Afty Bednar in children

, medical expert
Last reviewed: 08.10.2019

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The mysterious word "aphthae" in Greek means sores on the surface of mucous membranes. Afty Bednar is the erosion in the mouth mainly in newborns, rarely in older children. Most often, premature, weakened babies and children from dysfunctional families are exposed to the disease, where they do not pay enough attention to oral hygiene. [1]


The classification and incidence rates are unclear. Depending on the study, incidence rates vary greatly from 4.1% to 52.6%   [2],  [3], [4]

Causes of the down Bednara

One of the main causes of damage in the mouth is permanent injury to the mucous membrane due to:

  • rough nipple skin (happens when scarring cicatrization);
  • too tight latex nipples;
  • use of unorthodontic pacifiers;
  • rubbing the mouth after feeding hard material (bandage, gauze). [5]

Other risk factors for the formation of aft are bottle non-sterility, a reflex to pull various objects into the mouth, a consequence of other diseases (influenza, celiac disease,  [6]gastrointestinal, etc.).

A study by Bessa et al. [7] revealed that Bednar's aft is the cause of: damage to the oral mucosa (24.9%), improper bite (4.7%). A study by Bezerra and Kosta  [8] shows that 2.3% of children aged 0 to 5 years experienced lesions of the oral mucosa, consisting of Bon nodules (37%), candidiasis (25%) and geographic language (21%).


Aphthae caused by injury, pass through the stage of formation of a bubble, its rupture, inflammation and necrosis of tissues, covering the defect with whitish fibrin - the final product of blood coagulation - insoluble fibrous protein that covers the wound and promotes its healing.

The pathogenesis of other forms (herpetic, recurrent stomatitis, etc.) is associated with the etiology of these pathologies.

Later reports suggest a new hypothesis about the pathogenesis of Bednar aft as a consequence of the immune process. [9]

Symptoms of the down Bednara

The first signs of Bednar aft in children are expressed in a special restless and agitated behavior. While breastfeeding, touching the nipple causes pain, the child stops and cries.

They are clearly visible in the mouth with the naked eye. The characteristic of the Bednar’s afta is the following: located between the hard and soft palate, irregular oval in shape, outlined with a red, inflamed rim, symmetrical in relation to each other, covered with a friable yellow-grayish tinge, soft on palpation. [10]

Complications and consequences

Usually heal spontaneously within one month without complications. 

The ulcers in the mouth heal, but with a long process, this may affect the flow of nutrients into the body of the child, because the baby does not fully receive the required dose of mother's milk because of the pain during feeding.

Attaching a secondary infection can provoke ulcers and even perforation of the palate.

Diagnostics of the down Bednara

The diagnosis is made on the basis of the anamnesis and the characteristic clinical picture. 

Examination of a smear taken from the surface of an aphta and serodiagnosis help to recognize the disease.

Differential diagnosis

Differential diagnosis is carried out with chronic recurrent aphthic stomatitis (its lesions are located elsewhere), herpetic sore throat, syphilis, tuberculosis, diphtheria. [11], [12]

Treatment of the down Bednara

In the diagnosis of aphtha Bednar, first of all, they eliminate the damaging factor: they pick up the right nipple, use special pads on the chest, which do not allow coarse areas of the breast to touch the baby’s mouth, sterilize the bottles.

Treatment consists of treating oral erosion from plaque with drugs such as trypsin, chymotrypsin, lysozyme (the bandage is moistened in a 0.05% solution), for this purpose, applications of proteolytic enzymes can be used for 10 minutes. This is followed by treatment with antiseptic agents of plant origin (decoctions of chamomile, sage, St. John's wort) and accelerating tissue regeneration (rosehip oil, sea buckthorn).

The pain is removed by local means: anesthetic ointment, lidocaine.


Preventive measures relate to raising parents' awareness of how to behave with a newborn, how to follow the rules of breast and artificial feeding, how to properly handle nipples.

Rubbing the mouth of a child with a preventive purpose is not required. Older children should be weaned from dragging foreign objects into their mouths.


The prognosis of pathology is favorable, although healing sometimes does not occur too quickly.

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