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I’m breastfeeding my 10-week-old daughter and have always noticed a white tongue due to the breast milk. For two days now,  I have noticed small black dots on her white tongue. Is this a symptom of thrush? If not thrush, what could be the cause? She seems comfortable and in good spirits otherwise.—R.T. ,a mom of two in Toronto, Ontario

Our Mommy MD Guide’s reply: I nursed all of my babies, and at least one of them had thrush. 

I’m glad your daughter is happy and nursing well. Those are always good signs. Thrush is a caused by the growth of a fungus, called Candida albicans, on the tongue and elsewhere in the mouth. It’s rather common in nursing babies. 

The fungus normally appears in creamy white patches, but there can be variations of color. The patches can be painful, and if you scrape them lightly with a clean washcloth, they might bleed. Usually the patches appear on a baby’s tongue or inner cheeks, and they can spread to the roof of the mouth, gums, and back of the throat. 

Because thrush can be painful, babies with thrush sometimes don’t eat well, and they often cry. 

I’d recommend calling your baby’s pediatrician’s office on Monday to discuss your baby’s signs and symptoms with the nurse. A baby who’s nursing can spread thrush to the mother’s nipples, so if your baby is diagnosed with thrush, ask the doctor about treating yourself, too. Take care! 

Rallie McAllister, MD, MPH, MSEH, a mom of three sons, family physician, and coauthor of The Mommy MD Guide to Pregnancy and Birth 

When to call the doctor or midwife: If you think your baby has thrush, call your doctor the next business day. 

The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.