It starts with a fever and a grumpy, off-colour baby. A day or two later, small spots appear on the hands and feet, and sore blisters in the mouth make feeding painful. Hand, foot and mouth disease is a common viral illness in babies and young children, especially in nurseries. It is usually mild and clears within 7 to 10 days. Here is how to care for your baby and when to get help.
Quick answer: hand, foot and mouth disease
- Cause: enteroviruses, often coxsackievirus.
- Symptoms: fever, sore mouth and throat, then spots or blisters on hands, feet, mouth and sometimes the nappy area.
- Main worry: dehydration, because a sore mouth makes drinking hard.
- Usually clears in 7 to 10 days without treatment.
Symptoms
- fever, tiredness and poor appetite at first
- painful sores or ulcers inside the mouth and on the tongue
- a rash of small red spots or blisters on the palms, soles, bottom or legs
- drooling, refusing feeds and irritability
- sometimes, peeling fingernails or toenails a few weeks later, which grow back normally
How it spreads
The virus spreads through coughs, sneezes, saliva, blister fluid and poo. It is most contagious in the first week, but the virus can stay in poo for weeks. Wash hands well, especially after nappy changes, and clean toys and surfaces.
Caring for your baby at home
- Offer frequent small feeds of breast milk or formula; older babies can have cool drinks and soft, cool foods.
- Avoid salty, spicy or acidic foods that sting.
- Give paracetamol (acetaminophen), or ibuprofen from 6 months, for pain and fever. See acetaminophen vs ibuprofen.
- Do not pop blisters.
- Count wet nappies to check hydration.
See dehydration in babies and baby rashes.
When to talk to your doctor
- fewer wet nappies, refusing all drinks or signs of dehydration
- a baby under 3 months with fever or symptoms
- fever above 39°C, or lasting more than 3 days
- stiff neck, unusual sleepiness, jerky movements or difficulty walking: seek urgent help
- symptoms not improving after 10 days
Frequently asked questions
Is it the same as foot-and-mouth disease in animals?
No, they are completely different and unrelated.
Does my baby need to stay home?
Many health services say children can return once they feel well, but nursery policies vary. Keep them home while they have a fever.
Can my baby get it again?
Yes, because several different viruses cause it.
Sources
- NHS: Hand, foot and mouth disease
- CDC: Hand, foot and mouth disease
- American Academy of Pediatrics, HealthyChildren.org: Hand-Foot-and-Mouth Disease
This guide is general information, not medical advice. If your baby is unwell or not drinking, contact your doctor.