CLEANING BABIES MOUTH AND THRUSH

By Sr Teresa Hayward (RM, RN, Lactation consultant, Infant & Paediatric Nutritionist, Baby Sleep Consultant)

Mouth bacteria thrive from day one in baby’s mouth but at the same time cleaning baby’s mouth can introduce unnecessary bacteria to their mouth.

Parents will notice white sediments on baby’s tongue after a feed. This is milk left over from the feed, and not thrush. Usually baby’s saliva will clean the tongue itself and it no reason for concern, especially if baby is breastfeeding, as breast milk has antibacterial properties in it, meaning it is unnecessary to clean baby’s mouth.

If you however find that baby’s saliva is not cleaning the tongue or you are picking up a sour or acidic smell in baby’s mouth, then you can clean the mouth. It is also necessary to clean baby’s mouth if baby has severe reflux or Gastric oesophageal reflux disease (GORD) as these babies are often vomiting a lot meaning there will be more gastric acid in their mouths and on their gums. It is also necessary to start cleaning baby’s mouth when they start solids or get their first tooth.

If you decide to clean baby’s mouth, the best way to do this is to use a moistened clean cloth or gauze and then wrap it around your finger and wipe the gums, tongue and cheeks. Use cooled boiled water to clean the mouth as this is deemed to be sterile water.

When you do need to start to brush the little teeth, it is important to make use of fluoride free toothpaste. It is important to discourage children from swallowing toothpaste, especially if it does have fluoride. Toothpaste is deemed as toxic and it can cause fluorosis if swallowed, which means that the tooth enamel becomes mottled.

DO NOT USE GLYCERINE TO CLEAN BABY’S MOUTH!

It is important to remember that all babies are born dentally healthy and it is our aim and responsibility to keep them that way. Here are some tips to help parents in doing that:

· Mom’s oral health is important especially during pregnancy. Good dental hygiene reduces the transfer of bad bacteria to baby’s mouth

· Start cleaning baby’s mouth as soon as it is needed

· Don’t give your child a sweet tooth by adding sugars or honeys to foods, don’t give juices, and introduce them to vegetables first when introducing solids

· Don’t make feeding, especially formula or bottle feeding a pacifier or comfort

· Aim to stop bedtime bottle by 1 year and no night feeds

· Never put juices, cold drinks or sweetened drink s in a bottle

· Eat your fruit, don’t drink it

· Ensure adequate intake of vitamin D for tooth development

· Give medicines in a syringe or dropper, never a spoon

· First dental visit by 1 year

THRUSH

Thrush in a baby’s mouth can be extremely irritating but it is treatable. Thrush is a yeast infection of the mouth that is caused by a fungal organism called Candida Albicans and can spread to the gut and to their buttocks.

Oral thrush is very common is babies under one year but is easy to treat, whereas systemic thrush and thrush in the nappy area is more difficult to treat.

Symptoms of thrush

· White patches in the mouth and on the tongue that look like cottage cheese or milk curds – this will be noted on tongue, cheeks, gums and lips of baby

· A sore mouth

· Poor appetite

· Miserable baby

· Nappy rash

Treatment of thrush

· An oral fungal medication – Daktarin, Nycastatin – continue for at least 5 to 7 days

· A probiotic such as Reuterina drops

· If baby is breastfed, then both mom and baby must be treated

· Mom must decrease her yeast and sugar intake

· All bottles, breast pumps, dummies must be sterilised using heat, not sterilizing fluids

· Anything such as blankets, doo doo blankets etc that come in contact with baby’s mouth must be washed on a hot wash

WHY GLYCERINE IS A NO-NO

It is not recommended to use Glycerine to clean your baby’s mouth. It is not a mouth cleaner and this is a very incorrect old wife’s tale. Using Glycerine to clean your baby’s mouth is the same as you using coke as mouth wash. Glycerine is pure sugar.

It is also not used to prevent thrush but it will cause thrush as it is making the mouth a lovely warm, wet, sweet area for thrush to grow.

My next point is the type of glycerine that is being used. Not all Glycerines can be used internally and it often seen that the incorrect types of Glycerine is being used.

The Glycerine that is in the “funny” shaped bottle is not to be used in the mouth. It is in fact a skin or hair product and the same as Vaseline. Medicinal glycerine is the only Glycerine that can be used orally or internally but its intended use is for enemas or laxatives

Health professional and Lactation consultants have noticed a huge increase in thrush from the use of glycerine and lactation consultants are seeing an increase in thrush on nipples and mouths from use of glycerine. We are also seeing an increase in the number of caries in milk teeth as the glycerine soaks into the gums and damages the enamel of the milk teeth still in the gums.