What causes a white tongue coating in a six-month-old baby?

Generally, a six-month-old baby's white tongue coating may be caused by milk residue, inadequate oral hygiene, oral thrush (candidiasis), indigestion, or spleen and stomach deficiency. Appropriate measures can be taken based on the specific situation. Detailed analysis is as follows:

1. Milk Residue

Babies primarily consume milk, and components such as proteins in milk can easily adhere to the surface of the tongue, forming a white coating. After each feeding, give a small amount of warm water to rinse away residual milk in the mouth. No special treatment is required.

2. Inadequate Oral Hygiene

Babies have poor natural oral self-cleaning ability, leading to long-term accumulation of food debris on the tongue and gums. Use sterile gauze dipped in warm water to gently wipe the tongue and gums once or twice daily, taking care to avoid damaging the mucous membranes.

3. Oral Thrush (Candidiasis)

Infection of the oral mucosa by *Candida albicans* results in white, curd-like patches adhering to the tongue surface. The underlying mucosa becomes red and inflamed after the patches are wiped off. Treatment under medical guidance may include nystatin tablets, fluconazole oral solution, or sodium bicarbonate solution. All feeding utensils should be thoroughly disinfected.

4. Indigestion

A baby’s gastrointestinal function is not yet fully developed; improper feeding can lead to food stagnation and upward rising of gastric dampness, resulting in a thick white tongue coating. Medications such as Bacillus subtilis live bacterial granules, Xingpi Yang'er Granules, or pediatric spleen-strengthening and food-accumulation-resolving oral liquid may be taken as directed by a physician. Feed according to demand and avoid overfeeding.

5. Spleen and Stomach Deficiency

A baby’s spleen and stomach functions are still immature, with weak digestive capacity, leading to internal retention of dampness that manifests as a white tongue coating, often accompanied by poor appetite. Under medical guidance, medications such as pediatric spleen-strengthening granules, Shenling Baizhu Powder, or infant spleen-strengthening oral liquid may be used. Gently massaging the abdomen in a clockwise direction can also aid digestion.

In daily care, maintain cleanliness of feeding equipment and practice on-demand feeding to prevent overfeeding. After introducing complementary foods, keep the diet light and easy to digest, and monitor the baby’s mental state and bowel movements. If the white tongue coating persists or is accompanied by irritability, crying, or refusal to eat, seek medical attention promptly to determine the underlying cause.