the mother's nipple or on the nipple of the bottle so that the gel stays in contact with the baby's oral mucosa long enough before it is swallowed. This is usually repeated two to three times a day. "
Contact with the mouth is important, but ingestion of the product in the intestines is just as important according to the dermatologist. "Indeed, what is present on the oral mucosa is obviously also a little in the intestine, so it must be cleaned in turn. Often a baby who has oral thrush then develops it in the breech area, as the fungi move down into the intestine and so on. It will therefore be necessary also treat it for that. "
The Candida Albicans thrives in acidic environments, so you can try to reduce the acidity in your baby's oral lining by applying a small amount of baking soda. After diluting it in water, run some over the whitish deposits with clean hands. Be careful, however, dilute the bicarbonate well and not to apply the product in concentrated form. Although effective at the time, this method does not allow oral thrush to disappear completely and permanently. Antifungal treatment is usually always necessary.
Are there possible complications?
In all bacterial or fungal diseases in infants, there is always a risk of complications, as the immunity is not sufficiently developed. Take the example of a staphylococcus. This can remain on the skin, but can also enter the body and cause sepsis. The same is true for Candida, although it is extremely rare. The vast majority of oral thrush in babies are completely benign and do not affect other organs.
Antibiotics are among the elements that can aggravate yeast infection or candidiasis. In fact, this type of bacteria can evolve in a baby's mouth or a woman's vagina undetected, because it is not violent and latent enough. A baby is often given antibiotics for another illness and this can be the cause of the development of oral thrush. If a child has already contracted one from a very young age and ingests an antibiotic a few months later, they should be monitored closely because new candidiasis may develop.
Can we prevent oral thrush?
In a child who has had oral thrush in the past, it can be anticipated that it will come back each time he is given an antibiotic. While trying to always have his tube of DAKTARIN on hand, do not hesitate to put a little in the mouth on this occasion.
In slightly older children and even in babies, they should not be habituated sugar because the acidity promotes the development of candidiasis. According to Catherine Gaucher, "Being careful about what we feed our children is a good way to prevent the development of certain bacteria. Homeopathy can also help a lot thanks to its global management of the field. "
Many thanks to dermatologist Catherine Gaucher, member of the Saint-Jacques Hospital association, for her expertise.