Newborn Thrush vs Milk Tongue: How to Tell the Difference and What Is the Right Treatment

If you've seen white patches on your baby's tongue, you may be faced with a newborn thrush vs milk tongue dilemma. From understanding the telltale signs to figuring out when it's time to consult your pediatrician, we've got your guide to navigating these common infant oral conditions.

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If you have a newborn thrush vs milk tongue dilemma, we’re here to help. Is it just a milk coating? Or could it be a more serious issue, namely newborn thrush (or oral thrush)?

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 is a white coating on their baby’s tongue. This leads to the uncertainty of newborn thrush vs milk tongue.

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?

What Is Milk Tongue

To get into the difference between newborn thrush and milk tongue, let’s start with what a milk tongue is.

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

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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 a 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 tongue movement, hindering it from touching the roof of the mouth. In turn, this absence of friction may cause a “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.

What Is Baby 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?

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If your baby has recently been given antibiotics, a “side effect” might be oral thrush. This is because the antibiotics reduce the levels of “good” bacteria in your baby’s mouth, 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.

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

Newborn Thrush vs Milk Tongue: Symptoms

Symptoms of Milk Tongue

Milk tongue is a condition that affects the mouth and throat, causing problems with speech and swallowing. It can also cause pain in the mouth or throat.

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Symptoms include:

  • difficulty swallowing
  • pain in the mouth or throat when swallowing
  • a sensation of food sticking in the throat
  • a feeling of mild to moderate discomfort while eating or drinking

Symptoms of Baby 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 while you observe the symptoms of oral thrush in his mouth. This nappy rash may be caused by the same fungus and must also be treated.

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?

Newborn Thrush vs Milk Tongue: Spotting the Difference

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

It’s 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.

Newborn Thrush vs Milk Tongue: How to Clean

How to Clean Milk Tongue

Milk tongue is easy to treat and prevent in your baby! Here’s how:

  1. You’ll need a soft toothbrush, warm water, and a washcloth or cotton swab.
  2. Gently brush your baby’s tongue with the toothbrush until all of the milk tongues have been removed.
  3. Rinse the brush thoroughly after each use and let it dry before using again on another part of your baby’s mouth.
  4. Rinse their mouth thoroughly with warm water after brushing their teeth and let them rest for at least five minutes before feeding them again so that any remaining food particles have time to digest fully before eating more food (which could cause choking).

Mother use finger to clean asian baby tongue with clean gauze.

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How to Clean Baby Tongue Thrush

Baby thrush is a fungal infection that can occur in babies and toddlers, especially bottle-fed ones. It’s caused by Candida albicans, a yeast that naturally lives on the skin and in the mouth. When this yeast is allowed to thrive, it can cause symptoms like white patches on the tongue, a white coating on the roof of the mouth, and even diaper rash.

If your baby has thrush, here’s how you can clean their tongue:

  1. Use a soft toothbrush with warm water and a drop of liquid dish soap (not gel)
  2. Gently brush your baby’s tongue from one side to another until you see all of the white patchiness gone (this may take several passes)
  3. Rinse off the toothbrush with warm water and dry it off.

Newborn Thrush vs Milk Tongue: Treatment

Treatment for Milk Tongue

If your baby is suffering from the condition known as milk tongue, it may be hard to know what to do. Here are some tips for how to treat this condition:

  1. The first thing you need to do is make sure your baby is eating a healthy diet. You want to ensure that they get plenty of nutrients from their food and drink plenty of water. If your baby is dehydrated, this can lead to the development of a milk tongue, so you must ensure they get enough fluids throughout the day.
  2. You should also try to discover any underlying causes for your child’s milk tongue. For example, if they have an allergy or sensitivity to something in their diet, then this could be causing their symptoms. Try removing certain foods from their diet and see if this affects their symptoms.
  3. If these measures fail, you should consult with your doctor about other possible treatments for milk tongue in babies, such as using an oral rinse containing lidocaine or a steroid nasal spray called fluticasone propionate (Flonase). These treatments are effective at reducing symptoms of milk tongue.

Treatment for Baby 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 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. Newborn Thrush vs Milk Tongue: Prevention


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How to Prevent Milk Tongue

It is important to know how to prevent milk tongue in babies. Milk tongue is a condition that can be seen in newborns and it may lead to complications. It is important to keep your baby well hydrated and feed them when they are hungry. The most common cause of milk tongue is dehydration. It can also be caused by feeding too much formula or insufficient breast milk.

If your baby develops milk tongue, you should contact your doctor immediately because it may lead to dehydration which can cause serious problems for your baby. You should also avoid giving your baby anything by mouth, including water until their tongue returns to a normal colour.

How to Prevent 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 to prevent transmitting the infection to the baby during the process of 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.

Updated by Pheona Ilagan

Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.


Written by

Nalika Unantenne