Hand, foot and mouth disease in infants

An infant may be irritable, drool more than usual, refuse the breast or bottle, or wake frequently because swallowing hurts. Small spots or blisters may occur on the hands, feet, around the mouth, or on the nappy area. Some infants have mild skin findings and more noticeable mouth discomfort. Because babies cannot describe symptoms, changes in wet nappies, alertness, and feeding are useful clues.

Continue breast or formula feeds in smaller, more frequent attempts if tolerated. Cool fluids or a suitable soft diet may help older infants who already take them safely. Never dilute formula or give medicines, gels, or herbal products without age-appropriate advice. Keep the skin clean, use gentle bathing, and prevent scratching. Wash hands after nappy changes and before feeds, and clean shared toys.

Contact a clinician promptly if feeding drops, wet nappies become noticeably less frequent, the mouth is very dry, there are no tears, or the infant is unusually sleepy or hard to settle. Seek urgent help if the baby is difficult to wake, has breathing difficulty, a seizure, blue or grey lips, or a rapidly worsening appearance. Any very young infant with fever should receive prompt medical advice.

Ask how to judge hydration, which feeding pattern is safest, and what pain-relief options are appropriate for the infant. Tell the clinician about feeds, wet nappies, temperature readings, rash onset, and any known contact with the illness.