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Hand, Foot and Mouth Disease

Hand, foot and mouth disease, caused by a Coxsackie A virus, is an infection that occurs mainly in children between 6 months and 4 years of age. It has no relationship to hoof and mouth disease of cattle. The symptoms are a low-grade fever-100° to 102°F (38° to 39°C); small, usually mildly painful ulcers in the mouth; and small water blisters or red spots on the palms and soles, and on the webs between the fingers and toes. Small blisters or red spots may also appear on the buttocks or lower legs. 

The fever and discomfort usually disappear in three or four days and the mouth ulcers usually resolve in seven days, but the rash on the hands and feet can last 10 days. 

Hand, foot and mouth disease is quite contagious, and usually some of your child's playmates will develop it at about the same time. The incubation period after contact is three to six days. Your child may return to school or day care when the fever returns to normal. Most children are contagious from two days before the rash appears until two days after it disappears. 

Home care instructions 

  • Offer a soft diet for a few days and encourage your child to drink plenty of clear fluids. Cold drinks, ice pops, ice cream and sherbet are often well tolerated. Do not give your child citrus fruit, salty foods or spicy foods since they will further irritate his mouth. Avoid foods that need much chewing. For infants, you may try giving liquids by cup or syringe, rather than a bottle because the nipple can cause pain. 
  • Give acetaminophen or ibuprofen if necessary. Acetaminophen or ibuprofen may be given for a few days if you child's fever is above 102°F (39°) or the mouth ulcers are very painful. See the section on "Fever" for dosages. 
  • A Benadryl and Maalox mixture may be given. Add 1/2 tsp Benadryl to 1/2 tsp of Maalox. In children under the age of 4 place the mixture in the front of mouth after meals. In children ages 4 and up mix equal amounts of Benadryl and Maalox and use as a mouthwash after meals. 


Call the office if the mouth sores and rash/blisters last longer than 7 days, your child's symptoms worsen or for signs of dehydration (dry sticky mouth or tongue, no urination in >8hrs).