A young mother tries to notice the first signs of any disease in her baby, so she closely looks at every fold and spot on the baby’s skin. Many parents have encountered such a phenomenon as a white coating on the tongue of a baby. In most cases, this is considered normal, but there are exceptions in which you need to consult a doctor. What factors need to be considered? Why does my baby have a white coating on his tongue? First of all, it is important to understand the baby’s nutrition: whether he drinks breast milk or is fed a special baby formula.
White coating on the tongue of a baby during breastfeeding
Mother's milk is not as rich as formula, so in the first months the baby may nurse almost every 30 minutes. Due to the constant presence of milk in the mouth, a baby may have a coating on his tongue throughout the day, and this is absolutely normal. Until approximately 3-4 months of life, the baby's salivary glands are underdeveloped and do not produce enough saliva. This is why a white coating forms on the baby’s tongue.
There is no need to clean off such a coating on a baby’s tongue; it does not bother the baby at all and does not cause discomfort, because it is ordinary mother’s milk, which does not have time to be washed off the tongue. When the baby’s condition is normal, he is cheerful, cheerful and actively suckles at the breast - there is no reason to worry.
Signs of pathology
A congenital defect of the frenulum is detected by a number of signs. They are visible to the naked eye and are diagnosed by a doctor during the initial examination of the newborn.
The main one is the unusual shape of the tongue with the tip slightly pulled down. It looks a bit like a small heart.
There are secondary factors that manifest themselves during feeding in the baby and the mother:
- The baby smacks his lips and releases the nipple, which increases the duration of the feeding session and, in general, it becomes quite difficult to feed the baby.
- Without eating, the baby gains weight worse.
- Due to poor nutrition, colic occurs more often in a child. He regurgitates food.
- The pathology does not allow the newborn to hold the mother's breast correctly, which is why cracks and bite marks remain on the nipple, and less milk is produced.
If these symptoms appear, you should take a close look at the child.
White coating on the tongue of a bottle-fed baby
Formula-fed babies, like infants, eat very often in the first months of life and are thus constantly in contact with milk. Residues from such food may remain on the baby's tongue and cause plaque to form. However, in such children, the plaque should disappear 1-2 hours after feeding, since the intervals between meals are slightly longer than when breastfeeding.
The deposits from milk or formula are easily washed off with water, so you can do a little experiment. Invite your baby to drink water from a bottle or spoon (it should wash away most of the plaque), but if this does not happen, then you better contact your pediatrician. The doctor will be able to find out the cause of the white plaque in the baby and prescribe appropriate treatment. What else can cause deposits in a baby's mouth?
Causes of the defect
The most common cause of the defect, provoking half of the cases, is a genetic predisposition and hereditary factor.
Another reason is the use of hormonal medications and antibiotics by a pregnant woman. Moreover, the most dangerous period is the first trimester of gestation. This factor also influences the formation of other oral pathologies.
A certain motivating factor in the formation of pathology can be late pregnancy - after 35 years, but this is not at all necessary and has a negligible effect.
The exact causes of this problem have not been studied, so sometimes it appears even without obvious reasons.
Causes of white plaque on a child’s tongue
Let's find out the opinions of professionals. What does Dr. Komarovsky say about plaque on the tongue in infants? Like most doctors, he identifies the following reasons:
- dysbacteriosis and gastritis;
- stomatitis;
- intestinal dysfunction;
- other pathologies.
Every mother should arm herself with recommendations that will help her prevent a similar condition in her child. After plaque has already appeared, be sure to consult a doctor who can determine the exact cause of its appearance and prescribe the necessary treatment.
Features of consistency and thickness of plaque
By paying attention to the thickness and consistency of the plaque covering the tongue, you can identify the reason why it appeared:
- a thin layer of wet plaque - occurs after feeding or regurgitation;
- a thin layer of dry deposits – an allergic reaction;
- thick whitish coating – indicates dysbacteriosis;
- viscous dense formations of white color - gastritis with high acidity;
- dense cheesy – viral stomatitis;
- thick, loose plaque – thrush or candidiasis.
Maybe it's thrush?
Thrush, or candidiasis, is an infectious disease caused by fungi (Candida). Doctors often use the term “candidiasis” and claim that most children under one year of age suffer from this disease. The appearance of thrush most often manifests itself in the first 3 months of a child’s life, since during this period of life his oral cavity is not yet populated by healthy microorganisms, and the immune system, alas, is not strong enough.
What is the cause of plaque on the tongue of a baby at an older age? It happens that the immune system does not work properly and a fungal infection appears in the child's mouth or cheeks. Against the background of reduced immunity, for example after a respiratory viral infection, the risk of developing thrush increases.
Fungal infection
The development of thrush in the child’s mouth occurs as a result of the growth of Candida fungi. Intensive reproduction of pathogenic microorganisms occurs as a result of the influence of various factors.
Often babies become infected with thrush during childbirth, crossing the birth canal
These include:
- Weakened immune system.
- Dysfunctions of the microflora of the gastrointestinal tract.
- Hormonal disorders.
- Conducting antibacterial therapy.
- Excessive dryness of the oral mucosa.
Infection with Candida fungi occurs under the following conditions:
- In utero. Infection can occur through the placenta, umbilical cord and amniotic fluid.
- During childbirth. Often babies become infected with thrush during childbirth, crossing the birth canal. Therefore, it is important for women to exclude the development of thrush, especially in the last stages of pregnancy.
- Finding a child in a hospital and maternity hospital. Inappropriate and non-sterile care of the child contributes to the child becoming infected from health care workers.
- Poor sanitary conditions at home. Babies are born with a weakened immune system. Therefore, keeping a child in an unsterile home environment promotes the penetration of various microorganisms and bacteria into his body.
Diagnosis of candidal glossitis involves a complete collection of anamnesis data and conducting various types of comprehensive research.
Important! In most cases, when diagnosing thrush in a child, an instrumental examination is not performed.
For these purposes the following is carried out:
- Microscopic examination of the oral mucosa by taking a scraping from plaque and then examining it under a microscope. This allows you to determine the presence of Candida mycelium threads and yeast-like cells.
- Bacteriological research. Allows you to identify the type of Candida fungus and the number of its colonies. Sowing mushrooms on a nutrient medium helps install the most effective antifungal drug. This is necessary, since many medications have different effects on grown fungal colonies.
- Serological study. It is carried out if necessary to study antibodies that are concentrated in the blood serum.
The difference between thrush and milk plaque
How to determine the cause of plaque on the tongue of a baby? If a person does not have the opportunity to see a doctor or a frightened mother cannot wait to determine the nature of the plaque, then simply try to wash it off with water. If the situation has not cleared up, perhaps the child does not want to drink water (this happens to children in the first weeks of life), do not worry, there is another simple way to determine the cause of plaque. Try to gently remove the plaque from your baby's tongue with clean hands or a cloth. The fact is that plaque from thrush cannot be removed so easily, and in those places where you still manage to clean the child’s tongue, you may notice a bleeding surface. This sign is considered an undeniable symptom of thrush, and your child needs urgent treatment.
How to clean your tongue?
To cleanse the child's tongue of white plaque, parents can use a soda solution.
This is an affordable and budget-friendly product that can be easily prepared at home.
The procedure is carried out in several stages:
- Dissolve one teaspoon of baking soda in a glass of warm filtered water.
- Wash your hands thoroughly with soap and prepare a small piece of sterile bandage.
- Wrap a bandage around your finger and dip it in a glass of medicinal solution, thoroughly saturating the fabric.
- Gently wipe your baby's tongue, inner cheeks and palate, removing all plaque. There is no need to apply force or pressure; just walk over the affected areas with light movements so as not to cause discomfort to the child.
- Repeat the procedure 5-6 times a day until the oral cavity is completely clean.
Important information! Baking soda has bactericidal properties and neutralizes the effects of inflammation in the oral cavity.
However, self-cleaning of the tongue with soda solution can only be done after consultation with the pediatrician . You also need to make sure that the child does not have allergies.
The influence of thrush on the child’s condition
With candidiasis, the baby’s general condition worsens, he becomes capricious, lethargic and refuses to eat. Candida spots in the mouth cause severe discomfort to the baby; sucking the breast or bottle becomes painful for him, and because of this he constantly cries. In rare cases, there is an increase in body temperature, as with a cold, sometimes it reaches 39 degrees.
Candidiasis rarely affects only the tongue. Usually the entire oral cavity becomes covered with white spots, even the area around the mouth can be affected by the fungus. When the baby eats, the plaque peels off and disappears for a while, and the inflamed mucous membrane of the mouth is visible.
Degrees of anomaly
In pediatrics, there are several degrees of pathology of the frenulum under the baby’s tongue:
| Degree | Symptoms |
| I | Thinning of the frenulum up to a translucent state and its shortening, which prevents the normal mobility of the tongue. |
| II | A frenulum with a defect is attached close to the end of the tongue, causing it to resemble a heart when raised. |
| III | The short, thickened section of the frenulum is also located close to the edge, which is why the tongue bends in a slide when lifted. |
| IV | A massive cord penetrates the muscular structure of the tongue, which usually occurs in parallel with a cleft lip or palate. |
| V | The dense area of the frenulum almost does not appear against the background of the tongue and fuses with the muscles, severely limiting the latter’s ability to move (the so-called ingrained tongue) |
Thus, the danger of pathology increases depending on the degree of limitation of tongue mobility.
How to treat candidiasis in a baby?
Typically, your pediatrician should prescribe antifungal medications to treat oral thrush. Infants are given convenient dosage forms (syrup or solution) that should be used to lubricate the tongue and oral mucosa. The duration of treatment for plaque on the tongue of an infant depends on the degree of the disease, but is usually within 7-10 days. Feeling better occurs within 3-4 days.
The oral cavity is cleansed, and the child can begin to eat milk with renewed vigor, and then sleep peacefully. If it seems to you that the baby’s condition has returned to normal, this does not mean that you need to stop treatment. Candidiasis is a very persistent disease, and if you stop taking medications, the plaque and spots will definitely return. In this case, the fungus will become resistant to previously used drugs, and a new, most likely aggressive, treatment will have to be prescribed.
Treatment of candidiasis
The main method of treating the disease is the use of local antifungal and antibacterial agents, as well as antibiotics. Antimycotic (antifungal) drugs can not only eliminate the symptoms of the disease, but also destroy the fungus in the oral cavity, as well as in other organs and tissues. For this purpose, antibiotics of the polyene series (levorin, nystatin, etc.), as well as clotrimazole, econazole and other imidazoles, are used. Fluconazole, Diflucan, and Nizoral also have a pronounced antifungal effect.
A significant part of antibiotics has a number of side effects and has a negative impact on the immune system. Therefore, when treating children, antibiotics are used only in the most severe cases, as well as in cases where there is a risk of complications and generalization of the process. At the initial stages of the disease and with a mild course of the disease, preference is given to local remedies. We recommend using ASEPTA series rinses, which contain chlorhexidine and other active ingredients that have antimicrobial and anti-inflammatory effects. To remove plaque, you can use special ASEPTA Baby wipes. The individually packaged finger wipe is made of hypoallergenic materials and allows you to carefully clean the mucous membranes without the risk of damaging them or causing additional infection. It is also recommended to regularly treat the oral cavity with Lugol or silver solution. This procedure must be repeated every three hours.
For the prevention and treatment of candidiasis in children, diet and oral hygiene are also of great importance. It is recommended to exclude or strictly limit the amount of food containing simple carbohydrates - these are, first of all, confectionery and flour products. Make sure your child brushes his teeth regularly - it is best to use a special toothpaste for this, for example - ASEPTA Baby, Kids, Teens. The components contained in these pastes help prevent caries and, as a result, reduce the infectious load on the child’s immunity.
Prevention of tongue thrush in infants
Do not forget about preventive measures to prevent the formation of candidiasis in the baby’s mouth. It is important to regularly ventilate and humidify the air in the room. Do not forget about the importance of walks in the fresh air, after them the baby’s sleep normalizes and the immune system is strengthened.
If a child is fed artificially, then you need to thoroughly wash all the items necessary for feeding (bottle, pacifier), and even the pacifier. When breastfeeding, it is important for the mother to monitor her health and not eat a lot of sweets, which can provoke active reproduction of the Candida fungus. There is no need to wash or wipe your breasts with antiseptic agents. The Candida fungus is present in the body of every person, and the further development of the infection depends only on the state of immunity.
Frequent washing of the mother's breasts can dry out the skin, resulting in the formation of microcracks, which are the main factor contributing to the appearance of thrush in the baby. If you are not sure about the cause of thrush in your child, consult your doctor for help. A competent pediatrician will prescribe the optimal treatment specifically for your case. If you determine the cause of the white coating on your baby’s tongue in time and complete the prescribed course of treatment, the likelihood of complications will be minimized.
When should you consult a doctor?
You should know! You need to show your child to a pediatrician and undergo an examination if:
- the baby is suffering from diseases of viral etiology - the symptom may be a sign of infectious stomatitis;
- the white coating has a cheesy consistency and is difficult to remove by regular wiping - this indicates the appearance of thrush;
- plaque forms not only on the tongue, but also on the gums, inner lips, tonsils;
- the child has become restless and irritable, refuses to feed and cries constantly.
If the plaque disappears a few hours after its appearance, and the baby’s general condition is normal, there is no need to see a doctor.
Reference! This is explained by the fact that in this case the symptom does not warn of the development of pathology and is not considered dangerous.
Causes of yellow coating on a child’s tongue
The appearance of a yellow coating on a baby's tongue can seriously frighten parents. If such plaque lasts for a long time and looks like a thick dense mass, and at the same time a sharp, unpleasant odor is felt from the baby’s mouth, then this is a sign of a serious illness. Do not forget that the tongue is one of the organs of the digestive system, and changes in its color may indicate diseases of the gastrointestinal tract (pancreatitis, hepatitis, colitis, cholecystitis, gastritis).
Pathological changes in the digestive system are accompanied by a decrease in the child’s appetite, stool disturbances, and the baby’s crying (due to abdominal pain). There are other reasons for the appearance of a yellow coating on the tongue in an older child:
- overeating (the child may have eaten too much fatty food, resulting in nausea, dry mouth and a yellow coating on the tongue);
- infectious disease (infection is accompanied by high temperature, which provokes the formation of a yellow-brown coating, you can also notice bleeding wounds on the tongue);
- poisoning (in this case, liver function is disrupted, the body becomes intoxicated and dehydrated, which leads to the appearance of plaque);
- jaundice (the tongue itself and the mucous membranes of the mouth become stained);
- local inflammatory processes in the child’s mouth (caries, sore throat, gingivitis, stomatitis, glossitis);
- somatic diseases (autoimmune processes, diabetes mellitus and kidney disease).
Carrying out diagnostics
Some young parents believe that they can diagnose the disease themselves.
However, only an experienced doctor can establish the exact cause of the symptom and make a diagnosis.
During the examination, the pediatrician will assess the baby’s general condition, check the lymph nodes and, if necessary, refer to specialists :
- dentist;
- infectious disease specialist;
- neurologist;
- gastroenterologist;
- endocrinologist;
- nephrologist;
- immunologist.
For your information! To determine the cause that caused the appearance of an unpleasant symptom in a newborn, the small patient is prescribed a series of examinations and tests.
Possible diagnostic methods include:
- biochemical blood test - performed to assess the condition of the gallbladder, liver and pancreas;
- general blood test – necessary for diagnosing infectious and inflammatory processes in the body;
- bacteriological culture for microflora from the oral mucosa - prescribed for suspected candidiasis or viral stomatitis to identify the pathogen;
- Abdominal ultrasound, gastroscopy or fluoroscopy – performed if gastritis is suspected;
- coprogram – carried out to diagnose intestinal microflora.
