Treatment of Aphthous Ulcers in Infants

Initial Management

The American Academy of Pediatrics recommends oral acetaminophen for pain relief in infants with aphthous ulcers 1
Topical 2.5% lidocaine ointment can be cautiously applied to the ulcer in infants, but use sparingly to avoid accidental ingestion 1
Apply white soft paraffin ointment to the lips every 2 hours to provide protection and comfort, as suggested by the British Journal of Dermatology guidelines 2
Clean the mouth daily with warm saline mouthwashes or an oral sponge, as recommended by the American Academy of Pediatrics 1, 2
For infants, parents can use a clean finger wrapped in gauze soaked in warm saline to gently clean the affected areas 1

Consider applying a small amount of topical steroid to accessible lesions in infants, as recommended by the American Academy of Pediatrics 1
Clobetasol propionate 0.05% cream or ointment can be applied topically to affected areas in very small amounts in infants, according to the British Journal of Dermatology guidelines 2
Mucoprotectant agents can help protect the ulcer from further irritation in infants 1
Apply barrier dressings when practical, though these may be difficult to maintain in the oral cavity of an infant, as noted by the Pediatrics journal 3

Ensure adequate hydration in infants with aphthous ulcers, as painful ulcers may cause the baby to resist drinking, as recommended by the American Academy of Pediatrics 1
If the ulcer is on the lip, nursing care is important as an adjunct therapy, according to the British Journal of Dermatology guidelines 4

Overuse of topical anesthetics can lead to accidental ingestion and potential toxicity in infants, as warned by the American Academy of Pediatrics 1
Petroleum-based products carry the risk of accidental oral ingestion in young children, as noted by the Pediatrics journal 3
Systemic corticosteroids should be avoided for simple aphthous ulcers in infants unless absolutely necessary, as recommended by the American Academy of Pediatrics 1