Key takeaways: Hand, foot, and mouth disease is a common viral illness in children under 5. It causes fever, painful mouth sores, and a rash or blisters on the hands, feet, and diaper area. It usually goes away in 7 to 10 days. The main concern is dehydration if mouth sores make feeding painful. Handwashing helps prevent spread.
Hand, foot, and mouth disease (HFMD) is common, especially in childcare settings.
Cause
HFMD is caused by enteroviruses, most often coxsackievirus.
Signs
- Fever, sore throat, and fussiness.
- Mouth sores: painful spots or blisters on the tongue, gums, and inside the cheeks.
- Rash: flat or raised red spots, sometimes with blisters, on the palms, soles, and often the diaper area, legs, and arms.
- Poor feeding or drooling due to mouth pain.
Some children later lose fingernails or toenails weeks afterward. They grow back.
How It Spreads
Through saliva, nasal mucus, blister fluid, and stool. The virus can stay in stool for weeks after symptoms go away.
Home Care
- Offer feeds often. Cold liquids may feel better for older babies.
- Pain relief: ask your doctor about acetaminophen or ibuprofen (6 months and older).
- Avoid acidic or salty foods for older babies.
- Don’t use numbing mouth gels on babies.
Signs of Dehydration
- Fewer wet diapers.
- Dry mouth, no tears.
- Unusual sleepiness.
Preventing Spread
- Wash hands, especially after diaper changes.
- Clean toys and surfaces.
- Avoid sharing cups and utensils.
Childcare
Children may return when fever-free and able to participate, per many childcare policies. Check with your provider.
Call your baby’s doctor if your baby: is under 6 months, won’t drink, has signs of dehydration, has a fever over 3 days, or seems very unwell. Seek emergency care for stiff neck, seizures, unusual sleepiness, or trouble breathing.
The Bottom Line
HFMD is common and usually mild. Focus on keeping your baby hydrated and comfortable, and practice good handwashing.
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Sources
- Centers for Disease Control and Prevention. Hand, foot, and mouth disease. https://www.cdc.gov/hand-foot-mouth
- American Academy of Pediatrics. Hand, foot, and mouth disease. HealthyChildren.org. https://www.healthychildren.org
- Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2024-2027 Report of the Committee on Infectious Diseases. 33rd ed. American Academy of Pediatrics; 2024.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
