Dr. Shalaka Samant PhD who says... The information provided in this article about the causes, symptoms and possible preventive measures for children’s yeast infections is medically correct.
This page describes yeast infection in children of all ages and the preventative steps you can take to avoid them. Dan will also be sharing some of his own experiences as a child, since he struggled with illnesses that he later realized were most likely related to yeast infections throughout much of his childhood. If your child does have a yeast infection or other illnesses that could lead to a yeast infection, please refer to the treating children’s yeast infections page at the bottom of this webpage.
Just how serious can a yeast infection in children become? Read Crystal and Jakobs story here.
Written by Dr. Trisha Berger, PhD
When babies are born, they come into the world having had little exposure to bacteria. There is little to no bacteria present in their intestines and their immune system has not been fully developed. It is not until they pass through the vaginal canal, where they are exposed to their mother’s bacteria, that they acquire good bacteria(1). Babies will also receive bacteria from their mother through their milk(2), if they are breastfed. These bacteria will start to build the baby’s microbiota throughout different locations in the body, including their gut. The types of bacteria composing their microbiota can have profound effects on their health throughout childhood and later in life(2).
Once the gut microbiota begins to establish, the bacteria help contribute to infant health by digesting nutrients from the mother’s milk that would not otherwise be digestible by the infant. Human milk contains oligosaccharides that cannot be digested by the infant, but are instead digested by bacteria in the intestines. When these bacteria digest the oligosaccharides, it causes the pH of the gut environment to be reduced, which provides the body with a first line of defense against bad bacteria, pathogens, parasites, viruses, and microbes that can make the infant sick(2).
If at all possible, breastfeeding is the best thing you can do for your baby in their first year of life. While breastfeeding, the mother passes her repertoire of antibodies along to her child, which helps the child defend against invading pathogens until their immune system has developed enough to make their own antibodies(3). Breast milk also contains other anti-microbial factors that help defend the infant from pathogens early in life(4). A strong and healthy immune system will keep your child healthy, making them less likely to need medications that can cause yeast infections in children.
Similar to bacteria, yeast are part of the microbiota that live on and in parts of the human body. Along with the other microorganisms that make up the microbiota, the growth of yeast is kept in check by the bacteria that cohabitate with and by interactions with the immune system. Yeast infection in children occurs when there is a change in these conditions that allow them to grow more than they normally would. In other words, their growth is normally kept under control, but if something changes, they can overgrow.
Dr. Shalaka Samant, PhD says...
Although yeast is normally found on the skin, in the digestive system and vaginal area, it may cause an infection under certain conditions such as when the skin is damaged or subject to prolonged warmth and moisture, when the body’s normal microbial population has been altered, such as when antibiotics are administered, or when a child has a suppressed immune system.
Fungal infections in children are broadly classified into three types:
1. Culture-proven Bloodstream Infections at a Specialist Pediatric Hospital. Pediatr Infect Dis J. 2020 Mar 20. doi: 10.1097/INF.0000000000002605.
Yeast infection in children and toddlers is caused by a number of different factors, depending on the site of yeast overgrowth. In toddlers, the most common sites of yeast infections are the mouth and throat (also called thrush or oropharyngeal candidiasis(5) and skin surfaces—including areas covered by their diaper (a form of diaper rash) or areas where skin folds may occur(6)—or under the fingernails.
Females can also get vaginal yeast infections. Males can get yeast infections on their penis (aka balanitis). Both of the latter are usually related to diaper rashes, but can also be acquired sexually in adolescents(7,8). Yeast infections can also occur in the gut, where yeast are part of the normal microbiota(9).
Yeast infections on the skin surface are usually caused when a hospitable environment is created for the yeast, such as a build up of moisture or friction, either from the skin rubbing together or from a diaper(6).
Dr. Shalaka Samant, PhD says...
A majority of children, at one time or other suffer some or the other form of fungal infection. Oral thrush is a common manifestation of the opportunistic yeast Candida albicans’ overgrowth in the oral cavity of children (2). It appears as white patches known as “plaques” which resemble milk curds, most commonly in babies, particularly in the first few months of life (3). Outbreaks of thrush in older children may also be the result of an increased use of antibiotics and steroids, which disturbs the balance of microbes in the mouth.
Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take advantage of all these factors. So diaper rash or napkin dermatitis associated with fungal infection is another common occurrence in infants and toddlers (4).
Tinea capitis (scalp ringworm) infections are common in children aged 3-9 years living in crowded urban areas. Tinea pedis (athlete’s foot) and Tinea versicolor (white spots) are also common fungal infections in children.
2. Oral Candida in children. Oral Surg Oral Med Oral Pathol. 1984 Jan;57(1):37-40.
3. Oral candidiasis: the clinical challenge of resistance and management. Int J Antimicrob Agents. 1996 Feb;6(3):155-9.
4. Superficial Mycoses Associated with Diaper Dermatitis. Mycopathologia. 2016; 181(9): 671–679. Published online 2016 May 19. doi: 10.1007/s11046-016-0020-9.
Yeast infection in children can also be caused by a disruption of the microbiota. The most common cause of this disruption is the use of antibiotics(10). Antibiotics are used to treat infections caused by bacteria, such as strep throat or some forms of pneumonia. They are not used to treat illnesses that are caused by viruses, such as the flu or the common cold.
Children tend to get a wide range of sicknesses. They seem to bring home from school whatever is going around at the time. This usually means a trip to the doctor, where they may prescribe antibiotics, depending on the symptoms of the illness and what may be causing it. When children (and adults) take antibiotics, they not only kill off bad bacteria that are causing an infection, but also good bacteria that are present in the gut and other sites(11,12).
In the gut, these bacteria are not only helping out the immune system, as was mentioned earlier, but they are making products to keep yeast growth in check(13). When antibiotics kill off these bacteria, the yeast can now grow unchecked, causing a yeast infection in children. Antibiotic use can also cause yeast infections in the mouth and throat(5), or thrush.
Yeast infections are also common in children that are immunocompromised, where their immune system is not working properly. This can be the result of a genetic defect (where they are lacking parts of their immune system that is required to have an immune reaction to yeast)(14), another illness that is suppressing their immune system (such as cancer or HIV/AIDS)(15), or taking a medication that suppresses their immune system (such as corticosteroids or chemotherapies)(16).
The symptoms indicating a yeast infection in children will vary depending on the location where the infection is taking place. Common yeast infection symptoms in children and toddlers include(17,18):
Dr. Shalaka Samant, PhD says...
Immunocompromised children, such as extremely premature infants, children receiving cancer chemotherapy, or those receiving immunosuppressive therapy for undergoing stem cell transplantation are at a particularly high risk of developing systemic invasive fungal infections (5).
Systemic infections can be life-threatening and are associated with high morbidity and mortality. Because diagnosis is difficult and the causative agent is often confirmed only at autopsy, the exact incidence of systemic infections is difficult to determine (6).
practice update of antifungal prophylaxis in immunocompromised children.
Rev Esp Quimioter. 2019 Oct;32(5):410-425. Epub 2019 Sep 11.
6. Emerging fungal infections among children: A review on its clinical manifestations, diagnosis, and prevention. J Pharm Bioallied Sci. 2010 Oct-Dec; 2(4): 314–320.doi: 10.4103/0975-7406.72131.
If you do have to give your child antibiotics and your child is prone to getting yeast infections due to antibiotics, their doctor may prescribe an antifungal to take with the first and last round of the antibiotic. However, just as bacteria can develop resistance to antibiotics, fungi can develop a resistance to antifungals(19). Therefore, using them to prevent a yeast infection, rather than treat it, should be done with caution.
In some cases, the antifungal nystatin has been used to prevent yeast infections in very young children or people who are immunocompromised(20). Nystatin is a prescription anti-fungal derived from a soil-based bacteria and is completely safe since it does not enter the blood stream(20).
Dr. Shalaka Samant, PhD says...
The chances of children getting fungal infections can be minimized by making sure that they practice good hygiene. If possible, children should not be allowed to share personal items such as brushes and bath towels. It should be ensured that they do not go bare-footed to public places, such as shower rooms and swimming pools. And finally, after bathing, children should be towel-dried to prevent any tinea infections.
Correct diagnosis is important for ensuring the correct prescription of topical antimycotics for these various infections. Nystatin and imidazoles are effective. Topical miconazole is effective in treating superficial infections such as diaper rash complicated with candidiasis (7).
It is important to realize that there are resistant fungal strains, especially in the hospital setting, that might cause these infections in children. Another complicating factor when considering appropriate antifungal therapy, especially in systemic fungal infections, is that some patients are infected by more than one pathogen simultaneously.
7. Topical miconazole nitrate ointment in the treatment of diaper dermatitis complicated by candidiasis. Cutis. 2006 Feb;77(2):113-20.
Another way to prevent yeast infections is through the use of probiotics. Probiotic bacteria can help to replenish the good bacteria of the microbiota when it becomes depleted. Some researchers have even suggested adding it to an infant’s formula, if they are unable to be breastfed. Though more research is needed on this, several studies have shown probiotics to provide benefits to infants that are formula fed(2).
Probiotics have also provided benefits to people suffering from antibiotic-associated diarrhea. In fact, simultaneous use of a probiotic with antibiotics is recommended to prevent antibiotic-associated diarrhea(10).
Dr. Shalaka Samant, PhD says...
There is growing evidence that restoring the natural microbial population by consuming/applying probiotic preparations can tackle fungal infections as the good bacteria compete with the pathogenic yeast for binding sites and nutrients (8).
8. Probiotics for Prevention and Treatment of Candidiasis and Other Infectious Diseases: Lactobacillus spp. and Other Potential Bacterial Species. Published: July 13th 2016. DOI: 10.5772/64093
Dr. Berger is a diversely trained scientist with expertise in cancer biology and immunology. She received her PhD in Cancer Biology from the University of Colorado Anschutz Medical campus and has completed two postdocs, one at the University of Colorado Anschutz Medical Campus and one at Fred Hutchinson Cancer Research Center in Seattle.
Her research has focused on how the immune system promotes cancer progression and metastasis in a variety of cancer types. She has experience in various lab settings, from basic science to highly translational research.
She also has extensive teaching experience, including developing curriculum for undergraduate courses. She enjoys writing for all types of audiences, from layman to science professionals.
Written by Dan Jackowiak Nc, HHP
I did not get the benefit of breastfeeding as a baby. Forty years ago, breast-feeding was looked upon as something not necessary. Instead, I grew up on a diet of cow’s milk. Although it is not established as medical fact, I do believe the diet of cows milk triggered an over production of mucous in my respiratory tract resulting in bronchitis multiple times a year.
When I was six months old, I had pneumonia that resulted in hospitalization. As a result, I was given antibiotics and a number of other medications. The recent research on the effects that antibiotics can have in disrupting microbiota, suggests that these early events were detrimental to the development of my normal microbiota and its ability to help me fight off infections.
I had pneumonia seven times and bronchitis every year until I was about 11 years old. Because of this, I was prescribed antibiotics two to three times every year. By the time I was 10, my digestive system was totally destroyed by all these antibiotics. I ended up with diarrhea that lasted an entire month! I would also get ringworm, athlete's feet often, and I had very bad smelling gas.
I have since learned that antibiotics can cause diarrhea(10) and destroy good bacteria in the intestines and other sites of the body, leading to an overgrowth of yeast(11). I believe this was the cause of much of my illness as a child. Eventually, I was taken off all of the medications and instructed to eat a healthy diet. After about a month living at my Grandma's, I recovered. My health improved and I never had pneumonia again.
As a result of these experiences, I am a firm believer in letting the immune system deal with illness before I use medication. I now prefer to use natural supplements rather than antibiotics or other over-the-counter medications. If my kids become sick, I give them Pedialyte to drink, and herbs and supplements based on their symptoms. If possible, I get them to eat and rest. However, if their symptoms become severe enough, I will take them to the doctor, but I am now extra cautious about using antibiotics.
It is very common for children to be prescribed antibiotics(21), but research is now showing us the detrimental effects they can also have if they are overused(11)
Dr. Shalaka Samant has a B. Pharm degree from Mumbai University where she was a gold-medallist. Later, she received her Ph.D. in Pharmaceutical Biotechnology from the University of Illinois – Chicago, followed by, postdoctoral training from Yale university and University of Texas-Health Science Center. For her pre-doctoral work, she was the recipient of the prestigious American Heart Association predoctoral fellowship award.
She has over a decade of experience in the areas of molecular biology, microbial strain manipulation, and synthetic biology amongst other areas. She was a postdoctoral research associate in the lab of Dr. Jorge Galan, a renowned gastrointestinal infectious disease researcher.
Dr. Samant has functioned as the principal investigator on several biotechnology research projects funded by the Department of Biotechnology (DBT), Govt. of India. She has mentored several graduate students towards their dissertation research in diverse areas such as therapeutic protein expression and development of cell-based assay platforms for drug discovery.
She is now the founder and chief consultant at Biombrella, a life science consulting firm that provides deep-dive research, scientific writing and content generation services to various pharmaceutical, nutraceutical and biotech start-ups. She was recently interviewed for the Summer 2019 issue of ‘The Pharmacist’ – University of Illinois-Chicago.
Treating Yeast Infection in Children
This webpage explains what to do to treat yeast infection in children.
Do you have any questions about children's yeast infections or yeast infections in general? Ask your question here or contact us using the contact page of this website. It is also always a good idea to talk to your doctor as well.
Chong CYL, Bloomfield FH, O'Sullivan JM. Factors Affecting
Gastrointestinal Microbiome Development in Neonates. Nutrients.
2. Tamburini S, Shen N, Wu HC, Clemente JC. The microbiome in early life: implications for health outcomes. Nat Med. 2016;22(7):713-722.
3. Brandtzaeg P. The mucosal immune system and its integration with the mammary glands. J Pediatr. 2010;156(2 Suppl):S8-15.
4. Lonnerdal B. Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr. 2003;77(6):1537S-1543S.
5. Pankhurst CL. Candidiasis (oropharyngeal). BMJ Clin Evid. 2013;2013:1304.
6. Tuzun Y, Wolf R, Baglam S, Engin B. Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clin Dermatol. 2015;33(4):477-482.
7. Loveless M, Myint O. Vulvovaginitis- presentation of more common problems in pediatric and adolescent gynecology. Best Pract Res Clin Obstet Gynaecol. 2018;48:14-27.
8. Wray AA, Khetarpal S. Balanitis. StatPearls. Treasure Island (FL)2019.
9. Ezeonu IM, Ntun NW, Ugwu KO. Intestinal candidiasis and antibiotic usage in children: case study of Nsukka, South Eastern Nigeria. Afr Health Sci. 2017;17(4):1178-1184.
10. McFarland LV. Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiol. 2008;3(5):563-578.
11. Yoon MY, Yoon SS. Disruption of the Gut Ecosystem by Antibiotics. Yonsei Med J. 2018;59(1):4-12.
12. Sam QH, Chang MW, Chai LY. The Fungal Mycobiome and Its Interaction with Gut Bacteria in the Host. Int J Mol Sci. 2017;18(2).
13. Noverr MC, Huffnagle GB. Regulation of Candida albicans morphogenesis by fatty acid metabolites. Infect Immun. 2004;72(11):6206-6210.
14. Li J, Vinh DC, Casanova JL, Puel A. Inborn errors of immunity underlying fungal diseases in otherwise healthy individuals. Curr Opin Microbiol. 2017;40:46-57.
15. Singh S, Fatima Z, Hameed S. Predisposing factors endorsing Candida infections. Infez Med. 2015;23(3):211-223.
16. King J, Pana ZD, Lehrnbecher T, Steinbach WJ, Warris A. Recognition and Clinical Presentation of Invasive Fungal Disease in Neonates and Children. J Pediatric Infect Dis Soc. 2017;6(suppl_1):S12-S21.
17. Children's Hospital of Philadelphia. Candidiasis (yeast infection) in children. https://www.chop.edu/conditions-diseases/candidiasis-yeast-infection-children. Accessed December 26, 2019.
18. Taylor M, Raja A. Oral Candidiasis (Thrush). StatPearls. Treasure Island (FL)2019.
19. Center for Disease Control and Prevention. Antifungal Resistance. Fungal diseases https://www.cdc.gov/fungal/antifungal-resistance.html. Accessed December 26, 2019.
20. Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther. 2016;10:1161-1171.
21. Hersh AL, Shapiro DJ, Pavia AT, Shah SS. Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics. 2011;128(6):1053-1061.
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