White tongue in babies

It is common for a baby to have a white tongue, which causes concern for many parents. There are two causes of white tongues in newborns and infants: milk residue and thrush. If the white coating is only on the tongue, thrush is unlikely to be the cause. Most babies with thrush do have a white tongue; however, most babies with a white tongue do not have thrush.

Milk residue (“milk tongue”)

It is common for babies to have a buildup of milk on their tongues, and it is more common in newborns because they do not make as much saliva to wash off the milk. It is harmless, and you do not need to clean it off or try to prevent it from happening. If you were on a 100% milk diet, you might have one too!

The coating is usually thin. If you wipe the tongue with a warm, moist cloth, some of the white coating will come off. It tends to be worse after feedings.

Oral thrush

Thrush is an infection caused by a yeast, Candida albicans. The same yeast causes vaginal yeast infections in women, and babies usually get the yeast on their skin during the birth process. The yeast grows in babies’ mouths because their immune system is immature, and they lack part of the immune system that keeps it from growing in older children and adults.

Babies with thrush may have a thick white coating on the tongue. They will also have white patches inside the cheeks and often a thin white coating inside the lips. The white patches will not come off with wiping.

Thrush is harmless and rarely causes significant symptoms, but it does seem to cause some minor discomfort in some babies.

The infection is treated with antifungal medications. Pacifiers and bottles should be sterilized daily, and mothers should treat their nipples after breastfeeding. It is easy to treat but may recur until the baby’s immune system matures.

For more information, see our article on thrush.

Summary

White tongues are common in babies, and it is either milk residue or thrush. Thrush will be present on more than just the tongue. Neither condition is serious; however, thrush should be treated by your baby’s pediatrician.