When you have a new baby, your whole world changes. Along with motherhood comes a range of new experiences you must learn… including identifying various health conditions.
One common issue many new moms face relates to a white coating on their baby’s tongue. Is it just a milk residue on the baby’s tongue? Or could it be a more serious issue, namely newborn thrush (or oral thrush)? If you too have a newborn thrush vs milk tongue dilemma, we’re here to help.
Milk tongue vs thrush: Identifying the Two
Milk Tongue
Almost all newborns will have a white coating on their tongues or milk residue on baby tongue—known as “milk tongue.” This is not surprising given that their main source of food for six months is milk. If a little one is formula-fed, the coating might look a bit thicker.
White on baby tongue
As newborns have less saliva in their mouth compared to older children, they are unable to wash away the milk, thus accumulating as a milk residue on baby tongue.
Moreover, more often than not, the “milk tongue” coating gets automatically brushed off as your baby nurses, and his tongue brushes against the hard palate of his mouth. When the tongue does not reach the hard palate, some babies might develop persistent “milk tongue.”
This lack of friction between the tongue and hard palate might be caused by:
- Tongue tie: This happens when the tissue that connects the tongue to the bottom of the mouth (the frenulum), is too short. This restricts movement of the tongue, hindering it from touching the roof of the mouth. In turn, this absence of friction may cause “milk tongue.” Tongue tie can be rectified by a simple medical procedure, which you can read about here.
- A high, hard palate: If the hard palate (the top of the mouth) is too arched for the tongue to rub against, it could lead to milk residue on the tongue. If you suspect your little one’s hard palate is high, or arched, speak to a pediatrician. She/he will determine if this is the case, and then tell you what to do about it.
If you have nipple thrush, this could morph into oral thrush in your baby when you breastfeed.
Oral Thrush
Before you panic, please know that oral thrush is a very common condition in newborns and even older babies.
Oral thrush is caused by a fungus called Candida Albicans. According to medical experts at the National Health Service, UK (NHS), this fungus is present in the mouth of healthy people and it usually doesn’t cause problems. But sometimes, it can overgrow and infect the membranes in the mouth.
Candida lives on the surface of the skin and inside the body in areas like the mouth, throat, gut, and vagina.
The immune system of a newborn is not fully functional until after birth. The weakened immune system of a newborn may make him or her more susceptible to infection, allowing Candida to grow and produce mouth thrush. Because yeast flourishes in damp, warm environments, the mouth is ideal for a yeast infection.
What causes it?
It’s common for babies to have white on their tongues as milk residue could be the most common reason, although it could also be a sign of oral thrush.
If your baby has recently been given antibiotics, a “side effect” might be oral thrush. This is because the levels of “good” bacteria in your baby’s mouth are reduced by the antibiotics, allowing the growth of fungus levels.
Dr. Pratibha Agarwal, a consultant pediatrician for Kinder Clinic, explains that oral thrush in babies may also occur more commonly when the mum has a vaginal fungal infection or if she’s been on antibiotics for a long time.
This infection can then be passed on to her baby during breastfeeding if the mom’s nipples (nipple thrush) are affected, resulting in oral thrush in the baby.
Now that you know what causes the two conditions, we’re back to this question: newborn thrush vs milk tongue – how can you tell the difference?
It’s easy to clean your newborn’s tongue. Just use a soft cloth or clean piece of damp gauze to do so. If it’s milk tongue, the patches will come off easily. Image: YouTube screengrab
Symptoms of Oral thrush
Oral thrush symptoms in babies include:
- White patches in the cheeks, tongue, gums and roof of the mouth
- White mouth sores
- Redness in the mouth
- Cracked corners of the mouth
- Fussy feeling during feeding
- Clicking sound during feeding
- Diaper rash
Milk tongue vs thrush: Spotting the Difference
Because they look so similar, oral thrush and milk tongue are frequently confused. Which is it in your newborn: milk tongue or oral thrush?
It’s actually quite simple to spot the difference. If it’s milk tongue, the white residue will easily come off when brushed gently with a soft, damp cloth, revealing a healthy, pink tongue underneath.
But if it’s newborn oral thrush, the white patches will not come off easily and may even bleed if you try too hard to remove them. Untreated newborn thrush may even be painful, resulting in your newborn being fussy at your breast.
Newborn thrush vs milk tongue. | Image from Shutterstock
Moms, you’ll be relieved to know that oral thrush in most instances, is not dangerous. The treatment of oral thrush may be in the form of an oral anti-fungal gel applied to the inside of the mouth. An anti-fungal suspension may also be prescribed to be taken orally.
You’ll want the medicine to stay on their tongue or inside their mouth for as long as possible for it to work. So, give your baby the medicine at least 30 minutes before feeding.
You should expect the infection to clear up in a few days after administering the treatment.
You can also help your breastfeeding baby by reducing your sugar intake while he is being treated for the thrush.
Home remedies: How to get rid of white tongue on baby
These home treatments may be miracle cures but exercise with great caution! Remember that the best way to go is still under a medical treatment recommended by your doctor.
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Baking Soda
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- About ½ teaspoon of baking soda to 1 cup of boiled, cooled water.
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Tea tree oil
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- 1-2 drops to ½ cup of boiled, cooled water.
- * Use a clean cotton bud to wipe either solution in your baby’s mouth.
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Virgin coconut oil
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- According to one study, coconut oil can be used to treat fungal infections, which is especially important today that drug-resistant Candida species are on the rise.
How to clean baby tongue thrush
Bacteria can be found in a baby’s mouth just like they can in yours. Cleaning your baby’s tongue may seem superfluous if he or she isn’t consuming solid meals or hasn’t developed teeth yet. Oral hygiene isn’t just for older kids and adults; babies’ mouths need to be cleaned as well, and the sooner you start, the better.
Cleaning the white on baby tongue is an easy process. All you need are warm water and a washcloth or piece of gauze.
Start by washing your hands with soap and water. Next, support your baby by laying her down on your lap and holding her head by your hand. Dip the cloth into the warm water and lightly rub your baby’s tongue in a circular motion using the cloth. Softly rub over her gums and on the inside of her cheeks too.
You can also gently massage and clean away milk residue from your baby’s tongue and gums with a gentle finger brush. Brush your baby’s tongue at least twice a day, if possible.
Remember that a milk residue on a baby’s tongue is different from an oral thrush! Oral thrush goes away with proper medication so be sure to contact a medical professional for help.
Prevention of Newborn Oral Thrush
Here are some tips you can adopt to prevent your baby from an oral thrush:
- After each feeding, gently wipe or brush your baby’s mouth.
- Keep all equipment used for feeding sterilized.
- You can also sterilize pacifiers and toys that your baby may put into his mouth.
- If a pregnant mum has a vaginal yeast infection, she should get treated for it to prevent transmitting the infection to the baby during the process of a normal birth.
- If you’re pumping your milk, keep it refrigerated until you’re ready to consume it to avoid yeast growth.
- A breastfeeding mum with a fungal infection around the nipple area should get treated for it immediately. This will prevent the infection from continuously passing to and from between her and her baby.
- Change your breast pads frequently and wash your breastfeeding bras in hot water to avoid recurrent infections.
- If a child is on prolonged antibiotics, taking probiotics may help restore the balance of oral and gut flora. This reduces the likelihood of a condition like oral thrush.
- Wash your hands well after changing your little one’s diaper. This helps prevent the spread of thrush as the fungus can be passed through your baby’s digestive system.
- Consider lowering your sugar intake. According to a 2017 study, greater glucose levels may enhance Candida growth.
Image from iStock
When to see the doctor?
Immediately call your doctor when you notice white on the baby’s tongue, is not milk residue, and is difficult to clean or remove. It could be oral thrush, or if it was something else, your pediatrician can run tests and give you the proper medication.
If your nipples are breasts are also sore and may have been caused by your baby’s oral thrush, visit your doctor and have it checked.
Both of you must be treated simultaneously to prevent recurring infections.
We hope this article has helped solve your newborn thrush vs milk tongue problem. To learn about nipple thrush in breastfeeding mums, click this link.
Additional information from Margaux Dolores
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