My question is regarding thrush. It is not on the DHEC Exclusion list for child care centers, and all of the research we have done seems to point to it not being very contagious. However, we recently had three children in our 6mos-12 mos class have it within a few days of each other. We clean our toys regularly and if they are “mouthed” they are put into a bucket after play to be sanitized. What are your recommendations for children with thrush attending classroom care?



Thrush is a yeast infection causing mouth infections in young infants. The signs and symptoms of thrush are white patches on the inside of cheeks and on gums and tongue. The children would need to be seen by their pediatrician to confirm the diagnosis and provide the appropriate treatment.

According to the American Academy of Pediatrics, the yeast that causes thrush is widespread in the environment and normally lives on the skin, and is found in the mouth and stool. It can be controlled by using good hand-washing techniques. This includes, but not limited to, before and after handling food, administering medication, after diapering and toileting, handling body fluids, wiping noses, mouths and sores. It can also be controlled by treating the individuals who have an infection.

One additional suggestion is to make sure you properly wash and sanitize toys, bottles and pacifier nipples after they have been mouthed. You would not want to allow sharing of mouthed objects between children without first washing and sanitizing them. Once you have alerted the parents and had the child seen by their pediatrician, prescribed medications would need to be administered as instructed. I hope this additional information is helpful. 

Seema Csukas, M.D., Ph.D.