Mathilde Lacombe

As first-time parents, you might notice your infant having newborn thick saliva during their first few weeks. Seeing this can be concerning and confusing, especially when the saliva looks stringy, sticky, or bubbly. While this is usually normal, as a parent, you have to understand its possible causes so you’ll know when it is harmless and when to take action.

There are times when thick saliva isn’t actually saliva at all but mucus from mild congestion or postnatal drip. This is very common in newborns, whose tiny nasal passages can quickly become clogged. Tools like a newborn nasal aspirator can help clear mucus, making it easier for your baby to breathe and swallow comfortably. 

Understanding Normal Newborn Drooling and Saliva Production

Drooling is a common occurrence for babies because they have weak oral muscles, as they are still developing. Instead of swallowing saliva, it will pool in their mouth and dribble out.

Humans have six salivary glands that produce saliva, and when these glands produce excess saliva, they tend to drool. The saliva glands produce 2 to 4 pints of saliva every day. We have teeth and complete muscle control to keep the saliva from running down our shirts. Newborns, on the other hand, have an underdeveloped swallowing reflex, making them more likely to drool or appear to have thick saliva.

The saliva production increases as your baby grows, especially between 3 to 6 months, because this is the time when babies explore the world orally and begin early teething behaviours. Most children gain full control of their swallowing muscles between 18-24 months, which significantly reduces drooling. 

The first major drooling phase typically lasts until 12-15 months, especially as teething progresses. During this time, saliva plays an important role in keeping your baby’s mouth healthy by washing away food particles and bacteria while soothing the gums.

Potential Causes of Excessively Thick or Stringy Saliva

While some drooling and mild newborn thick saliva are normal, certain factors can make your baby’s saliva appear unusually sticky, stringy, or dense.

• Immature swallowing reflex
  

Newborns have not yet developed full control of their mouth and throat muscles. Since they swallow less frequently than older infants, saliva can accumulate and appear thicker than usual. This is one of the most common causes of thick saliva in newborns.

• Dehydration or infrequent feeding
  

If your newborn is not feeding well or is going longer than usual between feeds, saliva can become more concentrated, leading to a pasty or sticky texture.

• Dry air or low humidity
  

When the air is too dry, it can thicken both saliva and mucus. This is prevalent in air-conditioned or winter environments. A humidifier can help maintain comfortable moisture levels to prevent overly thick saliva.

• Oral thrush or mouth irritation
  

Yeast infections in the mouth can change saliva texture, making it thicker or stickier. Babies may also show white patches on the tongue or gums, fussiness during feeding, or poor latch.

Differentiating Thick Saliva from Mucus (Postnasal Drip)

Thick saliva and mucus both look similar, especially when your baby is congested. However, they have different purposes in the body, and knowing the difference between the two can help you understand what your baby is experiencing.

When your baby’s saliva appears sticky, it may be due to dehydration, immature swallowing, or even early teething behaviour. Babies with thick saliva may drool more or have small bubbles form around their lips. Thick saliva looks and feels:

• Clear or slightly bubbly

• Slippery or foamy

• More watery than mucus

• Found mostly in the mouth
  

Mucus is thicker and heavier than saliva. When your baby has a nasal congestion, mucus can drain down the throat, known as postnasal drip, which can cause gagging or coughing. It may appear:

• Cloudy, milky, or yellowish

• Sticky and difficult to wipe

• More concentrated in the back of the throat
  

If the secretion is clear and bubbly, it is more likely a thick saliva. But if it’s sticky, milky, or makes your baby cough, it’s mucus or postnasal drip. Use a newborn nasal aspirator to remove excess mucus from the nose, reducing postnasal drip.

Gastroesophageal Reflux (GERD) as a Factor in Saliva/Mucus Texture

Newborns’ digestive systems are still developing, which is why gastroesophageal reflux is common in them. When milk and stomach acids flow back into the esophagus, it can irritate the throat and trigger the body to produce extra saliva as a protective response. 

When reflux happens:

• Their throat becomes irritated

• Extra saliva mixes with small amounts of milk or mucus

• Secretions may appear thicker or frothier than usual
  

Here are signs that your newborn’s thick saliva may be reflux-related:

• Frequent spit-ups or wet burps

• Gagging or swallowing sounds after feeds

• Hiccups

• Arching of the back or fussiness when lying flat

• Sour-smelling breath or small spit-up stains around the mouth
  

Home Care and Comfort Measures to Manage Secretions

Here’s how you can keep your newborn with thick saliva or excess drooling comfortable and reduce their irritation.

• Use soft, absorbent cloths or drool bibs: A pool of saliva can dampen your baby’s clothes. Use soft, newborn-safe bibs or cloths to keep their skin dry and prevent irritation.
  

• Gently wipe their chin and neck area: your baby’s skin is sensitive, and excess moisture can lead to redness or rashes. Use a soft cloth to lightly pat the area dry.
  

• Apply a protective barrier ointment: if the skin becomes irritated, apply a thin layer of petroleum jelly or a barrier cream approved by your pediatrician to help protect the skin from further moisture.
  

• Keep the air moist with a humidifier: moist air can thin newborn thick saliva and mucus, making it easier for your baby to swallow and breathe comfortably.
  

• Clear nasal congestion safely: if mucus mixes with saliva, it can make secretions appear thicker. Use saline drops and a newborn nasal aspirator to help reduce mucus buildup and improve airflow.

Oral Hygiene Practices to Address Thick Saliva and Potential Thrush

It’s important that your newborn has good oral hygiene, especially when dealing with newborn thick saliva, milk residue, or early signs of thrush. Although newborns don’t have teeth yet, focus on keeping their mouths clean and reducing the buildup of saliva or milk that can contribute to infections.

• Clean their gums with a soft, damp cloth

• Sterelize pacifiers and bottle nipples regularly

• Keep their mouth moist with frequent feeding

• Watch for signs of thrush: white, cottage cheese-like patches on the tongue, gums or inner cheeks, fussiness during feeding, difficulty latching, or thick, sticky saliva

• Remember to avoid wiping off thrush patches forcefully
  

Recognizing Signs of Difficult Swallowing or Breathing Issues

While newborn thick saliva is harmless, it is important that you recognize when saliva or mucus is affecting your baby’s ability to swallow or breathe comfortably. Your little one still has very small airways, so even small changes in saliva or mucus consistency can make them work harder to breathe or feed

Watch for these symptoms that may suggest your newborn is having difficulty swallowing or breathing issues:

• Frequent gagging or choking on saliva

• Coughing during or after feeds

• Drooling combined with poor feeding or weak sucking

• Noisy, congested breathing even when the nose is clear

• Wheezing or raspy sounds

• Flaring nostrils

When to Consult the Pediatrician About Changes in Saliva

It is normal for babies to have newborn thick saliva, and it is an important part of their early development. However, certain symptoms can signal an underlying issue that needs medical attention. Contact your pediatrician if you notice:

• Persistent difficulty breathing

• Frequent choking or gagging episodes

• Poor feeding or signs of dehydration

• Thick saliva mixed with fever or illness

• White patches in the mouth

• Persistent reflux symptoms

• Blue lips, pauses in breathing, or severe distress