By Kara Stephens
Memorial Day weekend last year, I was changing my daughter, Kinsey, when I noticed a blister on her finger and a few red marks near her diaper line and on her knees. I really didn’t worry too much about it at first, thinking it may have been some sort of mild allergic reaction or bug bites from playing outside all day. Later that afternoon, she took a drink from her sippy cup and began to cry as she shoved her hands into her mouth, desperately trying to figure out what was causing the pain. Thinking it was just the budding of new baby teeth I went and got some Orajel from the medicine cabinet. Only when I went to apply it I noticed the pain wasn’t caused by her teeth, but several blisters that had formed on the back of her throat and tongue. At this moment I knew something was wrong and all of my epidemiology and infectious disease coursework came flooding back to me. Remembering a case study I had read, I suspected the low-grade fever she had for the last day or two (I innocently thought was due to teething) and the blisters were likely a result of hand, foot, and mouth disease (HFMD). That night I saw the number of blisters on her tiny hands multiply as the rash spread to the area around her mouth and legs, and at this point she was refusing to eat or drink anything – making it even more difficult for her to sleep. As you can imagine after a night trying to soothe our inconsolable toddler, my husband and I were relieved Kinsey’s pediatrician was able to see her the following morning. I told him Kinsey’s symptoms and he confirmed that she in fact had HFMD and provided us with a few suggestions. We also learned a few tips along the way. Since we are currently in HFMD season again, I would like to share these tips and facts with anyone who may find themselves caring for a child with HFMD.
Hand, foot, and mouth disease (HFMD), or any disease for that matter, can sound frightening to any parent. However, HFMD is actually very common this time of year — that is, from spring to autumn. While anyone can get it, HFMD typically affects infants and children younger than 5 years of age. Symptoms of HFMD include fever, mouth sores, and rash.
What were Kinsey’s signs and symptoms?
Well, in retrospective, we knew Kinsey had a low-grade fever about two days before I noticed the blisters on her finger, diaper line, and knees. She never seemed to be in any real discomfort during this time until later that day when I noticed the sores in her mouth. That evening it seemed as if the infection shot into overdrive and blisters began rapidly popping up everywhere, including some uncommon places like around her mouth and upper legs. The good news is she was back to her spunky-self in about 4 days.
The rash is usually on the palms of the hands and soles of the feet. However, like Kinsey’s case and as CDC highlights, the rash can appear in other areas as well, such as the knees, elbows, buttocks, or genital area.
As for Kinsey’s mouth sores, they looked just like canker sores, only smaller. If you have ever had a canker sore, you can probably understand how painful it would be to have 15-20 of them on the back of your tongue and throat. These sores caused Kinsey the most discomfort – making it difficult for her to eat and drink over the next 3-4 days. Learn more about HFMD signs and symptoms here.
How did she get such a nasty bug?
HFMD spreads from an infected person to others through:
- close personal contact, such as kissing or hugging,
- the air by coughing and sneezing,
- contact with feces, and
- touching objects or surfaces that have the virus on them.
There is no vaccine to protect against HFMD. However, you can reduce your risk by:
- Washing our hands often with soap and water, especially after changing diapers and using the toilet.
- Disinfecting dirty surfaces and soiled items, including toys.
- Avoiding close contact such as kissing, hugging, or sharing eating utensils or cups with people with HFMD.
If you are a parent with multiple children or even if your child goes to daycare or school, you probably know how difficult it can be to keep your child from kissing and hugging their siblings and friends. Therefore, we were really strict on making sure our daughters didn’t share their utensils and cups, and made sure we all were practicing good hand-washing habits.
Likewise, if your home is anything like mine, I’m sure you can agree that toys seem to be overly abundant at times – and this was definitely one of those times. To keep us from having to disinfect a home full of toys every night, we selected a few toys for “free reign”, locked the rest in the playroom, and closed them off entirely for about a week. We then separated the remaining toys into two batches so our girls would always have something to play with while the other set of toys “took a bath”. We found it easiest to disinfect one batch during nap, and the other at night so there was always a clean set available for them to play with. I also put a bin out of my oldest daughter’s reach for any toys that we knew Kinsey played with throughout the day to ensure they were disinfected before our oldest touched them. CDC has specific disinfecting instructions here.
Is there any treatment for HFMD?
From a mother’s perspective, lots of love, infant Tylenol, and warm baths were the best treatment for Kinsey’s rash. As far as treating her mouth sores, we avoided all salty and acidic foods like crackers and orange juice, used lots of Orajel (the cool cucumber kind), fed her rice crispies after they had been softened in milk, and kept the Pedialyte freezer pops coming. Kinsey didn’t eat a whole lot the first 2 or 3 days due to the pain, but we knew it was crucial that Kinsey take-in fluids to stay hydrated, so we focused on making sure she ate the Pedialyte freezer pops and gave her lemon flavored sports drink whenever she would take it. Within 3 or 4 days she was starting to eat more. We actually ended up freezing some GoGurt into yogurt popsicles which were a big hit.
What should you do?
Trust your intuition – only you really KNOW your child. If you believe your child’s health is at risk, contact your health care provider immediately. Often times all we need is the reassurance we are doing all that we can to soothe our little ones, and for those sleepless nights – a little pat on the back to let us know it will all be over soon!