We spoke with Dr Manish Mittal, Senior Consultant – Paediatrics, Cocoon Hospital, Jaipur, to understand more about Epstein pearls in newborns.
What Are Epstein Pearls in Newborns?
Epstein pearls are tiny white or yellowish bumps that can appear inside a newborn’s mouth.They are small cysts filled with a protein called keratin and are usually found:
- Along the baby’s gums
- On the roof of the mouth
- Near the area where the hard and soft palate meet
What Do Epstein Pearls Look Like?
Epstein pearls usually look like:- Small, round bumps inside the baby’s mouth
- White, cream, or yellowish in colour
- Only a few millimetres in size
- Firm to the touch rather than soft
- Similar to tiny teeth or leftover milk
- Easy to notice when the baby opens their mouth
Why Do Newborns Get Epstein Pearls?
Epstein pearls form naturally during a baby’s development before birth. As the mouth develops, some cells can become trapped beneath the surface and form these tiny bumps. There is nothing parents can do to prevent them, and they are not caused by feeding or poor hygiene.Are Epstein Pearls Normal in Newborns?
Yes, Epstein pearls are normal and harmless in most newborns. They are quite common and usually do not bother the baby. They are not linked to serious health problems and generally do not affect the baby’s daily activities.Do Epstein Pearls Affect Breastfeeding or Bottle-Feeding?
“Epstein pearls are harmless and usually do not cause pain. Babies can continue breastfeeding or swallowing normally without discomfort.”- Dr Manish Mittal, Senior Consultant – Paediatrics, Cocoon Hospital, Jaipur
Epstein Pearls vs Oral Thrush: What’s the Difference?
White spots in a baby’s mouth can sometimes be confused with oral thrush.| Epstein Pearls | Oral Thrush |
| Small, white or yellowish bumps | White patches or coating |
| Usually found on the gums or roof of the mouth | Often appears on the tongue, inner cheeks, gums, or roof of the mouth |
| Firm and separate from nearby tissue | May look like creamy patches |
| Usually do not bother the baby | May sometimes make feeding uncomfortable |
| No treatment is usually needed | May need antifungal treatment prescribed by a doctor |
How Long Do Epstein Pearls Last?
Dr Manish Mittal says that Epstein pearls usually disappear on their own within a few weeks after birth. You may notice them becoming smaller before they completely go away. They do not need to be squeezed, scraped, or treated. If the spots persist longer than expected or start to look different, have your baby checked by a paediatrician.Do Epstein Pearls Mean My Baby Has a Dental Problem?
No, Epstein pearls are not a dental problem. They are a normal finding in a newborn’s mouth and are different from natal teeth, which are actual teeth present at birth.If you are unsure whether a white bump is an Epstein pearl or a tooth, your baby’s paediatrician or dentist can take a quick look and confirm what it is.
What Can Parents Do at Home?
Dr Manish Mittal says that most parents do not need to do anything for Epstein pearls. Leaving them alone is usually the best approach while they naturally clear.- Feed your baby as usual
- Do not pop, squeeze, or scrape the bumps
- Avoid applying oils, medicines, or home remedies
When Should Parents See a Doctor?
Consider contacting your baby’s paediatrician if:- Your baby is having trouble feeding or refusing feeds
- Your baby develops a fever or seems unusually unwell
- The spots spread or appear in several areas of the mouth
- You notice bleeding or fluid coming from the spots
- The spots remain for longer than expected
- You are unsure whether the spots are Epstein pearls or another mouth condition
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FAQs on What Are Epstein Pearls in Newborns? Are They Normal?
- Are Epstein pearls contagious?
No. Epstein pearls are not contagious because they are not caused by an infection. Your baby cannot spread them to another baby through feeding, touching, or close contact. They develop naturally during mouth development before birth. - Can Epstein pearls interfere with teething later?
No. Epstein pearls do not interfere with the normal development or eruption of baby teeth. They are separate from the teething process and usually disappear well before your baby’s first teeth begin to appear. - Do Epstein pearls leave scars?
No. Epstein pearls usually disappear without leaving scars or marks. Once they clear, the baby’s mouth generally looks normal again, and there is usually no lasting change to the gums or palate.