Why does a baby have thick white tongue coating when fed formula milk?

Thick white tongue coating in infants fed formula milk may result from formula residue, incomplete digestive development, insufficient water intake, oral thrush, or indigestion. This condition can be improved through oral cleaning, adjusting feeding practices, increasing fluid intake, or medical treatment. If the thick tongue coating persists or is accompanied by refusal to feed or excessive crying, prompt medical attention is required.

1. Formula residue: Unremoved proteins from formula milk may adhere to the surface of the tongue, forming a thick white layer without other discomfort. It is recommended to gently wipe the infant’s tongue and oral mucosa with a warm, soft cloth after each feeding.

2. Incomplete digestive development: Due to immature spleen and stomach function, infants may digest and absorb formula slowly, leading to milk stagnation and thick white tongue coating. Feed on demand to avoid overfeeding, and hold the baby upright after feeding to burp and aid digestion.

3. Insufficient water intake: Inadequate hydration during formula feeding can cause dryness of the oral mucosa and accumulation of tongue secretions. It is recommended to offer small amounts of warm water between feedings to clean the mouth and maintain hydration.

4. Oral thrush: Caused by Candida albicans infection of the oral mucosa, characterized by white patches on the tongue and inside the mouth that are difficult to wipe off. The infant may refuse feeding and cry frequently. Under medical guidance, use antifungal medications such as nystatin suspension, sodium bicarbonate solution, or fluconazole oral solution to relieve symptoms.

5. Indigestion: Improper feeding or weak digestive function may impair milk digestion, resulting in thick white tongue coating, bloating, and curds in stool. As directed by a physician, medications such as Bacillus subtilis live bacteria granules, pediatric spleen-strengthening and food-accumulation relieving oral liquid, or Xingpi Yang'er granules may be used to alleviate symptoms.

Clean the infant’s mouth promptly after feeding, offer appropriate amounts of warm water between meals, feed regularly according to need, avoid overly concentrated formula, and ensure proper sterilization of bottles and nipples to support healthy oral hygiene and digestive development.