What does it mean if a newborn has thick white coating on the tongue?

Generally, thick white tongue coating in newborns may be caused by factors such as fetal swallowing of amniotic fluid, milk residue, characteristics of oral mucosa, indigestion, gastroesophageal reflux, or candida infection. Symptomatic management, including general care or medication, may be needed. If discomfort occurs, it is recommended to seek medical attention promptly and receive appropriate treatment under a doctor's guidance. Detailed explanations are as follows:

1. Fetal Swallowing of Amniotic Fluid

Inside the uterus, fetuses swallow amniotic fluid, which may contain impurities such as meconium. After birth, these substances may remain in the newborn's mouth and form a coating on the tongue. This condition usually resolves naturally over time and requires no special treatment.

2. Milk Residue and Oral Mucosal Characteristics

After breastfeeding or formula feeding, milk residue may remain on the tongue. Additionally, the oral mucosa of newborns is delicate, and a thin white layer easily forms on the tongue surface, known as tongue coating. This is a normal physiological phenomenon that generally does not require special treatment, only regular oral hygiene care.

3. Indigestion

The digestive system of newborns has not fully developed, and overfeeding or consuming hard-to-digest food may lead to indigestion. In such cases, increased gastrointestinal food residue and bacterial byproducts may reflux into the oral cavity via saliva, irritating the tongue and oral mucosa, resulting in a thickened tongue coating. Infants may experience symptoms such as abdominal distension, belching, or vomiting. It is recommended to use medications such as复合凝乳酶胶囊 (compound rennet capsules), 酪酸梭菌活菌散 (Clostridium butyricum powder), or 肠炎宁颗粒 (enteritis relief granules) under medical supervision.

4. Gastroesophageal Reflux

Gastroesophageal reflux mainly results from dysfunction of the lower esophageal sphincter or excessive gastric acid secretion, causing stomach contents to flow back into the esophagus. This reflux may bring gastric acid into the mouth, which irritates the tongue and leads to the formation of a coating. Symptoms such as vomiting and refusal to eat may also occur. It is recommended to use medications such as 健脾丸 for children (pediatric spleen-strengthening pills), 健胃消食片 (digestive tablets), or cimetidine tablets under medical guidance to alleviate symptoms.

5. Candida Infection

The immune system of newborns is not yet fully mature, allowing Candida in the oral cavity to overgrow. When the immune system cannot effectively control this growth, Candida proliferates and adheres to the tongue and oral mucosa, forming white patches. Infants may also experience oral pain, irritability, difficulty breastfeeding, and other symptoms. It is recommended to use medications such as nystatin tablets, fluconazole for injection, or bifidobacterium quadruple viable tablets under medical supervision.

It is recommended to maintain good oral hygiene for the newborn. After each feeding, gently wipe the baby's tongue and oral mucosa with a clean, soft piece of gauze or a finger brush using lukewarm water.