Hand, Foot and Mouth Disease: Comfort and Hydration

Hand, foot and mouth disease often causes a sore throat, painful mouth ulcers and spots on the hands or feet. It can also affect the bottom or other areas. The illness is caused by viruses and usually improves within about seven to ten days, but a sore mouth can make drinking difficult much sooner.

For a baby or toddler, hydration and overall behaviour are more useful things to watch than the number of spots. Get advice if you are unsure of the diagnosis or your child seems more unwell than expected.

Make drinking the priority

Offer breast milk or the usual correctly prepared formula to a baby, with smaller, more frequent feeds if that is easier. For a child already having other drinks, cool fluids may be more comfortable. Avoid acidic drinks such as fruit juice if they sting the mouth.

Do not force a large drink at once or insist on finishing a meal. Offer soft foods suitable for your child’s usual feeding stage if they want them. Very hot, salty or spicy foods can make mouth pain worse. Temporary interest in fewer solids matters less than being unable to take enough fluid.

Notice wet nappies or trips to the toilet. A dry mouth, fewer tears, reduced urine or unusual tiredness can accompany dehydration. Contact a clinician urgently if drinking is poor or urine is noticeably reduced. The dehydration guide explains why you should not wait for every sign to appear.

Ask about suitable pain relief

A pharmacist or clinician can help choose a medicine appropriate for your child’s age, weight and health. Follow the exact product instructions and use the supplied measuring device. Do not copy a dose from a sibling or alternate medicines without a clear plan.

Ibuprofen is unsuitable for a dehydrated child. Do not give aspirin to a child unless it has been specifically prescribed. Mouth gels, sprays and rinses also have age restrictions, so ask before using one in a baby or toddler.

Antibiotics do not treat the viruses responsible for this illness. If a clinician identifies a separate bacterial infection or another condition, they will explain whether a different treatment is needed.

Get help for worsening illness

Seek urgent advice for a child who cannot drink comfortably, has a concerning fever, appears increasingly unwell or is not improving as expected. Arrange review if symptoms have not improved after seven to ten days. Those timelines are not instructions to wait with a deteriorating child.

A baby under three months with a temperature of 38°C or higher needs immediate assessment. Breathing difficulty, a seizure, difficulty waking, blue or grey colouring, or a rash that does not fade under pressure requires emergency help. A presumed diagnosis must not explain away those changes. Our fever guide covers what to report.

Plan household and nursery care

Wash hands with soap and water, particularly after changing nappies and before preparing food. Clean frequently touched toys and surfaces as directed for the material, and avoid sharing cups, cutlery and towels. The virus can spread through saliva, stool and blister fluid, so hygiene still matters as the child improves.

Tell nursery about the illness and follow local guidance. Keep a child with fever or who cannot participate comfortably at home. In England, children generally do not need to wait until every blister heals once they feel well enough to return. Elsewhere, rules may also specify no fever and no uncontrolled drooling, and outbreak instructions can differ. The nursery illness guide helps organise the return plan.

A pregnant household contact should ask their maternity clinician about exposure, especially close to birth. There is usually little risk, but individual advice is appropriate. Call a clinic before attending with a contagious rash so staff can plan safely.