Yeast Infections (Thrush) in the Child Care Setting

Yeast infections are caused by various species of Candida, especially Candida albicans. These organisms are part of the germs normally found in various parts of the body and ordinarily do not cause any symptoms. Certain conditions, such as antibiotic use or excessive moisture, may upset the balance of microbes and allow an overgrowth of Candida. In most persons, these infections flare up and then heal. However, in newborns or persons with weak immune systems, this yeast can cause more serious or chronic infections.

Many infants acquire Candida infections from their mothers during birth. Many of those that escape this infection soon acquire Candida from close contacts with other family members and doting relatives and friends. These early exposures may result in an oral infection (thrush) that appears as creamy white, curd-like patches on the tongue and inside of the mouth. In older persons, treatment with certain types of antibiotics or inhaled steroids (for asthma) may upset the balance of microbes in the mouth, allowing an overgrowth of Candida that will also result in thrush. Outbreaks of thrush in child care settings may be the result of increased use of antibiotics rather than newly acquired Candida infections.

Candida may also exacerbate diaper rash, as this yeast grows readily on damaged skin. The infected skin is usually fiery red with lesions that may have a raised red border. Children who suck their thumbs or other fingers may occasionally develop Candida around their fingernails.

Oral thrush and Candida diaper rash are usually treated with the antibiotic nystatin. A corticosteroid cream can be applied to highly inflamed skin lesions on the hands or diaper areas. For children with diaper rash, child care providers should change the diaper frequently, gently clean the child’s skin with water and a mild soap and pat dry. While cornstarch or baby powder may be recommended for mild diaper rash, it should not be used for children with inflamed skin. High absorbency disposable diapers may help keep the skin dry. Plastic pants that do not allow air to circulate over the diaper area should not be used although the diapering system should be able to hold urine or liquid feces.

Since most persons are already infected with Candida, children with thrush and candida diaper rash need not be excluded from child care as long they are able to participate comfortably. Child care providers should follow good hygiene including careful handwashing and disposal of nasal and oral secretions of children with thrush in order to avoid transmitting the infection to children who are not already infected.

Daycare.com would like to thank the Centers for Disease Control and Prevention (CDC) and their contributors for this information in striving to make daycare and childcare a more productive and efficient service.