Thrush (Candidiasis)—Child Care and Schools

What is thrush?

Thrush is a yeast infection predominantly produced by Candida albicans , causing mouth infections in young infants.

What are the signs or symptoms?

  • White patches on the insides of cheeks and on the gums and tongue

  • Usually causes no other signs or symptoms

What are the incubation and contagious periods?

  • Incubation period: Unknown.

  • Contagious period: The yeast that causes thrush normally lives on the skin, in the mouth, and in stool. Mild infection of the lining of the mouth is common in healthy infants. Thrush can occur during or after antibiotic use. Repetitive or severe thrush could signal immune problems.

How is it spread?

  • C albicans is present in the intestinal tract and mucous membranes of healthy people.

  • A warm, moist environment (eg, mouth) fosters growth and spread.

  • Person-to-person transmission (although very rare) may occur from a mother to her baby when the mother has a vaginal yeast infection and from breastfeeding babies to their mothers when babies with thrush infect their mothers’ nipples.

How do you control it?

  • Use good hand-hygiene technique at all the times listed in Chapter 2 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition .

  • Treat infected individuals.

  • Wash and sanitize mouthed toys, bottle nipples, and utensils and do not let other children use them before sanitizing. Do not allow sharing of mouthed objects between children without first washing and sanitizing them.

Thrush ( Candida albicans ) infection in the mouth of a 1-week-old

COPYRIGHT JAMES BRIEN, DO

Infant with an open mouth, revealing a toothless, gummy interior and a tongue with white, irregular-shaped patches.

What are the roles of the educator and the family?

  • Report the infection to the staff member designated by the early childhood education program or school for decision-making and action related to care of ill children. That person, in turn, alerts the parents/guardians for treatment of the child.

  • Administer prescribed medication as instructed by the child’s health professional.

Exclude from educational setting?

No.

Disclaimer

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide , 7th Edition.

The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Copyright © American Academy of Pediatrics Date Updated: Mar 31 2026 16:54 Version 0.2

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starfish
February 12, 2026
Since February 21, 2026, no new cases of measles have been reported in NC. The NC DHHS no longer recommends early MMR vaccination for infants 6 to 11 months old since there is no sustained transmission currently. While this is welcome news, vaccination rates have dropped in NC and the US. There will likely be further outbreaks in the future. We can give the MMR dose early to families who want it. This applies to infants 6-11 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!