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Making It Through Hand, Foot and Mouth Disease: Tips for Survival {Daycare Outbreaks}

I know I’ve done an informational post on Hand, Foot and Mouth (herein, HFM) before but now that we have had personal experience with it I figured I might share any “wisdom” I’ve gained with others.

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Now, if you read my previous post you’ll know HFM is very common in daycare settings in the summer and fall in particular. It is a viral infection that can be caused by a few different viruses – so it is possible that your child gets it more than once. It is contagious via contact (child touches surroundings then touches their mouth etc) and since little kids tend to do less or at least less effective hand-washing than older kids or adults, that is why we commonly see it among this population.

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Disclaimer: this is not medical advice nor should it be interpreted as such. This blog is for informational purposes only. Please ask any medical questions to your healthcare provider. *Please note – some Amazon associate links are used in this post, so I may earn from your purchases.

Prefer to listen? Check out the podcast episode on this topic here.

How did you know it was HFM?

I knew because of knowledge & experience (clinically) with the infection, but the problem with viral infections like this with skin rashes is they can sometimes look similar.

Here is a list of a few common viral rashes that occur in children, and here is some additional information + fact sheets on common childhood rashes.

I really like the Royal Children’s Hospital Melbourne’s fact sheet on HFM, which I’ve linked just above and also in additional resources, because it gives a good image of HFM on the foot. You can also google HFM – however keep in mind that some photos that come up may not be HFM (they could be someone who posted in a forum asking if there child had HFM for example). Your best resource is of course, your healthcare provider. A phone consult will often do with a description of the rash. Most docs can identify it that way, or by e-mailing the office a photo for example. Or via virtual care if your office offers this! Yay virtual care – limiting spread of illnesses!

My daughter first presented with a very light pink rash in her elbow and knee creases – so I actually did not at first suspect HFM. These areas can be affected in HFM but obviously the kind of main areas you see the rash in are often the hands, feet and mouth. My daughters started in the knees and elbow area and we actually erroneously identified it as a bad eczema flare up! The weather was changing and these were the areas we usually saw her eczema flare up so it wasn’t totally far-off.

The day after we thought her eczema was flaring, it got worse and we quickly realized it couldn’t be eczema. She had also had a runny nose and cough, and it’s common for HFM to start this way. She never had the typical fever that occurs at the start of many HFM cases though. I checked her temp daily when she started her runny nose and then also the first few days we noticed the rash and her readings were all normal.

Not sure what type of thermometer to use for your child? Check out this post.

Symptoms & Management

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HFM is thankfully a relatively mild illness. Other than irritability and discomfort (plus her runny nose + cough), Maggie faired okay. Her rash slowly spread from elbows and knees to her mouth and around her butt. The mouth was most definitely the worst part – at least in appearance. We noticed a few spots on her hands and feet a few days in, but they were very light and not as clustered as the mouth, elbows and knees.

Maggie did lose her appetite for a few days – the day her cold symptoms started she had increased appetite, but the following two days she didn’t eat much. I focused on keeping her hydrated by offering her lots of water and any other fluid she was interested in, like small real fruit juice freezies or popsicles. Pedialyte is another option but we didn’t need to pursue this – luckily, Maggie really likes water.

We were not sure if she had any mouth sores or discomfort in the early days because of her appetite – but when we checked there weren’t any. If she did have some, we would have gone with Tylenol to manage discomfort (this is generally the recommendation for pain + fever, but check with your provider if you have concerns/questions). We also – just to be cautious- avoided any citrus drinks or acidic foods just in case there were any sores we couldn’t visualize. There are some things you can administer if your child has mouth sores – talk to your provider for guidance on this.

For the runny nose and cough we used the snot sucker (we just have a bulb syringe like this) and Baby Vicks on her chest at nighttime (we just have that one on hand). A humifier in the room is also a good idea – all of the time, but especially during colds or cold symptoms (or allergy symptoms!).

For the rash we applied calamine lotion twice a day. We also bathed her with an oatmeal wash a few times to help relieve the itching (we personally used Aveeno because once again, we had it on hand). Popped or opened blisters can have polysporin applied to them to prevent infection. You can apply a bandaid on top too if it’s quite open. We had to redirect her from scratching but she pretty much only did this when she was going to bed at night.

I kept her home for daycare for what ended up being 6 days – the first day was a Friday and she only had cold symptoms; followed by the whole following week where she had the rash. As there were a few cases at daycare, everyone stayed home that week so it worked out. We didn’t take her anywhere – I avoided the parks even until her rash had dried up. They say you’re most contagious for the first week of symptoms – though each source is slightly different. I saw 5-7 days as an average, but you can continue to be contagious for up to 3 weeks to months via the stool.

I had a hard time finding recommendations on when Maggie could return to daycare – most sources suggested speaking to your daycare about their guidelines, which I did. I also followed the AAP’s recommendation that her blisters had dried up and she felt well, therefore she could return.

Here is our complete survival kit – this is not medical advice, just what we used and what helped us:

*I have linked the snot sucker and Aveeno product up above. I didn’t include Tylenol (talk to your provider) or Baby Vicks (linked above) since cough isn’t always a symptom! You can find Calamine at your local pharmacy if you don’t have it on hand in a first aid kit and pick your own preferred freezies 🙂

How to avoid spreading it

Pray haha. Sort of kidding. My husband actually did end up getting it, but it presented totally differently than Maggie’s case with mouth sores and almost no rash whatsoever. He also did have a fever and chills for about 2 days prior to onset of the mouth sores/pain.

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The best defence against HFM is to keep up with hand-washing especially after diaper changes, or when coming in contact with open blisters or respiratory secretions of the sick person.

We kept all James’ toys away from Maggie and if she touched any of them, I washed them before giving them back to him. Keeping them apart was not easy – but miraculously, James did not get sick! It hurt my mama heart to tell Maggie she couldn’t kiss him though.

We also avoided sharing water bottles or other utensils or personal items with Maggie while she was sick. This includes towels, but James and Maggie have their own dedicated towels anyways.

The AAP also recommends disinfecting surfaces – we kept up with cleaning, but I can’t say I was following her around disinfecting every surface she came into contact with being I also have a 4 month old baby to care for. I’d say handwashing and abundance of caution with interactions is your best bet, but sometimes these things happen.

HFM is yucky and it can suck, especially for adults. But it’s generally mild and most major symptoms should start to disappear within 7 days for most typical cases. If you have questions or concerns, your best resource is your healthcare provider or a service like Telehealth where you can speak to a nurse about your concerns – they can give you guidance on whether to see your doctor, manage at home or go to ER. Keep an eye for signs of dehydration or any unusual behaviour and contact your provider or emergency services if needed. You can check out additional resources too for more information.

And yes – Maggie returned to daycare this Monday and is feeling much better!