Infant Illnesses | Spotlight on hand, foot and mouth disease

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"The illness lasts in total about 7-10 days till complete recovery takes place". (FreshSplash/Getty Images)
"The illness lasts in total about 7-10 days till complete recovery takes place". (FreshSplash/Getty Images)
  • If you've noticed strange blisters on your baby's palms and feet, it could be hand, foot and mouth disease.
  • It isn't very common but most likely occurs in children aged two to five.
  • A local expert explains how to treat this viral illness at home and when medical care is necessary.

    Having a newborn baby is overwhelming enough, but if they show signs of illness, it can be really scary.

    At Parent24, we've put together a series on common infant illnesses to help guide you when your baby is sick.

    Together with a local paediatrician or doctor, we'll help you decide when you should actually panic – it's probably not as serious as you think, but let's be sure.

    Catch more instalments of our #infantillness series here

    A typical concern

    "My two-year-old has come down with flu and has what looks like blisters on his hands and feet! He also has a fever, what could it be?"


    Your baby might have hand, foot and mouth disease (HFMD). 

    "HFMD is not extremely common. Outbreaks usually occur in crèches and pre-schools as the virus spreads from one child to another before the actual rash appears," Dr Iqbal Karbanee tells Parent24.

    A paediatrician and CEO of SA's first telehealth service, Paed-IQ BabyLine, Dr Karbanee says HFMD begins "like the normal flu, with the child looking ill, developing a fever and loss of appetite".

    However, this progresses and soon a rash starts to develop.

    "Within a few days, the child develops what looks like a rash initially but then develops into small blisters on the palms of the hands, soles of the feet and inside and around the mouth. The rash may sometimes extend to the rest of the body too."

    What causes HFMD? 

    Dr Karbanee says HFMD is classified as "a viral illness" which is caused by the coxsackie virus.

    The paediatrician explains that while easily identifiable, there is a slight chance of misdiagnoses since many viral illnesses commonly present with symptoms like skin rash and blisters.

    "Blisters in the mouth can also be due to herpetic gingivostomatitis. This can cause problems in younger children so medical advice should be sought to differentiate the two in cases where the mouth blisters are the main issue".

    MUST READ | Spots and rashes on baby? Here's what's normal and when to visit a doctor

    Symptoms to look out for

    According to Dr Karbanee, the typical symptoms of HFMD include:

    • Fever
    • Loss of appetite
    • Blisters in mouth, as well as on the palms and soles of the feet

    Dr Karbanee explains that the "loss of appetite [is] due to the blisters in the mouth, and the general feeling of malaise affects children often".

    How long will it last?

    "The illness lasts in total about 7 to 10 days till complete recovery takes place," Dr Karbanee advises.

    How is it spread?

    Despite the virus running its course in a relatively short period, Dr Karbanee says the illness is contagious, with 2 to 5-year-olds identified as the peak age group most likely to be infected.

    "The virus spreads in the prodromal phase that is before the rash appears and when the child looks a bit under the weather... This is why viruses spread so easily. Once the child is obviously affected by HFMD, parents would keep the child isolated, but the period of spread has already occurred."


    While the appearance of the blisters and your child's general lacklustre might seem to require serious care, Dr Karbanee says HFMD can be treated at home but special caution must be taken when managing fever.

    "Emphasis is on good management of fever. If the blisters in the mouth are problematic, the doctor will prescribe meds for this, but antibiotics are generally not needed for the treatment of HFMD".

    When to call the doctor

    Dr Karbanee says parents should seek medical attention in the case of a "child that is not taking in any food or fluids" or when "the blisters in the mouth start looking worse and perhaps even bleed, then the child should also be seen by a doctor".

    ALSO SEE Squeaky clean: How to sterilise baby bottles, and when to stop

    Tips and advice for parents

    "A rare complication of HFMD is the child who starts looking very tired and listless. In this case, the child must be seen by a paediatrician. Most cases of HFMD get better within 10 days and are uncomplicated. Parents should focus on controlling the fever, ensuring the child gets enough fluids and keeping the skin clean. The blisters do not leave any scars and heal well."

    You can also ask a doctor or paediatrician directly via Health24 here: Ask an Expert


    Share your stories and questions with us via email at Anonymous contributions are welcome.

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