Hand, foot and mouth disease in babies

toddler with rash

Hand, foot and mouth is common among babies and young children and although generally mild, it can be uncomfortable. Knowing how to spot the symptoms and prevent the virus from spreading further will help your baby get better faster.

Quick facts:

What does hand, foot and mouth look like?

Red spots, like blisters or sores, that show up not just on the tongue/mouth, hands, and feet, but on other areas, too.

Is hand, foot and mouth contagious?

Yes, very. The incubation period is about 3-5 days.

Is it dangerous?

No. It's quite uncomfortable, but shouldn't pose a significant risk.

Can adults get it?

Yes, they can. Most will be immune by adulthood, but it is possible.

How is it treated?

As with all viral infections, there's no specific treatment to get rid of hand, foot and mouth, but you can use over the counter medicines to alleviate the signs and symptoms.

What is hand, foot and mouth disease?

Also known as the Coxsackie virus, it's a common childhood illness that is highly contagious. Although adults can also get it, the virus is most common in children under five. It's not considered serious and usually passes within a week or so. The disease spreads quickly in warmer temperatures meaning it is most common in the summer and early autumn. Don't confuse it with foot and mouth disease though – that's the one that farm animals get and the two diseases are unrelated.

How do babies catch it?

The Coxsackie virus that causes hand, foot and mouth is most commonly spread through direct contact with an infected person's:

  • saliva, or saliva droplets from coughing or sneezing
  • faeces
  • fluid from the blisters it causes

The virus can spread like wildfire in daycare and nurseries where frequent nappy-changing and potty-training can spread the bacteria onto surfaces. Add to the mix a group of toddlers with a penchant for putting things in their mouths, and you have an outbreak.

Children who are diagnosed with the virus are most contagious during the first week and should be kept well away from daycare, playgroups or school to avoid infecting others.

My son had it when he was just over a year. He was really poorly with it and couldn't eat for several days. I then caught it and it was absolutely shocking.

What are the symptoms of hand, foot and mouth disease?

The disease itself has an incubation period of three to five days, meaning your child can be infected for this long before showing any symptoms. Babies that are infected will usually develop early symptoms that include:

  • Sore throat
  • Feeling tired
  • Mild fever

After a couple of days, blisters or sores will start to appear inside his mouth, around the tongue, gums and inside of the cheek. They'll also show up on the palms of his hands, in between his fingers and toes and on the soles of his feet. Occasionally, the blisters might also appear on your baby's bum and genitals. Eventually, they'll break open and can be very painful for your baby.

He's also likely to develop a non-itchy rash with flat or raised spots, smaller than those you get with chicken pox.

If your child has a rash but you're unsure whether or not he has the virus or another disease, this NHS rash information will help you identify the rash.

It doesn't have to appear on the hands, feet and mouth. It's only called this as it's where it's most likely to be seen. Neither of mine had it in their mouths. My son had it on his feet, knees and bottom and my daughter had it on her hands and feet.

My baby has blisters inside his mouth and is refusing to drink. What should I do?

One of the symptoms of the disease is blisters or sores inside the mouth, which – no surprise here – can make it very uncomfortable for your baby to feed or drink. If you spot any of the following signs of dehydration, take your baby to the doctor:

  • drowsiness
  • crying with no tears appearing
  • drier nappies than normal
  • dark yellow wee
  • cold hands and feet

What should I do if I think my baby's blisters are infected?

Sometimes, the blisters or sores associated with hand, foot and mouth disease can get infected. This is a secondary infection. If you see any of the following signs of a secondary infection, take your baby to see the doctor, who can give your baby an antibiotic to clear the infection:

  • Your baby's skin is sore, red, swollen and hot
  • The blisters start to yellow pus
  • Your baby's symptoms are getting worse or haven't improved after seven days

How is hand, foot and mouth disease treated?

While it is an uncomfortable and contagious disease, it's not serious. If you think your baby might have hand, foot and mouth, you can take him to your GP but she won't be able to do much – antibiotics can't be used to treat a virus. Your doctor will usually diagnose your child based on the symptoms above and advise you on how to treat them and avoid reinfection. Advice usually is to:

  • Give pain relief in the form of infant paracetamol or ibuprofen to help reduce the pain and any fever. Don't give aspirin to your baby though. Aspirin is linked to Reye's Syndrome which causes the brain to swell and shouldn't be given to anyone under the age of 16.
  • Use mouth-numbing sprays or teething gel to help reduce the pain of any mouth ulcers and blisters, making it easier for your baby to feed.
  • Offer plenty of feeds and water. Your baby may be reluctant to feed because of the pain caused by mouth blisters but it's essential that you keep him hydrated. If you're breastfeeding, then offer plenty of feeds. Giving small, frequent feeds will help to reduce your baby's discomfort. If your baby is older, try to keep him drinking water out of a sippy cup or bottle. If he is showing signs of dehydration, call your GP.
  • Calamine lotion and cold baths can help to relieve the itch from the rash.

If your baby is under three months and has a temperature of over 38°C or over six months with a temperature of over 39°C, you should always see your GP. Your little one should start to feel better within three to five days but it can take up to ten days for symptoms such as blisters to clear. If the symptoms do not improve after seven to 10 days, you should seek further medical advice.

Your baby can still harbour the virus in his system for up to a month after symptoms have cleared so make sure that you continue taking precautions to avoid spreading the disease.

My son had hand, foot and mouth at the start of the year. He was fine, just a bit spotty.

Can my baby get the virus again?

It is possible. Just like the common cold, there are many different strains of the Coxsackie virus. Your baby may become immune to the strain of hand, foot and mouth disease that they've just had, but they may catch the infection again from a different strain of the virus. Immunity usually improves with age.

You can help to protect your baby against getting it again by being careful with hygiene. Be sure to stifle coughs and sneezes with a tissue, and throw away tissues after one use. Wash and dry your hands and your baby’s hands often with soap and water.

Make sure to wash hands at these times at least:

  • Before and after a nappy change
  • After going to the toilet
  • Before breastfeeding or formula-feeding your baby
  • Before mealtimes, if your baby has started eating solids
  • After touching used tissues

Can I prevent it?

I was extra cautious, as I had a newborn. To the point of washing myself down before feeding her in the night and washing my hands between touching DS and her. It must have paid off as DD didn't catch it.

Knowing how to prevent the spread of hand, foot and mouth disease will help to clear the virus quickly and stop a recurrence. If you have other children, you'll also want to make sure that they don’t keep passing it between them.

  • Good hygiene is essential to stop the spread of the virus. Wash your hands – and your baby's hands – frequently and thoroughly, especially after a nappy change. Get rid of used tissues straight away after blowing your baby's nose and wash hands afterwards. Adults and older children can carry the virus without any symptoms so even if you aren't showing symptoms yourself, good hygiene and frequent hand washing is essential.
  • Don't share spoons or other utensils with your baby if he's infected. You could contract the virus and pass it back to him.
  • Wash your baby's bedding and other contaminated clothing on a high temperature to get rid of the bacteria.
  • Let potential visitors to your home know in advance if your baby has hand, foot and mouth disease. Given how contagious the virus is, it's important to forewarn 'at-risk' people in particular. The infection can cause complications for pregnant women if caught in the third trimester.

Do I need to keep my baby at home or can I take him to nursery as usual?

According to NHS advice, you should keep your child off school or nursery while they are feeling unwell.

But as soon as they're feeling better, they can go back to school or nursery. There's no need to wait until all the blisters have healed. Keeping your child off for longer is unlikely to stop the illness spreading.

I'm pregnant. Can my unborn baby get hand, foot and mouth disease?

By adulthood, it's likely that you're immune to the different strains of the Coxsackie virus. If you do get hand, foot and mouth disease, the chances are that it will be very mild and your unborn baby won't be affected at all.

If you catch the virus in the few weeks before your baby is due, do see your doctor. There is a chance you might pass the virus on to your baby once they are born. In this case, it's likely the infection will be mild for your baby too, but still worth letting your doctor and midwife know that there's a chance your baby might get the virus.

To protect yourself and your baby against hand, foot and mouth disease:

  • Always wash your hands thoroughly after going to the toilet, and after changing or handling a nappy. The virus can stay live in your baby's stools for a month or two after he stops showing symptoms of the virus.
  • Make sure your toilet and bathroom are very clean.
  • Don't share cups, cutlery or towels with your baby