What Parents Need to Know About Hand, Foot and Mouth Disease

Hand, foot, and mouth disease (HFM) is a viral illness that usually affects infants and children younger than 10 years old, specifically those 1 to 5. We spoke to Dr. Jonathan Auth, a CHOC Children’s pediatrician on what to expect with this common condition.

hand foot and mouth disease
Dr. Jonathan Auth, a CHOC Children’s pediatrician, explains hand, foot and mouth disease

Q: Is HFM contagious?

A: Yes, it can be spread through contact with feces, saliva, or mucus. The virus is common year round but tends to cluster in the summer and fall.

Q: What are the symptoms?

A: A fever is usually the first sign of the virus, followed by a reduced appetite and sore throat, which can cause a child to feel achy and irritable. After a few days, painful sores (red-yellowish blisters) develop in the back of the roof of the mouth. A skin rash with red spots may appear in the palms of the hands and soles of the feet, as well as on the knees, elbows and buttocks area.

Q: What should a child with HFM eat?

A: Make sure your child drinks plenty of fluids, such as water or milk, to stay hydrated. How much water should your child drink? At CHOC Children’s, we recommend that children drink the amount of 8 ounce cups of water equal to their age, with a maximum of 64 ounces for children over the age of 8. Most children do not have much of an appetite during this time. Cold or soft foods, such as popsicles, ice cream, yogurt or jello, are the most soothing given the sores on the throat.

Q: How is HFM treated?  

A: HFM usually clears up within a week. While there is no medical cure or vaccination for HFM, your child’s pediatrician can recommend ways to make your child more comfortable while the illness runs its course. Acetaminophen or ibuprofen can be given to ease painful mouth sores or discomfort from the fever. Download a parent’s guide to acetaminophen for children.

Children with blisters on their hands, feet or rest of the body should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and gently pat dry.

Everyone in the family should wash their hands often, especially after using the toilet or changing a diaper, and before preparing food. Shared toys should be cleaned often, as viruses can live on objects for a few days.

Call your child’s pediatrician if your child is sluggish, can’t be comforted or seems to be getting worse.

Q: Are there any complications?

A: Complications are rare. Occasionally, some complications could arise, such as dehydration, due to a child not eating well, or not being able to swallow enough liquids because of painful mouth sores. Sometimes the rash or sores on the body can be infected if there are breaks in the skin.

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6 Things Your Pediatrician Wants You to Remember in 2017

The new year is a great time to kick start healthy habits with your children that can be practiced all year long. We spoke to Dr. Reshmi Basu, a CHOC Children’s pediatrician, who offered the following tips:

pediatrician
Dr. Reshmi Basu discusses 6 things your pediatrician wants you to know this year.
1. Get your flu shot

If you haven’t received your flu shot this season, it’s not too late. Remember, the nasal flu vaccine is not recommended this season. The flu can make you much more sick than a regular cold and can have more complications, like pneumonia, so it’s important that everyone in the household over 6 months old receives it. If there is a new baby in the family, you can protect the baby by making sure anyone in contact with the baby has received the flu vaccine.

2. Wash hands often to keep germs away

Proper handwashing is especially important during cold and flu season. And remember to wash for at least 15-20 seconds and make sure to scrub between fingers and under nails.

3. Protect your child’s skin

During the winter it’s important to moisturize frequently throughout the day, especially after baths or showers, to treat and prevent dry skin. And, if you’ll be out in the sun, don’t forget the sunscreen. It’s best to apply it 15-30 minutes before sun exposure and reapply often.

4. Make well-child appointments and stay up-to-date on vaccinations.

 When children are young, there are frequent well checks with the pediatrician and these appointments usually include vaccines. As children get older (after 5 years old) and vaccines are not a part of every visit, it is easy to forget the well checks. They are still important, however, to see how your child is growing, how she is doing in school, and discuss any concerns. It’s also a good opportunity to get the flu shot (depending on the time of year) and make sure all other vaccines are up to date. Download CHOC’s  guide to making shots less stressful for kids.

5. Stay active.

The American Academy of Pediatrics recently lifted their rule on no screen time for kids under 2, with some limitations. Find time to be active. Make it a family activity– go on a hike, ride bikes together, or play in the park.

6. Read aloud to young children, starting at birth.

Try to read together for at least 15 minutes every day. Reading to your kids from a young age can help them with their speech development, communication skills, and even academic performance. And it’s a fun way to spend time together!

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When to See the Pediatrician This Season

As soon as the school year begins, pediatricians start seeing more infectious diseases because these illnesses are more communicable in a classroom setting. Poor weather enhances that communicability, so these ailments become even more prevalent during winter months. It can often be difficult for parents to decide which infections can be treated at home and which require a trip to the pediatrician.

We spoke with Dr. Michael Cater, a CHOC Children’s pediatrician, about what ailments parents should keep a close watch for this season, and how to tell when it’s time to make an appointment with their child’s doctor.

when to see pediatrician
Dr. Michael Cater, a CHOC Children’s pediatrician, offers advice on when to see the pediatrician this season.

Influenza season tends to pick up in late December or early January, Dr. Cater says, but its prevalence in the community depends on how many people get immunized. The Centers for Disease Control recommends that everyone over the age of 6 months receive an influenza vaccine. However, for this season, the nasal flu vaccine is not available.

Sometimes it is difficult for parents to decide which illnesses can be treated at home and which ones require a trip to the pediatrician. Dr. Cater offers tips on when it’s time to make an appointment:

  • Many infectious diseases in children are associated with a fever. If a fever of 100.4 degrees or higher lasts longer than three days, then a visit to the pediatrician is needed for future evaluation.
  • Labored breathing that doesn’t respond to home remedies. This could be an indication of a more serious respiratory infection.
  • If a child is vomiting and does not respond to dietary restriction.
  • Cases of diarrhea when the child doesn’t respond to dietary restrictions.
  • Sore throat associated with a fever and tenderness in the neck. This could indicate Strep throat, requiring antibiotics for the most effective treatment.
  • Ear pain in conjunction with an upper respiratory infection such as a cold, especially if the ear pain begins four or five days after the onset of the cold. This is highly suggestive of an ear infection, requiring antibiotics for the most effective treatment.

To avoid common infections this season, remember to get your family vaccinated against influenza, and practice proper hand washing technique. Children should wash their hands:

  • Before eating
  • After going to the bathroom
  • After blowing their nose
  • After playtime

Use hand sanitizer when you’re on the go and think your child may have touched something contaminated with germs, but use actual soap and water when you see dirt. Spend at least fifteen seconds vigorously washing hands front and back, and between the fingers.

Download this guide to personal hygiene to help prevent the spread of germs this season.

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Choosing the Right Pediatrician for your Child

During open enrollment, parents may evaluate their family’s healthcare plan, which can mean searching for new doctors and specialists for their children. Choosing your child’s primary care doctor is important. We spoke to Dr. Dan Mackey, a CHOC Children’s pediatrician, who offered tips to help parents make the right decision for their child.

Importance of a Pediatrician

It’s important for children to see a pediatrician, rather than a family practitioner who may treat older members of the family. A pediatrician is specially trained to care for infants, children and teens.   A pediatrician has graduated from medical school and completed a three-year residency program in pediatrics.  A board-certified pediatrician has passed rigorous exams administered by the American Board of Pediatrics.

Kids are not “little adults.” Different ages can present different illnesses and behavioral problems, which pediatricians are trained to recognize, diagnose and treat. Teens need pediatric care, too. Their bodies are still young and growing, their brains are still developing, and they are not yet ready for adult care, says Mackey.

A pediatrician’s office is generally designed with kids in mind, with waiting areas and exam rooms geared toward making children feel comfortable and engaged. Pediatricians’ office schedules are usually created to accommodate same-day and sick appointments.

In addition to choosing a pediatrician who is in-network with the family’s insurance plan, parents want to make sure the pediatrician is aligned with good pediatric subspecialists and their local children’s hospital.  Other factors to consider include:

  • Bedside manner
  • Interaction with office staff
  • Office hours and ease of scheduling an appointment
  • Medical records: paper or electronic
  • Method of communication with doctor: many offices offer phone, email and an online patient portal

Part of the Family

Having an open dialogue with your child’s pediatrician is important.  Parents shouldn’t shy away from asking questions.

“Being available for questions is important to families,” says Mackey. “A lot of teaching and education goes on over the years as the child grows up. It starts with educating the parent about nursing and nutrition, and continues with discussions about child safety, including issues like discipline and behavior.”

In addition to being a trusted resource on parenting, your child’s pediatrician is someone with whom you will spend a lot of time as your children grow up.

“Hopefully the relationship the family has with the pediatrician becomes a very long and pleasant one that lasts many years,” says Mackey. “Eventually, the pediatrician almost becomes part of the family, and a trusted member to turn to for help and advice. The best part of the job is getting to watch the child grow up.”

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