Hand, Foot and Mouth Disease in Toddlers: Symptoms, Home Care, and When to Call the Doctor
Quick answer: Hand, foot and mouth disease (HFMD) is a common viral illness in young children, especially those under 5 and in daycare. It usually starts with a fever and sore throat, followed by painful mouth sores and a rash of flat red spots or small blisters on the hands and feet (and often the diaper area). Most children get better on their own in 7 to 10 days. The biggest risk is dehydration, because mouth sores can make drinking painful.
What causes hand, foot and mouth disease?
HFMD is caused by enteroviruses, most often coxsackieviruses. It spreads easily through saliva, nose and throat fluids, fluid from blisters, and stool. Outbreaks are common in childcare settings, and cases often rise in summer and fall. HFMD is not related to foot-and-mouth disease in cattle, and pets don’t spread it.
Symptoms to look for
- Early signs: fever, sore throat, fussiness, and a poor appetite, usually 3 to 6 days after exposure
- Mouth sores: painful red spots that can blister, on the tongue, gums, and inside the cheeks, usually a day or two after the fever starts
- Skin rash: flat or slightly raised red spots, sometimes with small blisters, on the palms and soles. The rash may also show up on the knees, elbows, buttocks, or diaper area. On darker skin, the spots may look darker or gray rather than red.
- Drooling or refusing to eat or drink, especially in babies and toddlers
Not every child gets all of these symptoms. Some have only mouth sores or only a rash.
How to help your child feel better at home
There’s no specific medicine that cures HFMD, and antibiotics don’t help because it’s caused by a virus. Care focuses on comfort and fluids:
- Keep fluids going. Offer small sips often. Cold drinks, milk, ice pops, and water are usually easiest. Avoid acidic or spicy foods and drinks like orange juice and tomato sauce, which sting mouth sores.
- Offer soft, cool foods. Yogurt, smoothies, applesauce, and mashed foods are easier to eat. It’s OK if your child eats less for a few days, as long as they’re drinking.
- Ease pain and fever. Ask your pediatrician which pain reliever and dose is right for your child’s age and weight. Never give aspirin to children.
- Skip numbing mouth gels and sprays for young children unless your doctor recommends them. Products with benzocaine are not safe for children under 2.
- Leave blisters alone. Don’t pop them. Keep skin clean and trim nails to reduce scratching.
Watch for dehydration
Call your pediatrician if your child shows signs of dehydration:
- Fewer wet diapers, or no urine in 8 hours or more
- Dry mouth, lips, or tongue
- No tears when crying
- Unusual sleepiness or fussiness
- Sunken eyes, or a sunken soft spot on a baby’s head
When to call the doctor
- Your child isn’t drinking enough or shows signs of dehydration
- Your baby is younger than 6 months old
- Fever lasts more than 3 days
- Symptoms aren’t improving after 10 days
- Your child has a weakened immune system
- Sores or rash look infected, with spreading redness, warmth, swelling, or pus
Get emergency care right away if your child:
- Has a stiff neck, severe headache, or is very sleepy or hard to wake
- Is confused, has a seizure, or has trouble walking or weakness
- Has trouble breathing
These complications are rare but serious.
Is it contagious? When can my child go back to daycare?
HFMD is most contagious during the first week of illness. The virus can stay in stool for several weeks after symptoms go away, so good handwashing is important even after your child feels better. Most childcare centers let children return once they’ve been fever-free for 24 hours without fever medicine, feel well enough to join in, and aren’t drooling uncontrollably with mouth sores. Check your center’s policy.
How to prevent spreading it
- Wash hands often with soap and water, especially after diaper changes and using the bathroom. Hand sanitizer doesn’t work as well against these viruses.
- Clean and disinfect toys, doorknobs, and other shared surfaces.
- Avoid sharing cups, utensils, and towels.
- Avoid kissing or hugging while a child is sick.
Children can get HFMD more than once, because several different viruses cause it.
Can adults get it?
Yes, though adults often have mild symptoms or none at all. They can still spread it. If you’re pregnant and exposed to HFMD, let your doctor know.
Frequently Asked Questions
How long does hand, foot and mouth disease last?
Most children get better in 7 to 10 days. Fever usually goes away within the first few days, and mouth sores and rash fade over about a week.
Is hand, foot and mouth disease contagious?
Yes. It spreads through saliva, nose and throat fluids, blister fluid, and stool, and is most contagious during the first week. The virus can stay in stool for weeks, so keep up handwashing.
When can my child go back to daycare after HFMD?
Most childcare centers allow children to return once they’ve been fever-free for 24 hours without fever medicine, feel well enough to participate, and aren’t drooling uncontrollably with mouth sores. Check with your center, since policies vary.
What can my child eat with hand, foot and mouth disease?
Offer cold drinks, ice pops, yogurt, smoothies, and soft foods. Avoid acidic, salty, or spicy foods that sting mouth sores. Drinking enough fluids matters more than eating.
Can you get hand, foot and mouth disease twice?
Yes. Several different viruses cause it, so a child can get it more than once.
Related guides
- Sick Child Guide: When to Call the Doctor
- When to Call the Pediatrician About a Fever
- Cold vs. Flu vs. RSV vs. COVID in Kids
Sources
This article is for general information and is not a substitute for advice from your child’s doctor.
