Hand, Foot and Mouth Disease: Beginning Stages

After the first general symptoms, painful spots or ulcers may develop inside the mouth. Small red marks or blisters can then appear on the palms, soles, fingers, toes, buttocks, arms or legs. Some people have only a few skin changes, while others notice a more noticeable rash. Because early symptoms overlap with many viral illnesses, the first day or two may not provide enough information to identify the cause.

Start offering fluids regularly, even if each drink is small. Choose soft foods and avoid items that are salty, spicy or acidic when the mouth feels sore. Check that the child remains alert and continues to urinate. Wash hands with soap and water, especially after changing nappies or using the toilet, and avoid sharing household items. Keep a simple record of new symptoms so a clinician can understand the sequence.

Get prompt medical help if the child cannot keep fluids down, has very little urine, is hard to wake, has breathing difficulty, develops a stiff neck or severe headache, or appears to be getting rapidly worse. Contact a clinician if fever concerns you, symptoms do not fit the usual pattern, or you need advice for an infant. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can examine early changes.

Ask which symptoms should be monitored overnight, how to maintain fluids when mouth sores start, and when close contacts may return to childcare. You can also review [Fever](/symptoms/fever/) for general fever information.