{"id":15458,"date":"2020-09-14T10:00:50","date_gmt":"2020-09-14T14:00:50","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=15458"},"modified":"2022-08-24T11:56:56","modified_gmt":"2022-08-24T15:56:56","slug":"hand-foot-and-mouth","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/hand-foot-and-mouth\/","title":{"rendered":"The parent\u2019s guide to hand, foot, and mouth disease in children"},"content":{"rendered":"<p><i><span style=\"font-weight: 400;\">Endless coughs and sneezes, runny noses, and unexplained itchy bumps\u2014kids seem to be a magnet for germs. In our parent\u2019s guide to childhood illnesses, we talk about the symptoms and treatments for the most common conditions. Read the full series <\/span><\/i><a href=\"https:\/\/www.singlecare.com\/blog\/tag\/common-childhood-illnesses\/\"><i><span style=\"font-weight: 400;\">here<\/span><\/i><\/a><i><span style=\"font-weight: 400;\">.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\"> <a href=\"#HFMD\">What is HFMD?<\/a> | <a href=\"#symptoms\">Symptoms<\/a> | <a href=\"#diagnosis\">Diagnosis<\/a> | <a href=\"#treatment\">Treatment<\/a> | <a href=\"#prevention\">Prevention <\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hand, foot, and mouth disease sounds like something you would find in a barnyard, but it is actually a common and usually harmless childhood illness. It is contagious and often spreads easily through\u00a0<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/back-to-school-health-tips\/\"><span style=\"font-weight: 400;\">schools<\/span><\/a><span style=\"font-weight: 400;\"> and child care centers. Thankfully, most cases are mild and children recover without any serious or lasting effects.<\/span><\/p>\n<h2 id=\"HFMD\">What is hand, foot, and mouth disease (HFMD)?<\/h2>\n<p><span style=\"font-weight: 400;\">HFMD is a viral illness (usually coxsackievirus a16 or other enteroviruses). In the United States, it occurs more often in the\u00a0<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-keep-your-kids-healthy-all-year-long\/\"><span style=\"font-weight: 400;\">summer and fall<\/span><\/a><span style=\"font-weight: 400;\"> seasons. While adults and older children can catch the viral infection, it\u2019s most commonly in young children 6 months to 5 years old. It is not related to any animal diseases\u2014despite the similarity in name to foot-and-mouth disease (also known as hoof-and-mouth disease), which affects cows, sheep, and pigs.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The hallmark of HFMD is red flat spots that may blister in the mouth, on palms of the hands and soles of the feet, and occasionally on other areas of the body.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The\u00a0<\/span><a href=\"https:\/\/www.healthychildren.org\/English\/health-issues\/conditions\/infections\/Pages\/Hand-Foot-and-Mouth-Disease.aspx\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">incubation period<\/span><\/a><span style=\"font-weight: 400;\"> (time from exposure to illness to the appearance of symptoms) for HFMD is three to six days. People are<\/span>\u00a0<a href=\"https:\/\/www.cdc.gov\/features\/handfootmouthdisease\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">most contagious<\/span><\/a><span style=\"font-weight: 400;\"> during the first week of illness, but the virus can stay in the respiratory tract and shed for several weeks after a person recovers, and HFMD can be spread through feces up to several months after recovery. It\u2019s also possible to have HFMD and not be symptomatic, particularly for adults. Asymptomatic carriers of HFMD can still spread the illness.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because the illness is usually mild, and the contagious period can be long, children don\u2019t need to stay home from<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/school-nurses-chronic-conditions\/\"> <span style=\"font-weight: 400;\">school<\/span><\/a><span style=\"font-weight: 400;\"> or daycare, unless:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">They have a fever.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">They feel too unwell to participate.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There is a policy in place at the school or daycare that requires children with HFMD to stay home.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">They have open blisters. (The fluid inside the blisters is contagious. Blisters take about a week to dry up.)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Their healthcare provider recommends they stay home.<\/span><\/li>\n<\/ul>\n<h2 id=\"symptoms\">Hand, foot, and mouth symptoms<\/h2>\n<p><span style=\"font-weight: 400;\">HFMD starts with cold-like symptoms such as fever, sore throat, and runny nose. Then, blisters appear on the hands and\/or feet and (usually ulcers) in the mouth.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the U.S. Centers for Disease Control and Prevention (CDC), symptoms of hand, foot, and mouth disease include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Flat red spots (about the size of a pencil eraser or smaller) that rash on hands, feet, and sometimes buttocks, knees, elbows and\/or genitals. The rash consists of flat red spots that may blister.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Painful sores in the mouth that begin as flat red spots\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Sore throat<\/span><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/blog\/fever-temperature\/\"><span style=\"font-weight: 400;\">Fever<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Feeling unwell<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Reduced appetite<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Drooling<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Your child\u2019s symptoms may not all be present at the same time. Most cases of HFMD are mild and follow the above pattern of symptoms\u2014but a more severe form of HFMD caused by a new coxsackie virus began occurring in 2012 and continues to circulate.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Symptoms of severe HFMD are the same as HFMD, but can also include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A rash made up of many small blisters on arms, legs, and face.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Loss of fingernails and\/or toenails. This occurs in 4% of severe cases, three to six weeks into the illness. They will grow back (in three to six months for fingernails and nine to 12 months for toenails) and will look normal when they do.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It\u2019s common for the skin on fingers and toes to peel a week or two into HFMD. This is harmless and can be helped by applying moisturizing cream.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serious complications from HFMD are rare, but can include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Viral meningitis (an inflammation of the lining of the spinal cord and brain, which could result in a hospital stay for a few days)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Paralysis (rarely)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Encephalitis (brain inflammation, occurs rarely)<\/span><\/li>\n<\/ul>\n<h2 id=\"diagnosis\">How is hand, foot, and mouth diagnosed?<\/h2>\n<p><span style=\"font-weight: 400;\">\u201cHand, foot, and mouth disease is usually diagnosed clinically,\u201d says<\/span><a href=\"https:\/\/www.drsomamandal.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">Soma Mandal<\/span><\/a><span style=\"font-weight: 400;\">, MD, a board-certified internist at Summit Medical Group. \u201cThere is a typical appearance and location of the oral lesions and\/or lesions on the hands or feet. When the diagnosis is uncertain, a throat swab, stool sample, or fluid from the rash can be sent for testing.\u201d However, testing is rarely done since it can be expensive and won\u2019t change the management of symptoms since there is no treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">HFMD is usually diagnosed by a pediatrician or family\/general healthcare provider. Children should see their healthcare provider for diagnostic purposes, but in most cases the healthcare provider will not prescribe medical treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cCall your healthcare provider if the symptoms do not improve within a week, the child has a weak immune system, or is under 6 months of age,\u201d says Leann Poston, MD, a medical contributor for <\/span><a href=\"https:\/\/ikonhealth.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Ikon Health<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Get immediate medical attention if:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your child becomes dehydrated. Signs of dehydration include no urine in eight hours or more, dark urine, very dry mouth, no tears. Dehydration is a concern with HFMD because the child\u2019s sore mouth may discourage normal eating and drinking patterns.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The child looks or acts very sick.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You feel your child needs urgent medical attention.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Speak with your child\u2019s health care provider if:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your child is less than 6 months old.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your child is not immunized or delayed in immunizations\u2014be sure to call the office first to take precautions to prevent contamination.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The rash spreads to the arms and\/or legs.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The rash changes in appearance.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The fever lasts longer than three days.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There is no improvement after 10 days.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Your child has a chronic illness or is immune compromised.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You feel the child needs to be seen, but not urgently.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fingernails or toenails fall off.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">You have questions or concerns.<\/span><\/li>\n<\/ul>\n<h2 id=\"treatment\">Hand, foot, and mouth treatment<\/h2>\n<p><span style=\"font-weight: 400;\">\u201cThere is no medication that will shorten the course of the illness or make it go away,\u201d says Dr. Poston. \u201cAntibiotics will only help if there is a secondary bacterial infection.\u201d However, some over-the-counter medications can provide symptom relief.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Fever and pain relief<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Fever and pain can be treated with over-the-counter medications like<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/childrens-acetaminophen\"> <span style=\"font-weight: 400;\">acetaminophen<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/tylenol-childrens\"><span style=\"font-weight: 400;\">Tylenol<\/span><\/a><span style=\"font-weight: 400;\">) or<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/childrens-ibuprofen\"> <span style=\"font-weight: 400;\">ibuprofen<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/childrens-advil\"><span style=\"font-weight: 400;\">Advil<\/span><\/a><span style=\"font-weight: 400;\"> or<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/childrens-motrin\"> <span style=\"font-weight: 400;\">Motrin<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Mouth sore relief<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">\u201cSome pediatricians recommend a combination of<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/benadryl-allergy-childrens\"> <span style=\"font-weight: 400;\">Benadryl<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/maalox-junior-plus-antigas\"><span style=\"font-weight: 400;\">Maalox<\/span><\/a><span style=\"font-weight: 400;\"> to help with mouth sores,\u201d Dr. Poston says. \u201cCall your pediatrician to see if this is a safe and effective choice for your child.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Liquid antacid, such as Maalox or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/mylanta-maximum-strength\"><span style=\"font-weight: 400;\">Mylanta<\/span><\/a><span style=\"font-weight: 400;\">, can be used as treatment up to four times a day as needed, and is administered according to age. For children aged 1 to 6 years, put a few drops in the mouth or apply directly to mouth sores with a cotton swab. For children older than 6 years, give one teaspoon (5 ml) of Maalox or Mylanta as a mouthwash. Have the child keep it on the ulcers as long as possible then spit or swallow it. <\/span><i><span style=\"font-weight: 400;\">Do NOT use regular mouthwash<\/span><\/i><span style=\"font-weight: 400;\">\u2014it would be quite painful.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cHand, foot, and mouth disease usually goes away on its own in about a week,\u201d says Dr. Mandal. \u201cThe oral lesions may make it difficult to eat or drink, so cold foods such as popsicles or ice cream and pudding or gelatin are easier to swallow.\u201d Opt for hydration over solid foods, or try soft foods like mashed potatoes or soup. Avoid any salty or spicy dishes, which could irritate mouth sores. Bottle-fed babies may find the nipple of the bottle irritating and do better with cup, spoon, or syringe feeding while the sores heal.<\/span><\/p>\n<h2 id=\"prevention\">How to prevent hand, foot, and mouth<\/h2>\n<p><span style=\"font-weight: 400;\">Having HFMD once does not make you immune to it\u2014it is possible to get it again and again.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because HFMD is spread via respiratory route (droplets from coughing, talking, sneezing, etc. land on objects or other people and are transferred to that person\u2019s eyes, nose, or mouth), and via fecal-oral route (poop from an infected person gets on objects that other people touch and then they touch their eyes, nose, or mouth), good hygiene is the best way to prevent the spread and re-infection of HFMD.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cover coughs and sneezes, and teach children how to do so.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Handwashing with soap and water frequently for at least 20 seconds\u2014especially after using a tissue, using the washroom, or changing a diaper.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Clean and sanitize toys regularly, especially ones that have come into contact with saliva.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Avoid sharing food, drinks, toothbrushes, towels, or anything else that comes in contact with the mouth, particularly that of someone who has or has recently had HFMD.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Regularly clean and disinfect frequently touched surfaces.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If a person in the house has HFMD, keep them away from close contact with other children as much as possible\u2014discouraging kissing, hugging, sharing personal items like cups or utensils, sleeping in separate rooms\u2014until the infected person has made a full recovery.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If the child attends<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/why-kids-get-sick-at-school\/\"> <span style=\"font-weight: 400;\">school<\/span><\/a><span style=\"font-weight: 400;\">, daycare, or any place where they are in contact with other children and they contract HFMD, always inform the supervisor so they can let other parents know that their children may have been exposed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hand, foot, and mouth disease isn\u2019t fun, and it isn\u2019t pretty\u2014but it is generally mild and resolves on its own.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Endless coughs and sneezes, runny noses, and unexplained itchy bumps\u2014kids seem to be a magnet for germs. In our parent\u2019s guide to childhood illnesses, we talk about the symptoms and treatments for the most common conditions. Read the full series here. What is HFMD? | Symptoms | Diagnosis | Treatment | Prevention Hand, foot, and [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":53476,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[3564,19608],"coauthors":[8622],"class_list":["post-15458","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-children","tag-common-childhood-illnesses","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Hand, food, and mouth disease in kids: The parent\u2019s guide<\/title>\n<meta name=\"description\" content=\"It sounds like something you\u2019d find in a barnyard, but it\u2019s a common childhood disease. 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