Baby Has Black Spot On Tongue – Should I Be Alarmed?

Every mom’s horror story is waking up only to realize something about her baby seems off. With delicate infants, it could put you on heightened anxiety most of the time. Such as when you discover black patches in your newborn’s tongue that is certainly not just milk residue. Aside from being unsightly, does it cause any harm?

Black tongue, according to NCBI, is more prevalent in adults than in babies. But in those rare instances, it may happen even to a healthy full-term baby without any underlying medical conditions. It is medically known as lingua villosa nigra, which appears like a black patch of hair in babies’ tongues. Most of the time, it is not a call for alarm and resolves on its own after a couple of weeks, even without treatment. It happens when fungi take over and thrive on the tongue’s growing cells that cause the staining.

Difference between Oral Thrush and Black Tongue

Every human is a host to bacteria and fungi that live with us since we were born. Our immune system is our body’s warrior that stupors their growth, but they still exist within us. In other words, we are all carriers of inactive yeasts since we were born.  

But a tiny little human does not have a fully functioning body of a warrior just yet. That’s why babies are the haven of infections and illnesses as they grow. However, such infections can do so much in strengthening their immune responses later in life.

Most common among these intruders are yeasts like Candida. They are the culprit in spreading nasty infections such as diaper rash, oral thrush, and even the black hairy tongue. But unlike the first two, a black tongue does not cause discomfort or pain. The thing that may bother you the most is the fact that it is hideous to even linger in your baby’s mouth.

A black tongue is specifically located in the tongue, unlike oral thrush where the white patches can spread to the side and the roof of your baby’s mouth.

Causes of Black Tongue

The tongue’s muscle cells continue to grow. Sometimes, the body will not get rid of it faster. It will not shed off properly, especially in babies whose diet cannot cause abrasion to shed it off. Thus, they build up a layer of dead skin cells.

That’s when the yeast begins to thrive in these layers that resemble that furry discoloration. Sometimes the color can range from brownish into a greenish hue and not necessarily black.

Poor oral hygiene can also lead to tongue discoloration in infants. Still, this is associated with the overgrowth of yeast in the mouth. If your baby has an antibiotic medication, he may also manifest black tongue as a side effect.

For older children who may have suffered from diarrhea and upset stomach, the doctor may have recommended Pepto-Bismol. This product contains bismuth, that when bonded with the sulfur found in saliva, can create a black tongue.

On a different note, bismuth sub-salicylate is not safe. So, most doctors may recommend non-bismuth remedy if your child is suffering from a tummy problem. These medicines are safe even for two-year-old toddlers and will not risk turning your baby’s tongue black.  

Here are the common causes of black tongue in brief:

  • Candida infection
  • Poor oral hygiene
  • Antibiotic use
  • Bismuth staining
  • Food staining in older kids

Other Mouth Problems in Babies

Mouth problems are very common among babies. Most of them are harmless but can cause some major discomfort. Here are some of them that your baby is likely to experience as he grows up.


Oral thrush or white tongue is common in newborns, but may also happen in older babies. It is characterized by white patches in the tongue that may be painful when he is sucking during feeding. Babies with thrush may pass the infection to their mothers’ nipples if they are being breastfed.

Like the black tongue, thrush may resolve on its own after a few days. But since it may get in the way of his feeding, most moms choose to apply treatment for it. Furthermore, it is always a two-way treatment for both the mom and the baby. It will prevent spreading the infection from the baby’s mouth to a mother’s breast and vice versa.


Teething is one of the most disconcerting moments in your child’s life. He may become fussy and refuse solid food due to swollen gums before those baby teeth erupt. Some babies may even run a low-grade fever. While this is just another milestone in your child’s life, it’s also one of the most painful. There’s little you can do to alleviate his pain except to give him teething toys to keep him pacified.

Strawberry Tongue

A swollen and red tongue is uncommon in newborns and babies. It may be a precursor of other medical conditions. In older children, this may be a sign of an allergic reaction or a vitamin B-12 or folate deficiency. A strawberry tongue may also be a symptom of other serious illnesses like scarlet fever or Kawasaki disease.

Strawberry tongue can be treated depending on its cause. In any way that your child develops a swollen and red tongue, you should contact your pediatrician immediately.

Ulcers or Cold Sores

Ulcers and cold sores are also mouth diseases that can happen to older children. It is harmless in toddlers, but can get very dangerous in newborns and infants. It is caused by a virus and is therefore contagious. That’s why parents should be reminded to avoid kissing newborns to prevent them from contracting this disease. Wash your hands properly before handling your baby and his stuff.

If your baby has come in contact with someone having a cold sore, you need to contact your healthcare provider. It can get severe in very young babies as their immunity is not yet fully developed.

Black Tongue Treatment and Prevention

A black tongue, even on infants, will not require any treatment. A good and proper oral hygiene is the simple cure that is necessary for warding off other mouth and gum diseases in children. It should start as soon as your baby comes out of your womb and not only when he starts growing his teeth.

If the child is under medication, the black tongue will eventually fade off.

Cleaning your baby’s tongue every day helps prevent yeast from growing. Scraping it gently with a soft cloth or gauze will also lessen the appearance of any discoloration. Here’s how to clean your baby’s mouth properly:

Wash your hands

It’s a no brainer. The washing of hands is the most important step parents should not miss. It is a precautionary measure that your family and visitors should adopt around your baby. With the grim threat of the pandemic today, you can never be too lenient.

Clean your newborn’s tongue

Clean your newborn’s tongue

Infants do not produce as much saliva to remove milk residue in their mouths. Also, their milk diet cannot cause abrasion to scrape it off. Microorganisms can then thrive in the groove of your baby’s tongue if that milk residue is not removed. Make cleaning your baby’s tongue a daily habit until he is a little old enough to use a toothbrush.

Here’s how to do it:

  1. Wash your hands.
  2. Wrap a soft cloth or gauze around your finger.
  3. Dip it in lukewarm water, free of cleaning agents or anything.
  4. Gently rub the cloth in your baby’s tongue in a circular motion.
  5. Clean his gums, inside cheeks, and roof of the mouth as well.

Clean your baby’s stuff

Clean your baby's stuff

Sterilizing all the equipment like feeding bottles, dummy nipples, teething rings, and breast pumps can ward off bacteria and fungi growth. You can boil your baby’s feeding equipment for at least 10 minutes but make sure that these items are safe for boiling.

Steam and cold sterilizing are also good options. Never use a kitchen microwave for your baby’s stuff. It will not clean it thoroughly, but will only risk damaging the bottles and teats. You can purchase a microwave sterilizer specially designed for cleaning baby feeding equipment if you want to.

Clean your nipple before feeding

Clean your nipple before breastfeeding

No matter how plaintive that hunger cry can get, always take time to clean your nipple before feeding. According to experts, breastfeeding is one way of lessening the influx of infection among infants.

Owe it to the important components found in the mother’s milk. Clean and dry your nipple to remove harmful contaminants and microorganisms that may have attached to it before EVERY feeding.


A black tongue is not a cause for alarm if you find it in your baby’s tongue. It is caused by fungi feasting on dead skin cells that the baby’s tongue has not shed off. It can resolve on its own without any medication or therapy.

The best way to prevent and treat any mouth and gum problems in infants is by adapting a hygienic lifestyle. Babies need a sterile environment as their immune system is still developing. But if your instinct tells you that you need a doctor’s appointment, don’t hesitate to do so.  

Has your baby experienced this situation? What measures did you do to remove it fast? Share with us your baby’s story in the comment section below.

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Ann Marie is a licensed nurse in the Philippines. She experienced handling and assisting deliveries of newborns into the world. She also trained in labor rooms and pediatric wards while in nursing school - helping soon-to-be mothers and little kids in the process. Though not a mother by nature but a mother by heart, Ann Marie loves to take care of her younger cousins as well as nephews and nieces during her free time.

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