Oral Thrush in Toddlers: Symptoms and Treatment Guidance

Children with oral thrush?

Hello Dr.
Zhang,
My child is 13 months old and has recently been ill with diarrhea for two to three days.
We visited the hospital, received medication, and his bowel movements have returned to normal.
However, he has developed oral thrush.
The doctor prescribed cough syrup, nasal decongestants, anti-inflammatory pain relief syrup, an oral thrush topical treatment, and fever reducers.
Today marks the fourth day of treatment, but his temperature has remained elevated between 37°C and 38.2°C without improvement.
He is drinking milk relatively normally, but his mouth has white spots, redness, and swelling, and he is not drinking much water.
Should we continue administering the prescribed medications even though he no longer has a cough or nasal congestion? Could the inflammation in his mouth be the cause of his fever? Should we continue using the anti-inflammatory pain relief syrup? What else should we be aware of? Also, how much longer might this condition last? Seeing him in discomfort is quite distressing.

Thank you for your guidance!
Concerned mother

Amy, 20~29 year old female. Ask Date: 2004/09/25

Dr. Zhang Jinglong reply Pediatrics

Dear user, due to the busy schedule of Dr.
Chang Ching-Lung, Dr.
Chang Kuo-Chen is responding on his behalf.
We apologize for any inconvenience.
Generally, a fever should not persist for so many days, and oral thrush is unlikely to cause a fever.
Based on the reported symptoms, herpetic gingivostomatitis cannot be ruled out.
It is advisable to visit a hospital for a more accurate diagnosis by a physician.

Reply Date: 2004/09/25

More Info

Dear Concerned Parent,
Thank you for reaching out regarding your 13-month-old child who is experiencing oral thrush, commonly known as "ge口瘡" in Mandarin. I understand how distressing it can be to see your little one uncomfortable and unwell. Let’s discuss the symptoms, treatment options, and what you can do to help your child recover.

Understanding Oral Thrush:
Oral thrush is a fungal infection caused by an overgrowth of Candida, a type of yeast that naturally exists in the mouth. It can lead to white patches on the tongue, inner cheeks, gums, and sometimes the roof of the mouth. Symptoms often include:
- White patches in the mouth that may bleed when scraped.

- Redness and soreness in the mouth.

- Difficulty swallowing or eating.

- A burning sensation in the mouth.

- In severe cases, it can lead to a fever.

In your child's case, the presence of white spots and redness in the mouth, along with a mild fever, suggests that the thrush may be causing discomfort and possibly contributing to the fever.
Treatment Guidance:
It’s good to hear that your child has been prescribed medication for both the thrush and other symptoms like cough and nasal congestion. Here are some considerations regarding the treatment:
1. Antifungal Medication: The topical antifungal treatment prescribed for the oral thrush should be continued as directed by your healthcare provider. This medication is crucial in reducing the yeast overgrowth and alleviating symptoms.

2. Anti-inflammatory and Pain Relief: The anti-inflammatory and pain relief medication can help manage discomfort. If your child is still experiencing pain or discomfort in the mouth, it is advisable to continue this medication as well.

3. Hydration: Since your child is having difficulty drinking water, it’s essential to ensure they stay hydrated. You might try offering diluted juice or electrolyte solutions if they are more palatable. Avoid acidic drinks, as they can irritate the mouth further.

4. Monitoring Fever: A persistent fever of 37-38.2°C (98.6-100.8°F) can be concerning. While it may be related to the oral thrush, it’s essential to monitor your child closely. If the fever persists beyond a few days or rises significantly, consult your pediatrician.

5. Dietary Considerations: Soft foods that are easy to swallow may be more acceptable for your child during this time. Foods like yogurt (which can also help restore healthy bacteria), applesauce, and mashed bananas can be soothing.

6. Follow-up Care: Since your child has been on medication for four days without significant improvement, it may be wise to follow up with your pediatrician. They can assess whether the current treatment is effective or if adjustments are needed.

Duration of Illness:
The duration of oral thrush can vary. With appropriate treatment, many children see improvement within a week. However, if symptoms persist or worsen, further evaluation may be necessary to rule out any underlying issues.

Final Thoughts:
It’s understandable to feel worried when your child is unwell. Continue to provide comfort and care, and don’t hesitate to reach out to your healthcare provider for any concerns or if you feel your child’s condition is not improving. Your vigilance is crucial in ensuring your child receives the best care possible.

Wishing your little one a speedy recovery!
Best regards,
Doctor Q&A Teams

Similar Q&A

Understanding Oral Thrush in Children: Treatment Options and Side Effects

My child has been suffering from oral thrush that hasn't improved. The doctor prescribed a topical antibiotic, Mycostatin. What side effects might occur if I continue to apply it? If I don't apply the medication, will the oral thrush resolve on its own?

Dr. Wang Jiayi reply Pediatrics
Long-term use of Mycostatin rarely results in significant side effects. In addition to medication treatment for oral thrush, it is important to disinfect all items that come into contact with the mouth, including bottles and pacifiers. Regular medical check-ups and assessing immu...

Why Does My Baby Keep Getting Oral Thrush? Understanding Recurrences

Hello Doctor, I consulted you on February 25th regarding my concerns about my baby, who has just turned six months old. Since birth, my baby has experienced oral thrush six times. The attending physician recommended tests to check for any issues with the immune system. The test r...

Dr. Zhao Chongliang reply Internal Medicine
Oral thrush is a common condition in infants, partly due to their physiological leukopenia, which limits their ability to phagocytize fungi (Candida). Additionally, infants who rely solely on breast milk or formula may have lower levels of vitamin B2 and zinc, making them less ca...

Understanding Thrush in Infants: Causes, Symptoms, and Treatment Tips

Dear Dr. Pei, I would like to ask you a few questions. (1) My child has not yet recovered from oral thrush and has returned for a second consultation (at a different hospital). The second pediatrician believes that the reason for the persistent condition may be that the medicati...

Dr. Pei Rensheng reply Pediatrics
Dear Xiaofen, Hello! (1) Oral thrush is a type of candidiasis infection. Infants and young children with normal or compromised health, those who have used antibiotics or corticosteroids, and individuals with congenital or acquired immunodeficiency are all at risk for developin...

Understanding Itchy Tongue in Children: Possible Causes and Treatments

A 7-year-old child has been experiencing persistent itching of the tongue. They have been treated for suspected oral candidiasis and have been taking fluconazole for 7 days. However, the child still experiences intermittent itching, which has been shifting locations on the left s...

Dr. Zeng Guanghui reply Dentistry
Hello, it is recommended to consult an oral surgeon for further examination. Thank you.