Hand, Foot and Mouth Disease in Kids: Symptoms, Contagious Period, Care and When to Call the Doctor • Living Life as Moms | Mom Hacks, Toddler Snacks, and Kids Activities

Quick answer: hand, foot and mouth disease is a common viral illness in young children that causes fever, a sore throat, painful mouth sores and a rash of small blisters or spots on the hands and feet. Most kids recover in about 7 to 10 days with rest, fluids and pain relief that is safe for their age. Antibiotics do not work because it is caused by a virus. The biggest worry is dehydration from painful swallowing, so offer cold drinks often and call the doctor if your child cannot drink, has a fever that lasts more than a few days or seems very sleepy or ill.

One day your toddler is cranky and has a low fever. The next, they refuse to eat, and you find red spots inside their mouth and a rash on their palms. Hand, foot and mouth disease (HFMD) sweeps through daycares, preschools and playgroups every year, and it tends to be especially common in summer and fall. It looks alarming, but it is usually mild. This guide is part of our family safety guide, and it explains how to recognize HFMD, how to keep your child comfortable and how to stop it from spreading in your home.

Sources: Centers for Disease Control and Prevention (CDC) hand, foot and mouth disease pages; American Academy of Pediatrics (AAP) HealthyChildren.org guidance on hand, foot and mouth disease and fever; National Library of Medicine MedlinePlus. This article is general information and does not replace advice from your child’s doctor. Call your pediatrician if you are worried about your child.

What Hand, Foot and Mouth Disease Is

HFMD is an infection caused by viruses from the enterovirus family. Coxsackievirus A16 is the most common cause, and other coxsackieviruses and enterovirus A71 can also cause it. It is not the same as foot-and-mouth disease in cattle and other animals, which is a different illness that does not spread to people in this way.

HFMD mainly affects children under five, but older children and adults can catch it too. Having it once does not guarantee immunity, since several viruses can cause the illness, and a child may get it more than once.

Symptoms and How They Unfold

Symptoms usually show up three to six days after exposure. This waiting period is called the incubation period.

The first signs

Fever, often mild to moderate
Sore throat
Poor appetite or refusing food
A general feeling of being unwell and fussiness

Mouth sores

A day or two after the fever starts, painful red spots or blisters can appear in the mouth, on the tongue, gums and inside the cheeks. They may turn into small ulcers. This is the part that makes eating and drinking hurt.

The rash

A rash of flat or slightly raised red spots, sometimes with small blisters, often appears on the palms of the hands and soles of the feet. It may also show up on the buttocks, knees, elbows or around the diaper area. The rash is usually not itchy, though some children find it uncomfortable. Skin color can change how the rash looks, and on darker skin the spots may look purple, gray or darker than the surrounding skin.

Not every child has every symptom. Some have only mouth sores, and some have only a rash, which can make HFMD easy to miss.

How Long It Lasts

Most children feel better within seven to ten days. Fever generally goes away in a few days, and mouth sores heal in about a week. The rash may last a bit longer. Weeks after the illness, some children lose a fingernail or toenail, a harmless effect that is believed to be linked to the illness, and the nail grows back.

How HFMD Spreads

The viruses spread from person to person through:

Close contact: hugging, kissing and sharing cups or utensils
Respiratory droplets: from coughing and sneezing
Fluid from blisters: touching blisters or the fluid inside
Stool: contact with feces, such as during diaper changes
Contaminated surfaces: toys, doorknobs and tables that carry the virus

Children are most contagious during the first week of illness. The virus can remain in stool for weeks after symptoms go away, and some people spread the virus without having symptoms. That is why careful handwashing matters even when your child seems well.

How to Care for Your Child at Home

There is no specific medicine that cures HFMD. Care focuses on comfort and preventing dehydration.

Fluids first

Offer small, frequent sips of cold water, milk or diluted drinks.
Frozen treats such as popsicles or ice chips soothe the mouth.
Cold, soft foods like yogurt, applesauce, smoothies and pudding go down more easily.
Avoid acidic, salty or spicy foods and drinks, such as orange juice, soda and chips, which can sting.
For babies, keep breastfeeding or bottle feeding, even if feeds are shorter and more frequent.

Pain and fever relief

Acetaminophen can ease pain and fever in children, and ibuprofen is an option for children over six months old. Follow the dose on the label for your child’s weight and age, or ask your pediatrician.
Never give aspirin to children or teens, because it is linked to a serious condition called Reye syndrome.
Do not give medicines meant for adults, and do not use numbing mouth gels or sprays that are not recommended for young children without asking your doctor.
Our guide to fever in kids explains how to decide when a fever needs a call.

Rest and comfort

Let your child rest and keep activity low key.
Dress them in loose, soft clothing.
Keep the rash clean and do not pop blisters, since this can spread the virus and cause infection.
Use cool baths for comfort if your child enjoys them.

Signs of Dehydration

Dehydration is the most common reason HFMD becomes a problem. Watch for:

Fewer wet diapers or no urination in six to eight hours
Dry mouth or no tears when crying
Sunken eyes or, in babies, a sunken soft spot on the head
Unusual sleepiness or weakness
Very dark urine

If you notice these signs, call your doctor right away. Children who cannot drink may need fluids given by a medical team.

When to Call the Doctor

Call your pediatrician if:

Your child is under six months old and has a fever
Your child cannot drink enough or shows signs of dehydration
Fever lasts more than three days
Symptoms last longer than ten days
Your child has a weakened immune system
The rash looks infected, with spreading redness, warmth or pus
You are unsure whether it is HFMD, since other illnesses can cause similar symptoms

Go to the emergency room or call 911 if:

Your child has a stiff neck, severe headache or confusion
Your child is extremely sleepy, hard to wake or limp
Your child has trouble breathing
Your child has a seizure
Your child has a fever with a rash that looks like bruises that do not fade when pressed

These signs are uncommon, but they can point to rare complications such as viral meningitis or encephalitis. Our guide on teaching kids to call 911 is helpful for older children who may need to get help in an emergency.

Should Your Child Stay Home?

Many schools and daycares have their own rules, so check yours. The CDC advises that children with HFMD may return when they have no fever and feel well enough to take part in activities, and that blisters alone do not always require staying home, but facility policies vary. Children who are drooling heavily with mouth sores, who have uncontrolled blisters or who are too ill to participate should usually stay home. Our guide on when to keep your child home from school walks through the common rules.

How to Stop HFMD From Spreading at Home

Wash hands often with soap and water for at least 20 seconds, especially after diaper changes, using the toilet and before eating.
Clean and disinfect surfaces and toys that children touch, using a disinfectant that is labeled for use against viruses such as enteroviruses, and follow the label directions. Hand sanitizer is less reliable against these viruses than soap and water.
Do not share cups, utensils, towels or toothbrushes.
Wash soiled clothing and bedding in hot water.
Cover coughs and sneezes with a tissue or an elbow.
Dispose of diapers carefully, and wash hands afterward.
Avoid kissing a sick child on the face if possible.
Teach older kids to wash up and avoid touching their face.

Adults can catch HFMD too, though they often have milder symptoms. Parents should wash hands after caring for a sick child.

Pregnancy and Newborns

Most adults and children recover without complications. If you are pregnant and have been around a child with HFMD, tell your doctor, especially close to your delivery date, because newborns can occasionally become seriously ill from enteroviruses. Newborns with any fever need prompt medical attention.

Daycare and Group Settings

If your child attends daycare or preschool, tell the staff when your child is diagnosed, so that they can alert other families and clean toys and surfaces. Ask about the facility’s policies on return after illness. Keep siblings and visitors informed so that they can watch for symptoms.

Is There a Vaccine?

In the United States, there is no vaccine for the most common viruses that cause HFMD. A vaccine against enterovirus A71 has been used in some other countries. Hand hygiene and cleaning remain the main ways to lower the risk here.

Comfort Ideas Parents Find Helpful

Make a small cooler of popsicles and cold drinks for the couch
Offer a straw or a sippy cup, since some children find it less painful than drinking from a cup rim
Let your child eat what they will accept for a few days, since fluids matter more than meals
Keep screen time or quiet activities available for rest
Use cool cloths for comfort

How HFMD Differs From Similar Illnesses

Several childhood conditions can look a bit like HFMD, so a doctor may want to examine your child before naming it.

Chickenpox: causes an itchy rash with blisters that appears on the chest, back and face and spreads, rather than mostly on the hands and feet.
Herpangina: another enterovirus illness with sores in the back of the mouth and throat, but usually without a rash on the hands and feet.
Cold sores and canker sores: these usually affect the lips or a single spot in the mouth, and they do not come with the full pattern of fever and rash.
Strep throat: causes a sore throat, fever and sometimes a sandpaper-like rash, and it requires a test and antibiotics from a doctor.
Allergic reactions and eczema: may cause rashes but not the mouth sores and fever combination.

Because treatment is different, call your pediatrician if you are not sure what you are seeing, especially if your child has a high fever, a rash that is spreading or sores that seem to be getting worse.

Eating and Drinking Tips by Age

Young children often refuse food when their mouths hurt, so a few age-based ideas can help.

Babies: offer the breast or bottle more often in smaller feeds. A cool cloth on the gums before feeding may help some babies settle, and a pediatrician can advise on other options.
Toddlers: try cold smoothies, yogurt, ice pops and a favorite cup with a straw. Let them choose what they will accept.
School-age kids: soft foods such as mashed potatoes, scrambled eggs, oatmeal and ice cream often go down easily. Ask them to rinse with plain water after meals.

Avoid forcing food. A few days of limited eating is usually fine as long as your child is drinking enough and passing urine regularly. Once the mouth sores heal, appetite returns quickly.

What Parents Often Get Wrong

Thinking it requires antibiotics: it does not, because a virus causes it.
Offering orange juice: it can sting mouth sores.
Sending a child back too early: a child who is still feverish or unable to eat needs more time.
Skipping handwashing after the child recovers: the virus can still be shed for weeks.
Ignoring dehydration signs: this is the main danger.

Frequently Asked Questions

Is hand, foot and mouth disease serious?

Most cases are mild and clear up in about a week to ten days. The main risk is dehydration, and rare complications can affect the brain or heart, so call a doctor if your child seems very ill.

How long is a child contagious with hand, foot and mouth disease?

Children are most contagious in the first week, but the virus can stay in stool for weeks. Handwashing and cleaning matter even after symptoms fade.

What can I give my child for the pain?

Acetaminophen can be used for pain and fever, and ibuprofen is an option for children over six months, following the label or your pediatrician’s directions. Never give aspirin.

Can adults get hand, foot and mouth disease?

Yes. Adults are less likely to get it, and symptoms are often milder, but they can spread it to others.

When can my child go back to school?

In general, when the fever is gone and your child feels well enough to participate, but check your school or daycare’s policy.