What is infants' oral thrush – a patient series of symptoms and findings

Introduction  White patches in the mouth of infants are often assumed to be oral candidiasis. In this patient series, we aimed to investigate the symptoms reported in infants with suspected oral candidiasis, the culture findings from samples, and the treatment modalities advised to families.

Methods  The study was conducted at a mother and child wellness clinic between January 1, 2022, and October 31, 2023. Infants clinically diagnosed with candidiasis by a nurse were eligible for inclusion. Parents were asked to respond to a questionnaire regarding breastfeeding and their child's symptoms after obtaining consent. A candida culture sample was taken from all participating infants.

Results  A total of 44 infants were enrolled in the study, all of whom provided culture samples. Candida growth was observed in 14% (6/44) of cultures, with the most common finding being C. albicans (5/6). Out of the 44 families included, 34 responded to the symptom questionnaire. The most reported symptom/finding was white patches in the mouth in 29 cases (85%), followed by breastfeeding pain in 11 cases (32%). Lemon juice or lingonberry juice (n= 28, 82%), mineral water (n= 21, 62%), and nystatin mixture (n= 7, 21%) were the most frequently recommended treatments.

Conclusions  Candida growth in the oral cavity of infants was infrequent. Therefore, especially in cases with clear symptoms, confirming the diagnosis with culture before initiating antimycotic medication seems prudent.

Ilari Kuitunen, Iida Humalamäki, Marjo Renko