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What should caregivers know about hand, foot and mouth disease?

 Childhood _Obesity 

Children in child care settings are bound to be exposed to a number of ordinary viruses, from common colds to stomach bugs, in their first few years of life. One of the most common childhood illnesses is hand, foot and mouth disease, a scary-sounding viral infection that can cause painful sores on a child’s hands, feet and mouth.

The highly contagious coxsackievirus is to blame for most hand, foot and mouth infections, and generally children under age five experience the worst symptoms of the illness. Children older than seven and adults aren’t often affected by hand, foot and mouth disease. The virus spreads easily through contact with unwashed hands, saliva, mucus, feces or fluid from blisters.

Most child care centers, schools and camps report higher levels of hand, foot and mouth disease in the summer and fall months. There is no cure for hand, foot and mouth disease and no vaccine can prevent it, but fortunately symptoms generally clear up in anywhere from seven to ten days. Hand, foot and mouth disease is not the same as foot and mouth (or hoof and mouth) disease, a viral disease that affects cloven-hoofed animals.

What to Expect if Your Child has Hand, Foot and Mouth Disease

If your child has received a diagnosis of hand, foot and mouth disease, the good news is you can count on a full recovery. The bad news is that it can be quite painful in some cases, especially when mouth blisters are present. The incubation period for hand, foot and mouth is a few days, so expect the first symptoms to appear three to six days after your child’s contact with the virus.

The first symptoms are often feeling generally unwell, a loss of appetite and/or a fever. About one to two days after initial symptoms present, painful sores or blisters may develop in the mouth or throat, occasionally followed by blisters or rash on the hands, feet or bottom. In some cases children run the risk of dehydration because it can be so painful to swallow liquids.

As the infection runs its course, the blisters may peel, leaving an ulcer with a reddish base. Fluids from blisters contain the virus, and children will need to remain home until they are scabbed over and healing. Other symptoms may include: muscle aches and flu-like symptoms, drooling, nausea, vomiting, diarrhea, sleepiness, and irritability.

 How to Treat Hand, Foot and Mouth Disease

Since hand, foot and mouth disease comes from a viral infection, antibiotics will not lessen or improve symptoms of this illness. Your doctor will likely recommend rotating acetaminophen and ibuprofen for children who are uncomfortable or in pain. Aspirin should never be given to children or teens as a pain reliever as it can cause a rare but serious illness called Reye’s syndrome.

If your child has blisters on their hands or feet, try to keep them clean and uncovered. If a blister pops, caregivers should use a small amount of antibiotic cream to prevent infection and place a band-aid over the blister. Remember to wash your hands after touching blisters on your child.

Mouth and throat blisters are often the most painful for children. If your child is refusing food or drink, try offering cold foods like smoothies, milkshakes or popsicles. Cold foods can help relieve some mouth and throat discomfort. Avoid spicy or acidic foods as they will aggravate blisters and cause pain.

Since children with painful mouth and throat blisters often refuse to eat or drink, one of the most important aspects of caring for a child with hand, foot and mouth disease is making sure they stay hydrated. Try offering Pedialyte popsicles or Pedialyte in small sips or even through a medicine dropper, if need be.

Call your doctor if you notice signs of dehydration, which include a dry mouth, chapped lips, sunken eyes or significantly less urine output. You should also call your doctor if you feel like your child continues to get worse without any improvement. Occasionally children can contract multiple illnesses (like hand, foot and mouth and strep throat) at the same time.

In most cases, children can return to school or daycare after the fever is gone (without fever reducing medication) for 24 hours. In more severe hand, foot and mouth cases, children may need to wait until the blisters dry up and show signs of healing. 

How to Prevent Hand, Foot and Mouth Disease

Frequent and thorough hand washing is the best protection against contracting hand, foot and mouth disease, especially after using the bathroom or changing a diaper. Shared toys and play areas should be disinfected daily to prevent a variety of viruses from spreading. Lastly, it’s important to keep infected children home from school or daycare while they are running a fever or have open blisters on their skin.

For more information on hand, foot and mouth disease, including recommended treatments and when to call your doctor, visit,, or

By ABC Quality Team on February 14, 2023