A white coating on a newborn’s tongue is common, often concerning new parents. Understanding its cause helps determine if it’s harmless or requires attention.
Is It Milk or Something More?
A white appearance on a newborn’s tongue is often simply residue from milk after feeding. This milk film appears as a thin, uniform layer that covers the tongue. It can typically be gently wiped away with a soft, clean cloth or gauze, revealing the pink tongue underneath.
If the white coating does not easily wipe off, or if it reappears quickly after wiping, it might suggest something more than just milk. Patches that are thick, raised, and resemble cottage cheese are less likely to be milk. Observing the baby’s feeding behavior can also provide clues, as milk residue usually causes no discomfort.
What is Oral Thrush?
When the white coating on a newborn’s tongue is not easily removed, it may indicate oral thrush, which is a common yeast infection. This condition is caused by an overgrowth of Candida albicans, a fungus naturally present in the body. While Candida is present in the body, an immature immune system in newborns can allow it to proliferate.
Newborns can acquire Candida during passage through the birth canal if the mother has a vaginal yeast infection. The fungus can also be transmitted through breastfeeding if the mother’s nipples have a yeast infection, or from contaminated bottles and pacifiers. Beyond the tongue, oral thrush often presents as white or yellowish patches on the inner cheeks, gums, and roof of the mouth. These patches are raised and may bleed slightly if scraped.
Babies with oral thrush might exhibit fussiness during feedings, pulling away from the breast or bottle due to discomfort. The soreness caused by the infection can make swallowing painful, leading to reduced feeding and irritability. It is a localized infection of the mouth, distinct from systemic issues.
When to Seek Help and What to Expect
Parents should consult a pediatrician if the white coating on their newborn’s tongue does not wipe away easily or if it persists for several days. Other signs that warrant medical attention include the baby refusing to feed, showing signs of pain or discomfort during feeding, or if the white patches spread beyond the tongue to other areas of the mouth. A fever in conjunction with oral patches also suggests the need for a medical evaluation.
During a doctor’s visit, the pediatrician will examine the baby’s mouth to visually diagnose oral thrush. In most cases, a physical examination is sufficient, and no further tests are required. The common treatment involves an antifungal medication, such as nystatin, which is prescribed as a liquid solution. This solution is applied directly to the affected areas in the baby’s mouth, usually several times a day for a specified duration.
To prevent recurrence, parents are advised to sterilize pacifiers, bottle nipples, and any toys that the baby puts in their mouth. If the baby is breastfed, the mother may also need treatment for a fungal infection on her nipples to prevent reinfection of the baby. Maintaining good hygiene practices for all feeding equipment is a preventative measure.