Children - Oral thrush

Question 1

Oral thrush

Answer 1

• Mild fungal infection affecting the mouth and throat
• Overgrowth of candida albicans causes the symptoms

Question 2

What can oral thrush be caused by?

Answer 2

• Recent course of antibiotic medication
• if you are breast-feeding and you have recently been on antibiotics yourself, the levels of your healthy bacteria can be affected. This can make you, or your baby, more likely to develop thrush.

Question 3

Risk factors for oral thrush?

Answer 3

• Are they on inhalers? Steroid inhalers?
• Diabetes?
• Immunosuppressed?
• Abx?
• Any other symptoms? Colds?
• Born prematurely

Question 4

Symptoms of oral thrush

Answer 4

• white patches are known as plaques; resemble milk curds
• not so easily removed from the mucosa
• when the surface of the plaque is scraped away, a sore and reddened area of mucosa will be seen underneath, which may sometimes bleed.

Question 5

Treatment for oral thrush

Answer 5

Antifungal preparations
Miconazole oral gel – Daktarin oral gel®

Question 6

Daktarin oral gel®

Answer 6

• miconazole
• 4 months+
• Apply with clean finger or cotton bud (between 2 – 4 times a day)
• Continue treatment for 7 days after symptoms have cleared
• Make sure that the gel does not become a choking hazard by making sure you place the gel at the front of the mouth
• Don’t administer to the baby by putting on nipples, this can be a choking hazard

Question 7

Non-pharmacological Treatment

Answer 7

To avoid re-infection:
Sterilise bottles and feeding equipment
Sterilise any toys that the baby puts in their mouth
Washing hands thoroughly after changing the baby’s nappy

Question 8

Referral for oral thrush

Answer 8

Babies aged < 4 months
Persistent or recurrent infections
If there is fungal infection in the nappy area
Older children, especially if not linked to inhalers or broad spectrum antibiotics
Failure of treatment
Nipples affected – causing pain in breast? of mother