When to worry about fever with hand, foot and mouth disease

Most children with Hand, Foot and Mouth Disease notice fever along with a sore throat, reduced appetite, and small mouth ulcers or a rash on the hands and feet. Fever can make a child tired, yet alertness should improve between fever episodes. The illness can make drinking painful, so the fever matters partly because fluid loss may build quietly.

Offer frequent small sips of water, milk, or an oral rehydration drink. Soft, cool foods may be easier when mouth sores hurt; avoid acidic drinks and spicy foods. Keep clothing light and let the child rest. Use fever medicine only as directed for the child’s age and weight, and never give aspirin to a child. Track urination, drinking, alertness, and whether the fever is easing.

Get emergency help if the child struggles to breathe, has a seizure, cannot be woken normally, develops a stiff neck, or has blue or grey lips. Arrange prompt medical assessment if they cannot keep fluids down, urinate much less, have a very dry mouth, become unusually floppy, or worsen after seeming to improve. A clinician should also assess an infant with fever, a child with a weak immune system, or fever that does not settle as expected.

Ask whether the child’s fluid intake and urine output are adequate, which fever medicine and dose are suitable, and whether the mouth sores need additional pain relief. Tell the clinician when the fever began, its highest reading, any recent medicines, and any change in behaviour or breathing.