Canker sores, also known as aphthous ulcers, are small, painful lesions that can develop inside the mouth. These ulcers typically appear as white or yellow spots surrounded by a red border. While more commonly associated with older children and adults, infants can also develop canker sores. Although they can cause discomfort, especially during feeding, canker sores are generally not serious in babies and usually resolve on their own.
Recognizing Canker Sores in Infants
Identifying canker sores in a baby involves observing both physical signs and changes in behavior. Canker sores in infants typically present as small, round or oval lesions with a distinctive white or yellowish center and a red, inflamed border. These sores can appear in various locations within the mouth, including the inside of the cheeks, lips, on the tongue, gums, or the soft palate. They usually measure less than 5 millimeters in diameter, though larger ones can occur.
A baby’s behavior often signals the presence of these painful sores. Increased fussiness, irritability, or crying, particularly during feeding times, can be an indication. Babies with canker sores might refuse to eat or drink, show difficulty swallowing, or drool more than usual due to the discomfort. Sleep disturbances may also occur.
Common Causes and Triggers
The precise cause of canker sores is often unclear, but several factors are thought to contribute to their development in infants. Minor oral injuries are a common trigger, which can result from accidental biting of the cheek or tongue, irritation from rough foods, or even trauma from pacifier use. Dental procedures or teeth cleaning can also sometimes lead to the formation of these sores.
Nutritional deficiencies, such as insufficient intake of iron, folate, vitamin B12, or zinc, have been linked to canker sores. Stress can also play a role, as can sensitivities to certain foods like acidic fruits, spicy items, chocolate, or coffee. There is also evidence to suggest a genetic predisposition.
Providing Comfort and When to See a Doctor
Providing comfort for a baby with canker sores involves alleviating pain and preventing further irritation. Offer cool liquids, such as water or diluted juice, or cold foods like ice pops, to help numb the area and encourage fluid intake. Avoid hot, spicy, acidic, or rough foods that could further irritate the sores. Gentle oral hygiene, using a soft-bristle toothbrush, can prevent additional trauma. Over-the-counter pain relievers approved for infants, like acetaminophen or ibuprofen, can be administered to manage discomfort; however, it is important to consult a pediatrician for appropriate dosage guidance. Seek medical attention if the baby:
Refuses to feed.
Shows signs of dehydration such as fewer wet diapers, dry mouth, or sunken eyes.
Develops a high fever.
Sores are unusually large or numerous.
Sores last longer than two weeks.
There are signs of a secondary infection, such as increased redness or pus.
Differentiating from Other Oral Conditions
Distinguishing canker sores from other oral conditions is important. Oral thrush, a fungal infection, appears as white, cottage cheese-like patches on the tongue, inner cheeks, or lips that cannot be easily wiped away. Unlike canker sores, thrush is caused by an overgrowth of yeast and can make feeding difficult. Cold sores, caused by the herpes simplex virus, typically manifest as fluid-filled blisters that eventually crust over. These usually appear outside the mouth, on the lips, or around the nose, and are highly contagious. Canker sores, in contrast, are not contagious and form inside the mouth. Hand, Foot, and Mouth Disease (HFMD) is a viral infection characterized by painful mouth sores along with a rash of blisters on the palms of the hands, soles of the feet, and sometimes the buttocks. HFMD often includes fever and can be highly contagious. If there is any uncertainty regarding the nature of a baby’s oral lesions, consulting a pediatrician for an accurate diagnosis is recommended.