Many assume that bad breath only affects adults, however infants and young children can also be susceptible to the condition. In most cases, improper oral hygiene is the primary cause. However, in younger children, persistent bad breath may indicate underlying health concerns that require medical attention.
1. Health Conditions That Cause Bad Breath in Newborns
If your newborn has bad breath, identifying the root cause is essential in ensuring his/her wellbeing. Bad breath in infants can stem from various factors and should not be ignored, as it may signal an infection in the mouth or throat.
1.1 Sinusitis
A possible cause of bad breath in infants is sinusitis. If your baby has sinusitis, they may also experience frequent nasal discharge and sneezing. This condition can result from allergies, leading to blocked sinus passages. When the sinuses become congested, babies breathe primarily through their mouths, reducing saliva production and causing dry mouth.
A lack of saliva contributes to dry mouth, which can result in bad breath. If you suspect that your child has a sinus infection, schedule a consultation with a pediatrician to determine whether an antibiotic treatment is necessary.
1.2 Enlarged Tonsils
Enlarged tonsils or adenoid hypertrophy can also cause bad breath in newborns. Healthy tonsils are pink and free of spots, whereas infected tonsils may appear red, swollen, and covered with noticeable white patches that emit a foul odor.
Bacteria can accumulate at the back of the throat, and when combined with the sour smell of infection, this can result in unpleasant breath. If your baby’s tonsils appear inflamed, consult a doctor. A pediatrician may prescribe antibiotics to treat tonsillitis and alleviate symptoms.
1.3 Acid Reflux
Furthermore, acid reflux is a common cause of bad breath in newborns. This occurs when stomach contents, primarily milk, regurgitate into the throat due to an immature lower esophageal sphincter in infants. This allows stomach acid to flow back up, leading to frequent spit-ups. Acid reflux is usually not severe and tends to resolve as the baby grows, often subsiding by 18 months of age.
Though reflux often resolves on its own, the following steps may help reduce symptoms:
- Reduce the volume of each feeding while increasing feeding frequency.
- Help the baby burp frequently during feeding.
- Keep the baby upright for 20–30 minutes after feeding.
- Consider switching to a different formula.
- Adjust the pacifier size. A pacifier that is too large or too small may induce the baby to swallow excess air.
If you are breastfeeding, you can try to eliminate certain food such as dairy products, beef, or eggs from your child’s diet to check for possible allergies..
Medication is generally not recommended for uncomplicated reflux in newborns. However, in some cases, a pediatrician may prescribe acid-suppressing medications like Zantac for infants under 12 months or Prilosec for toddlers over 1 year old. Managing their acid reflux may help eliminate bad breath in newborns.
2. Less Severe Causes of Bad Breath in Newborns
Not all cases of bad breath in newborns indicate an underlying health condition. Sometimes, milk or food residue may be wedged under the tongue and gums, promoting bacterial growth and leading to an unpleasant odor. Certain habits, such as thumb sucking or pacifier use, may also contribute to bad breath by promoting growth of odour-causing bacterias, which can be easily remedied with habit changes.
2.1 Thumb Sucking
Thumb sucking is a common habit in babies, affecting approximately 80% of newborns and young children. This behavior can lead to dry mouth, increased bacterial growth, and ultimately bad oral odour. Most children naturally outgrow this habit between ages 2 and 4, with only 12% continuing past age 4.
For children under 4, intervention is not usually unnecessary, as this habit usually self-resolves with age. However, parents should still monitor this behaviour as some children may continue this habit way past their infancy
To minimize bad breath caused by thumb sucking, regularly clean the baby’s mouth, gums, and tongue using a soft, warm washcloth.
2.2 Pacifier Use
When a baby uses a pacifier, saliva and bacteria from the mouth will adhere to the surfaces of the pacifier, leading to an unpleasant odor that can re-enter the baby’s mouth with continued use.
If a pacifier is not cleaned regularly after frequent uses, it becomes a breeding ground for bacteria and germs, increasing the risk of bad breath. To prevent this, consider weaning your baby off the pacifier or ensure it is sterilized frequently to eliminate odour-causing bacteria and germs on the surfaces.
Most children naturally stop using pacifiers between ages 2 and 4. If your child struggles to give it up, consult a pediatrician or dentist for guidance on a smooth transition.
2.3 Excessive Dietary Sugar Intake
Allowing a baby to fall asleep with a bottle can promote bacterial growth, causing oral cavities, and ultimately leading to bad breath. To minimize the growth of oral bacteria and unpleasant breath, it is essential to establish good oral hygiene practices from infancy.
Gently wipe your baby’s gums at least twice a day, especially after feedings or before bedtime. This helps remove bacteria and prevents buildup on the gums. If your baby relies on a bottle to fall asleep, consider transitioning to a water-filled bottle, which does not encourage bacterial growth associated with bad breath.
3. Serious Medical Conditions Associated with Bad Breath in Newborns
In most cases, bad breath in infants is a sign of a localized oral infection, which only requires thorough dental care to resolve. However, in rare instances, it may indicate a more serious underlying medical condition.
3.1 Diabetes Mellitus
Type 1 diabetes occurs when a child's pancreas stops producing insulin, a hormone essential for converting food into energy. This happens because the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Several symptoms may be associated with this condition, including bad breath.
3.2 Chronic Kidney Disease
Chronic kidney disease (CKD) occurs when the kidneys suffer irreversible damage or experience reduced function over time. In young children, CKD may present with additional symptoms, including:
- Poor appetite
- Vomiting
- Headaches
- Stunted growth
- General weakness
- Chronic urinary tract infections (UTIs)
In summary, if your infant has persistent bad breath, it is important to consult a pediatrician. A doctor can help identify underlying causes such as sinus infections, bacterial infections, or other health conditions that may be contributing to the issue.At the same time, parents should establish good oral hygiene habits early on. Keeping your baby’s mouth clean, minimizing exposure to bacteria-prone objects, and promoting proper oral care can help prevent bad breath, allowing your child to maintain that sweet, milk-scented breath throughout infancy.
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