Hand Foot and Mouth Disease in Toddlers

Toddlers and children tend to be prone to viruses and bacterial infection. Immature immune systems can predispose them to certain illnesses such as; Hand, Foot and Mouth Disease or HFMD. Hand, Foot and Mouth Disease in toddlers is a completely different illness from foot-and-mouth disease or hoof-and-mouth disease that appears in the animal populations.

Most prevalent in the fall and summer months, this illness is very common in daycare centers, but older children and even adults can catch HFMD. Many adults were exposed to the virus when they were younger and may have antibodies to the virus.

What Causes Hand, Foot and Mouth Disease in Toddlers?

The enterovirus is responsible for Hand, Foot and Mouth Disease. It is highly contagious and common among toddlers and children who are in close proximity to each other, like daycare centers. They spread the virus through respiratory or fecal matter. One child with the virus coughs and then plays with a toy, then another child touches it and the virus is transmitted. Care providers that do not practice good hand washing habits can spread the virus after changing the diaper of one child and moving on to the next without washing their hands in between.

Once exposed, the virus takes about three to six days to incubate in the body. During that period, the person or child will not feel any symptoms and they will not know they have the virus. Symptoms usually appear after about a week.

After symptoms appear the illness is very contagious. The virus lives in respiratory secretions, fecal matter and fluid from blisters that appear on the body. The contagious phase can last for weeks after symptoms go away. There may be a policy against your child attending daycare during the phase with symptoms and maybe even some time after symptoms go away. You will need to check with your provider on their policies.

What Are The Symptoms of Hand, Foot and Mouth Disease in Toddlers?

Hand, Foot and Mouth Disease in toddlers will begin with a low-grade fever and he or she may not seem very hungry. If your child can speak, they may complain of a sore throat. You may notice that they are sleepier than usual and unwilling to play.

Within one to two days after the onset of the fever, you will notice sores in his or her mouth and they will be very painful. These tend to appear on the insides of the cheeks, the gum lines and on the tongue. This is part of the appetite loss and the increased crankiness.

You will also notice the development of a rash. This appears on the sole area of the foot, the palm area of the hands and possibly the buttock area. This rash begins very small and flat, but then progresses to actual blisters. Be very cautious of the fluid inside as it may contain the virus and cause it to spread. The good thing is, this rash doesn’t usually itch, but try to keep your child from scratching or picking at the blisters to prevent transmission.

How to Deal with Hand, Foot and Mouth Disease in Toddlers?

1. Foods and Drinks

Mild cases usually only require increased liquids and foods that are easily tolerated. You will need to check his or her temperature often. More severe cases may make your child appear and act very sick. You will need to make sure you are really pushing fluids and offer comfort as much as possible.

2. Pain Relief

During the illness, remember the mouth and throat are sore and it is best to avoid spicy, high acid and salty foods. Offer soft and cold foods such as popsicles, cold beverages and ice cream. Your doctor can recommend the best pain relief such as ibuprofen or acetaminophen. Make note that it is very dangerous to give aspirin to children. This can cause a very serious disorder known as, Reye’s syndrome which can be fatal.

3. Skin Irritation Relief

For skin irritation, you can try dipping a cotton ball or rag into ½ liquid Benadryl™ and ½ liquid Maalox™. Wipe it inside the mouth on the sores and dab on the rash. This can help soothe and cool the lesions. If they become too uncomfortable, you may need to consult your pediatrician for advice or prescription medication.

4. Mouth Rinse

You can also mix a mouth rinse with ½ teaspoon or 2.5ml salt into 1 cup or 237ml warm water and stir. Allow your child to take into his or her mouth without swallowing, swish and spit back out. Have them do this as many times as they need during the day.

How to Prevent Further Infection

Remember this illness is most contagious during the first week of symptoms. Once symptoms disappear, the virus does remain in the body for some time. Respiratory secretions can be infectious a few weeks after and the fecal matter can contain the virus for up to a few months. This means you need to take action to prevent continued spread including:

  • Keep them out of school as long as the school requires after HFMD
  • Use medical latex or vinyl gloves to change diapers or apply creams to the child’s skin
  • Encourage frequent hand washing for anyone in contact with the child, especially after diaper changes
  • Keep toys very clean and do not allow sharing of toys during the illness
  • Do not encourage kissing on the child or give your child kisses during the infection

Watch a video for more about hand foot and mouth disease from a mom who has a child with HFMD:

When Should You Call a Doctor?

Hand, Foot and Mouth Disease is often just a self-limiting illness and children usually recover just fine without any intervention. It is still very important to contact the doctor, especially if you aren’t absolutely positive your child has this illness. There are other conditions that can look like HFMD that are actually far more serious, like Strep. This is why you will need a doctor to confirm the diagnosis. Doctor’s will usually know if there is an outbreak of this virus in your area, due to them seeing other children with it. They can also give you some ideas on how to make your child more comfortable during the illness.

You will also need to contact the doctor if your child’s fever rises above 103°F. A fever that lasts for up to a week needs to be evaluated by a physician to make sure a secondary bacterial infection has not started. On the subject of fever, please keep in mind that it can cause a small child’s body to become dehydrated very quickly. Also, the sores in the mouth and sore throat may make it hard for them to take in enough fluids. Watch for sunken eyes, dry mouth tissues and increased sleepiness. Dehydration is very dangerous in a child and needs to be evaluated by a doctor quickly.

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