What Is Hand, Foot, and Mouth Disease?
Hand, Foot, and Mouth Disease (HFMD) is one of the most common childhood illnesses, especially in daycare and preschool settings. Despite its alarming-sounding name, it's usually mild and resolves on its own.The Basics
According to the CDC:
- Cause: Usually caused by Coxsackievirus A16 or Enterovirus 71
- Age group: Most common in children under 5
- Season: More common in summer and fall, but can occur year-round
- Contagious period: Most contagious in the first week, but can spread for weeks after
Symptoms to Watch For
The American Academy of Pediatrics notes that HFMD typically develops in stages:
Days 1-2: The Beginning
- Fever (usually 101-103°F)
- Sore throat
- Feeling unwell, reduced appetite
- Fussiness in younger children
Days 3-5: The Rash
- Mouth sores: Painful blisters on tongue, gums, and inside of cheeks
- Skin rash: Red spots or blisters on palms of hands and soles of feet
- May also appear on knees, elbows, and diaper area
Treatment at Home
There's no specific treatment for HFMD—it has to run its course. But you can help your child feel better:
Pain and Fever
- Children's acetaminophen or ibuprofen for fever and pain
- Never give aspirin to children (see Reye's Syndrome warning)
Mouth Sores
- Cold foods: popsicles, ice cream, cold smoothies
- Avoid acidic or salty foods that sting
- A magic mouthwash (ask your pediatrician) can help numb the pain
Hydration
This is the biggest concern. Mouth sores make drinking painful, but dehydration is the main complication to watch for.
- Offer small, frequent sips
- Cold drinks are often better tolerated
- Watch for signs of dehydration: fewer wet diapers, no tears when crying, dry mouth
When to Call the Doctor
Most cases of HFMD don't need medical attention, but call your pediatrician if:
- Your child isn't drinking enough fluids
- Symptoms worsen after the first few days
- Fever lasts more than 3 days
- Your child seems very ill or unusually sleepy
- The rash looks infected (pus, increasing redness)
Return to School
Most daycares require:
- No fever for 24 hours (without fever-reducing medication)
- Mouth sores have healed enough to eat and drink normally
- Blisters are dried and crusted over
Check your specific school's policy, as requirements vary.
Sources:
Remember: You can have HFMD more than once, as there are different strains. Getting it once doesn't mean immunity forever.