Did you receive a note home from your baby or toddler's day care informing you of a reported case of hand, foot and mouth disease (HFMD)? Take a deep breath.
Despite its cringe-worthy name, hand, foot and mouth disease (often caused by coxsackieviruses) is very common in babies, toddlers and preschoolers under age 5. Even though it spreads like wildfire — especially in day care settings — the infection is usually mild.
Here's everything you need to know, including how to prevent it in your little one(and yourself!)
What is hand, foot and mouth disease (coxsackievirus)?
Hand, foot and mouth disease is an infection caused by a virus, most frequently coxsackieviruses (usually types A and B), which are part of the enterovirus family. Doctors see it most during the summer and fall, although cases happen year-round.[1]
While it usually isn't serious, HFMD is like many viruses in that it can make young children (and their parents) pretty miserable.
The telltale sign of hand, foot and mouth disease is a painful bumpy, red rash or blisters in places you probably already guessed — the palms of the hands, soles of the feet and inside the mouth.
The virus is spread from person to person typically via respiratory droplets, unwashed hands, nasal secretions and/or fluid from blisters, to name a few ways. It can also cling to surfaces, where it can live for several days. Get your disinfectant ready!
Note: There is also a similar sounding infection called "foot and mouth disease," but this one is only seen in farm animals (usually cattle and swine). As much as you might compare your toddler to an animal, foot and mouth disease can't be passed to humans.
What causes hand, foot and mouth disease?
Babies or toddlers catch hand, foot and mouth disease from other babies, children or adults who have the virus. It's commonly caused by several different viruses and strains of the coxsackievirus.
Read This Next
Here's how hand, foot and mouth disease is transmitted:
Direct person-to-person contact
Your child (and you) can become exposed by direct contact with an infected person — especially if that little person coughs or sneezes on your little one or gives them a hug or a high-five. This also includes contact with open sores of an infected person. Parents and caregivers should be extra diligent about handwashing after any possible contact with a child's open sores.
Respiratory contact (i.e. saliva, sneezing, coughing)
What baby or toddler isn't known for putting just about everything into her mouth? Despite any parent's best effort, this age is prime for contracting viruses (and spreading that virus to others). Young babies under 6 months old are less likely to catch hand, foot and mouth because they're not moving around and grabbing objects as much, but an infant can become infected if a person carrying the virus touches the baby's hands or face.
Stool contact
In day care settings, many young children are together over the course of frequent diaper changes and possible accidents. In addition to hand, foot and mouth disease, contact with poop increases the risk of so many other viruses and infections.
Contaminated surfaces
That toy your toddler had in her mouth, the countertop she touched after sucking her thumb or the cellphone she just slobbered all over in the grocery checkout line are all examples of contaminated surfaces if your child also has hand, foot and mouth disease.
What are the symptoms of hand, foot and mouth disease?
Symptoms of hand, foot and mouth are progressive and typically appear three to six days after you or your child was first exposed to the virus.[2] (The waiting time is called the incubation period.) They include the following:
- Fever. This virus may first appear as a low-grade fever for one to two days. Your child may also have common cold symptoms such as fatigue, runny nose and sore throat. If your baby's temperature climbs to 100.4 degrees Fahrenheit or higher, you should call your doctor immediately if your little one is under 3 months old.[3] Regardless, you should call your pediatrician if your child has a fever of 100.4 or higher because she might need a COVID-19 test. Some children who get hand, foot and mouth don't have a fever at all, however.
- Mouth sores. After a day or two of fever, sores usually appear on the roof of the mouth, gums, tongue and inner lips. The sores often make eating and drinking difficult and may cause loss of appetite. Babies and toddlers may be extra fussy and refuse to nurse or drink from a bottle or cup because their mouth hurts. You might also notice more drool. Watch your child for signs of dehydration, which include dry mouth and fewer wet diapers or trips to the potty. In some children, hand, foot and mouth disease symptoms stop here.
- Body spots. Over the next day or so, the rash and red blisters may appear on various other parts of the body, such as fingers, palms of the hands, soles of the feet, elbows, knees, genital area and buttocks. The body spots vary; some might be tiny, flat and barely noticeable, while others may be more raised, sometimes with small fluid-filled blisters that may break open and crust over. Fortunately, these spots are usually not itchy, but sometimes, depending on their location, they can be painful.
Symptoms usually run their course for about one week. Peeling of the fingers and toes after one to two weeks can happen afterwards, but it's harmless.
If your child's fever lasts more than three days, or if she isn't drinking liquids or experiences dehydration, call the pediatrician immediately.
The symptoms of hand, foot and mouth in adults and older children are the same as the symptoms seen in babies and toddlers, but they tend to be milder in older age groups because they have stronger immune systems.
Pregnant moms who have been exposed to hand, foot and mouth disease may experience any of these symptoms and should let their doctors know right away. Fever in pregnancy can be harmful to a fetus, especially in the first trimester.
Is hand, foot and mouth contagious?
Yes, the virus is very contagious. Hand, foot and mouth spreads easily through families and day cares as the virus can live in an infected person's body for weeks or even months after symptoms have gone away.
Children, including babies and toddlers, are usually considered contagious two days before a rash or sores appear and until two days after they go away.
Check the policy at your child's day care or preschool. Most say children can return once they feel well enough to participate, their blisters have dried up and they're fever-free for 24 hours.
Can my child get hand, foot and mouth disease again?
Unfortunately, yes! The body will create immunity to the particular strain of the virus that caused your child's first bout of hand, foot and mouth disease. However, there are many different strains that could cause symptoms a second (and third) time.
How is coxsackievirus diagnosed?
If you think your child may have hand, foot and mouth disease, call your pediatrician. Typically, he or she will be able to diagnose your child by examining her and getting a read on her symptoms.
If your child is diagnosed with hand, foot, and mouth disease, make sure to inform the day care or school. Your privacy will be protected, but they do need to alert other parents and staff members to watch for symptoms and do their part to fully disinfect.
Treatments for hand, foot and mouth disease
In general, mild cases of hand, foot and mouth disease can be managed at home. (And no, you don't need antibiotics. HFMD is caused by a virus, not a bacteria.)
Here are some home remedies for treating hand, foot and mouth disease:
Over-the-counter pain and fever medicine
You can give acetaminophen (Tylenol) to a feverish baby who is 2 months or older and ibuprofen (Motrin or Advil) to a child 6 months or older. Follow the dosing instructions on the label, and never give medication to babies under 2 years old without consulting your pediatrician first.
If your child's mouth is sore, it might be a good idea to offer the medication 30 minutes before mealtime to help make eating and drinking less painful.
Plenty of liquids
Dehydration is a risk for little ones with hand, foot and mouth disease. Offer your sick child plenty of fluids to stay hydrated. For breastfed and formula-fed babies under 6 months, that will mean offering more frequent (and possibly smaller) feeds.
For babies older than 6 months, give water between nursing sessions or bottle feedings. And for children over a year old, you can offer water or a rehydration fluid like Pedialyte. You may need to give your toddler frequent sips of one or the other every 15 minutes. Check with your doctor.
Colder, softer foods
Think about what foods you'd want if your mouth or throat were sore. Ice cream, Popsicles, pudding and smoothies can be very soothing, along with warmer soft foods like mac-and-cheese and mashed potatoes. If your baby isn't on to solid foods just yet, you can actually make breast milk ice pops if you're so inclined.
Avoid giving your older baby or toddler salty, citrusy or spicy foods, along with acidic or citrusy drinks, as those can make mouth and throat sores more painful.
More sleep
There is something to be said about the power sleep has on healing our bodies. When your little one has a fever or is in pain, she's bound to be crankier.
Give her more opportunities to rest during the day, as she may have a harder time sleeping at night. (This treatment works for parents too.)
More snuggles and cuddles
There's nothing wrong with being a couch potato for the time it takes for your little one to recoup. Sometimes a little bit of TLC from Mom or Dad is enough to make her feel a little better.
How do you disinfect after hand, foot and mouth disease?
Disinfecting for viruses that can cause hand, foot and mouth disease and other diseases involves the following steps:
Put on gloves
Gloves can be disposable ones you throw away after one use or reusable gloves you have in your kitchen for various household cleaning and chores.
Scrub with soap and water
Any household cleaner and water will do. Because hand, foot and mouth disease can live on surfaces like toys, it's helpful to have a bin for the ones you see your teething baby or toddler munching on.
Keep the bin out of your child's reach, and wash the toys when you have time.
Disinfect
When it comes to disinfecting small toys, dishwashers are super handy and effective. No dishwasher? No problem. Over-the-counter cleaning products containing bleach also do the trick.
You can make your own disinfectant by diluting household bleach. Prepare a bleach solution by mixing 5 tablespoons (roughly a third of a cup) bleach per gallon of water, or 4 teaspoons bleach per quart of water. (If you go the DIY route, know that homemade bleach solutions are only effective at disinfecting for 24 hours. Only make what you plan to use that day.)
Wash hands, and safely store products when finished cleaning
This step is important for removing any chemicals that may have made their way to your hands in the process. Also be sure to store all cleaning products out of reach of your baby or toddler when you're done, in a high cabinet with a safety latch.
Call your child's day care or preschool
Ask your child's day care or preschool what methods they use for cleaning and disinfecting. Make sure they are using disposable gloves and have protocols in place to sanitize hands and changing areas from one child to the next.
Is there any way to prevent hand, foot and mouth disease?
It's very difficult to prevent your child from catching hand, foot and mouth disease. What you can do is reduce your little one's risk by practicing good hygiene and modeling (and coaching) healthy habits in the following ways:
- Wash hands frequently (especially before mealtime and after changing diapers).
- Don't share cups or eating utensils — even within the family.
- Carry hand sanitizer around for times when a sink may be unavailable.
- Discourage your child from touching her eyes, nose or mouth.
- Regularly clean and disinfect toys and surfaces.
- Avoid close contact with other children and adults who appear sick or under the weather.
While any threat to your baby or toddler's health is scary, know that hand, foot and mouth disease is a common condition that can easily be monitored and managed by your pediatrician. It will most likely go away on its own within a week.
So don't stress too much. By keeping your child hydrated and comfortable, you're doing a great job, and your little one will be back to herself in no time.
Yes 
No 
Trending On What to Expect
