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Parent’s Guide

Parent’s Guide: Hand-Foot-and-Mouth Disease

HFMD is a viral infection common in children under age 4. It is famous for causing a distinct rash and painful mouth sores. While uncomfortable, it typically resolves on its own without complications.

1

✅The Quick Check: Is it HFMD?

The diagnosis is based on where the spots appear. Look for small red spots or tiny water blisters in these specific areas:

  • The Hands: Palms and fingers.
  • The Feet: Soles and toes.
  • The Mouth: Small ulcers (sores) on the tongue or sides of the mouth.
  • The Buttocks: About 20-30% of children also get spots on their bottom.

Other Symptoms:

  • Low-grade fever (usually under 102° F).
  • Fussiness (due to mouth pain).
2

The “Severe” Form (Don’t Panic)

Since 2012, a stronger strain (Coxsackie A6) has become common. It looks worse but is treated the same way.

  • Widespread Rash: The rash spreads to the arms, legs, and face.
  • Peeling: 1 to 2 weeks later, skin on fingers and toes may peel.
  • Nail Loss: In rare cases, fingernails or toenails may fall off weeks later. This is painless and they will grow back normal.
3

🚨 When to Get Help

Call Doctor Now or Go to ER

  • Dehydration: This is the main risk because it hurts to drink. Look for: No urine for 8 hours, dry mouth, no tears.
  • Appearance: Child looks very sick or is hard to wake.

Contact in 24hrs

  • Gums are red, swollen, and tender.
  • Sores appear on the outer lip.
  • Fever lasts more than 3 days.
  • The rash spreads to arms and legs (just to confirm diagnosis).
4

🏠Home Care: Managing the Pain

There is no medicine to cure the virus; you simply have to manage the symptoms while it runs its course. Mouth pain is the biggest challenge.

Pain Relief

  • Medicine: Use Acetaminophen (Tylenol) or Ibuprofen (Advil/Motrin) to control pain and fever.
  • Magic Mouthwash (Age 1+): You can use liquid antacid (like Mylanta) to soothe mouth sores.
    • Ages 1–6: Put a few drops directly on the sores with a cotton swab.
    • Ages 6+: Have them swish 1 teaspoon as a mouthwash.

Diet & Hydration (The “Cold & Soft” Rule) Eating hurts. Avoid salty, spicy, or acidic foods (like orange juice).

  • Go Cold: Popsicles, slushies, milkshakes, and sherbet numb the mouth and provide fluids.
  • Go Soft: Mashed potatoes, mac and cheese, or cool soup.
  • Babies: If the bottle nipple hurts their mouth, try cup feeding, spoon feeding, or using a syringe to get fluids in.
5

🏫Return to School & Timeline

  • Contagious: HFMD spreads easily through saliva and contact.
  • Timeline: Fever lasts 1–3 days. Mouth sores last 5-7 days. Rash lasts 10 days.
  • Back to School: Your child can return when the fever is gone (usually 2–3 days). They do not need to wait for all the blisters to disappear, as long as they feel well enough to play.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.