Newborn Thrush Vs Milk Tongue: How Do You Tell the Two Apart?

If you've seen white patches on your baby's tongue, you may be faced with a newborn thrush vs milk tongue dilemma. Learn how to tell the difference.

When you have a new baby, your whole world changes. Along with motherhood comes a range of new experiences you must learn… including identifying various health conditions. One common issue many new mums face relates to a white coating on their baby’s tongue. This leads to the uncertainty of newborn thrush vs milk tongue.

Is it just a milk coating? Or could it be a more serious issue, namely newborn thrush (or oral thrush)? If you too have a newborn thrush vs milk tongue dilemma, we’re here to help. To identify the difference between the two, we’ve prepared the ultimate guide for parents to detect whether their baby is experiencing a newborn thrush or a milk tongue. You can read on to find out their symptoms, causes and how you can treat your little one. 

Newborn Thrush vs Milk Tongue: Identifying The Two

Newborn thrush vs milk tongue: How to tell the difference?

Milk Tongue

To get into the difference between oral thrush vs milk tongue, let’s start with what a milk tongue actually is.

Almost all newborns will have a white coating on their tongues — known as “milk tongue". This is not surprising given that their main source of food for six months is milk. If a little one is formula-fed, the coating might look a bit thicker. 

However, more often than not, the “milk tongue" coating gets automatically brushed off as your baby nurses, and his tongue brushes against the hard palate of his mouth. When the tongue does not reach the hard palate, some babies might develop persistent “milk tongue". 

This lack of friction between the tongue and hard palate might be caused by: 

  • Tongue tie: This happens when the tissue that connects the tongue to the bottom of the mouth (the frenulum), is too short. This restricts movement of the tongue, hindering it from touching the roof of the mouth. In turn, this absence of friction may cause “milk tongue". Tongue tie can be rectified by a simple medical procedure, which you can read about here
  • A high, hard palate: If the hard palate (the top of the mouth) is too arched for the tongue to rub against, it could lead to milk residue on the tongue. If you suspect your little one’s hard palate is high, or arched, speak to a paediatrician. She/he will determine if this is the case, and then tell you what to do about it. 

If you have nipple thrush, this could morph into oral thrush in your baby when you breastfeed.

Oral Thrush

Moving on to understanding the confusion with newborn thrush vs milk tongue, here’s what causes oral thrush.

Before you panic, please know that oral thrush is a very common condition in newborns and even older babies. 

Oral thrush is caused by a fungus called Candida Albicans. According to medical experts at the National Health Service, UK (NHS), this fungus is present in the mouth of healthy people and it usually doesn’t cause problems. But sometimes, it can overgrow and infect the membranes in the mouth.

What causes it?

If your baby has recently been given antibiotics, a “side effect" might be oral thrush. This is because the levels of “good" bacteria in your baby’s mouth are reduced by the antibiotics, allowing the growth of fungus levels.

Dr. Pratibha Agarwal, a consultant paediatrician for Kinder Clinic, explains that oral thrush in babies may also occur more commonly when the mum has a vaginal fungal infection or if she’s been on antibiotics for a long time. 
This infection can then be passed on to her baby during breastfeeding if the mum’s nipples (nipple thrush) are affected, resulting in oral thrush in the baby.
Signs and symptoms of oral thrush

Oral thrush can present with the appearance of soft, white creamy patches on your baby’s tongue, the inside of the cheeks or the roof of the mouth, says Dr. Agarwal who also specialises in the care of high-risk newborns and children. Unlike milk residue, the patches do not rub off easily and may bleed when removed.

Some babies may not seem to be bothered by the patches. However, others may be reluctant to feed, keep detaching from the breast or be quite irritable, if they are in discomfort.

You may also notice a nappy rash on your baby at the same time you observe the symptoms of oral thrush in his mouth. This nappy rash may be caused by the same fungus and will have to be treated as well.

Now that you know what causes the two conditions, we’re back to this question: newborn thrush vs milk tongue – how can you tell the difference?

It’s easy to clean your newborn’s tongue. Just use a soft cloth or clean piece of damp gauze to do so. If it’s milk tongue, the patches will come off easily. Image: YouTube Screengrab

Newborn Thrush vs Milk Tongue: Spotting the Difference

Which is it in your newborn thrush vs milk tongue dilemma? 

It’s actually quite simple to spot the difference between newborn thrush vs milk tongue. If it’s milk tongue, the white residue will easily come off when brushed gently with a soft, damp cloth, revealing a healthy, pink tongue underneath. 

But if it’s newborn oral thrush, the white patches will not come off easily and may even bleed if you try too hard to remove them. Untreated newborn thrush may even be painful, resulting in your newborn being fussy at your breast. 

So, it’s really about being observant and knowing the difference between newborn thrush vs milk tongue.

Treatment of Oral Thrush

Mums, you’ll be relieved to know that oral thrush in most instances, is not dangerous. The treatment of oral thrush may be in the form of an oral anti-fungal gel which is applied to the inside of the mouth. An antifungal suspension may also be prescribed to be taken orally. 

You can also help your breastfeeding baby by reducing your sugar intake while he is being treated for the thrush. 

Prevention of Newborn Thrush 

Here are some tips to help prevent the incidence of oral thrush in babies:

  • If a pregnant mum has a vaginal yeast infection, she should get treated for it in order to prevent transmitting the infection to the baby during the process of a normal birth.
  • A breastfeeding mum with a fungal infection around the nipple area should get treated for it immediately. This will prevent the infection from continuously passing to and fro between her and her baby.
  • If a child is on prolonged antibiotics, taking probiotics may help restore the balance of oral and gut flora. This reduces the likelihood of a condition like oral thrush.
  • Wash your hands well after changing your little one’s diaper. This helps prevent the spread of thrush as the fungus can be passed through your baby’s digestive system.

Ultimately, oral thrush in babies is not something that you should be overly worried about. However, if you suspect your baby might have the condition, or if you are breastfeeding and you think you have nipple thrush, then it is best to see your doctor without delay.

We hope this article has helped solve your newborn thrush vs milk tongue problem. To learn about nipple thrush in breastfeeding mums, click this link

References: National Health Service (NHS), Livestrong

Written by

Nalika Unantenne