Lisa Amir wrote,
"Don't forget that sometimes babies just have white tongues. A swab can be
taken to check and see if it is candida or not. "

Lisa,  I'm surprised to see that a white tongue in an infant can be normal.
What causes the white tongue?

Well, sometimes a tongue just has a white "coat". I imagine it is because
babies live on milk alone.

If you examine a baby after a feed, the tongue is often white. I always like
to try to examine the baby before the feed, but even then sometimes the
tongue is not completely pink. I'm just saying that not all whiteness on the
tongue is due to thrush.

I put the baby on the examination couch, and use the light to examine the
buccal mucosa (ie inside the cheeks) - if I see any whiteness or even white
film inside the cheeks I believe this is thrush. The other signs that some
people find confusing are white areas on the gums or palate - most of the
time these are Epstein's pearls or similar things and not thrush.

You can see good examples of thrush on the lips and buccal mucosa in Barbara
and Kay's Breastfeeding Atlas and in the new LC series unit on Candidiasis.
(The example labelled as "thrush on the tongue" probably is thrush, as they
say so, but I wouldn't stand up in court and swear on that one ;-) )

Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia
Looking forward to having Kay Hoover come to stay before the ILCA
conference!

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