Candidiasis, commonly known as a yeast infection, is a fungal infection caused by an overgrowth of Candida species, most often Candida albicans. This organism naturally lives on and inside the human body without causing harm, but an imbalance allows the fungus to flourish and cause infection. Children can get yeast infections, but the presentation in infants and young children differs from adults. Infections usually involve a child’s mucous membranes or skin folds rather than the genital tract.
Where Yeast Infections Occur in Children
The two most frequent locations for Candida overgrowth in children are the mouth and the diaper area. Oral candidiasis, commonly called thrush, appears as creamy white lesions inside the mouth, particularly on the tongue, inner cheeks, gums, or the roof of the mouth. These patches often resemble cottage cheese but cannot be easily wiped away like milk residue. Thrush can cause discomfort and difficulty feeding, as the soreness affects a baby’s ability to suck.
The infection is often acquired early in life, sometimes during birth as the baby passes through the birth canal, or later from contaminated items like pacifiers or bottle nipples. Diaper candidiasis, also known as a yeast diaper rash, is another common manifestation of this fungal overgrowth. This rash is distinct from a typical irritant diaper rash, appearing bright red or purplish with sharp, raised borders.
A distinguishing characteristic of yeast diaper rash is the presence of small, red spots, sometimes called “satellite lesions,” that pop up outside the main rash area. The rash tends to be found in warm, moist, deep skin folds, such as the creases of the groin and upper thighs. Unlike a standard rash that may improve with barrier creams, a yeast diaper rash will persist or worsen without specific antifungal treatment.
Key Risk Factors and Triggers
Candida requires specific conditions to transition from a harmless resident to an infectious agent, and several factors predispose children to this overgrowth. One of the most common triggers is the use of antibiotics. Antibiotics kill harmful bacteria and also the beneficial bacteria that normally control Candida populations, allowing the yeast to flourish unchecked.
Prolonged moisture and warmth create an ideal environment for the fungus to thrive, making diaper-wearing infants particularly susceptible. Extended exposure to wet diapers or a humid climate increases skin irritation, compromising the skin barrier and allowing Candida to take hold. Infants are also naturally more susceptible because their developing immune systems cannot regulate the balance of microorganisms as effectively as an adult’s. Medications like inhaled steroids, often used for asthma, can increase the risk of oral thrush by suppressing local immunity in the mouth.
Effective Treatment and Prevention Strategies
Treating a yeast infection requires specific antifungal medications, as standard creams or remedies will not resolve the fungal overgrowth. For oral thrush, a healthcare provider prescribes an oral antifungal suspension, such as nystatin, applied directly to the lesions in the mouth. The treatment period is generally several days, and it is important to continue the medication for the full course to prevent recurrence.
Diaper candidiasis is treated with topical antifungal creams containing agents like clotrimazole or miconazole, which may be available over-the-counter, or a prescription-strength nystatin ointment. After applying the antifungal, a barrier cream, often containing zinc oxide, can be applied over the top to protect the skin from further moisture and irritation. For prevention, parents should change diapers frequently to minimize the time skin is exposed to wetness and stool.
Allowing the skin to air dry completely after cleaning and ensuring all skin folds are thoroughly dried can help eliminate the moist environment Candida prefers. Sterilization of items that enter the baby’s mouth, such as pacifiers and bottle nipples, is also a preventative measure to avoid re-infection. Parents should contact their child’s doctor if the rash does not improve after three to five days of treatment, if the child develops a fever, or if the rash presents with open sores or spreads beyond the diaper area, as this may indicate a secondary bacterial infection or a more severe condition.