Handling Hand Foot and Mouth Disease

Hand Foot and Mouth won't happen to your baby, because he doesn't go to daycare, or because you don't frequent play places with hoards of dirty children, or because he's never around cattle...all myths of "who gets illnesses like that."

Hand Foot and Mouth is going around, and we found out in the worst way. BOTH boys got it, and the 1yo has it BAD. Our sitter is a friend with a clean home and healthy children, we haven't been to any public places with large amounts of children recently, and no...we don't frequent cattle ranches. So who got my babies sick?? Simple answer-- we'll never know!

The Basics

The good news is that Hand Foot and Mouth disease is just a virus, and not a relatively dangerous one at that.  It most commonly affects infants and children, and while parents can contract it from their Littles, they're very unlikely to display more than a fever.

According to the CDC, it is caused by members of the Enterovirus. More good news is that it is NOT related to "hand and mouth" disease (also known as "hoof and mouth" disease) in cattle, although it's often confused with it.

It usually starts with a high fever and loss of appetite, after which baby will develop sores in and around their mouth that can spread to hands, feet, and genitals (luckily, that last one doesn't come up in the name!).  There can also be a widespread rash over most of the body. The sores become blister-like, and can scab over and start to peel a few weeks later.  They are rarely itchy, but can be painful, especially in the mouth.  Sore throat is often reported as a symptom, independent of any sores in the throat. (It's important to note, however, that symptoms don't always arise in this order or immediately. I was avoiding the reality that HFM had struck us because neither boy had sores in his mouth and the rash was speckled and flat, more like Roseola or Sixth's. But when #2's bumps started spreading, getting bigger, and turning into blisters, I couldn't deny it anymore!)

HFMLeg

The bad news is that it is most contagious during the incubation period 3-5 days before you even notice a symptom! This means no matter how careful you think you are, you can come in contact with a carrier. It is spread through bodily fluids (sputum, nasal fluid, saliva, stool) or blister fluids. In fact, because adults don't often show symptoms, your child can contract it from anyone!

Treatment

Because HFM is a virus, there is no specific treatment. Going to the doctor will in the best case give you a firm diagnosis, and in the worst case get you a misguided prescription for an antibiotic to ease anxieties (but remember, antibiotics do nothing for a virus, and can cause more problems). The Mayo Clinic suggests seeing a doctor if mouth sores keep a child from consuming any liquids or if symptoms begin to worsen after a few days.  I made the decision not to go to the doctor. My mom gut told me it was a virus of some sort, based on the symptoms (I was just really pulling for a less icky one!), and I knew that my pediatrician would tell me it was a virus, and send me home with no more than I had before (well, except a bill for the office visit). I have a vast network of experienced natural moms, midwives, doulas, and birthy experts that, for better or worse, I rely on to help in situations like this. So, I hopped on Google and Forums, started sending pictures, and here's the best I came up with:

  • WAIT IT OUT: As all viruses, it needs to run its course. After baby has it, he is immune from it. However, because there are multiple strains, it is possible for him to get it again in another form. Usually, the timetable is 7-10 days.
  • PAY ATTENTION TO THE FEVERS: I am a firm believer in the fact that a fever is they body's natural response to combating infection, and left to its own devices will help the body build its defenses and heal.  Therefore, we try not to "treat" fevers.  102 and below we usually leave be; however, we know that #1 has a tendency to go from a manageable fever to an emergency room visit for a 105 temp very quickly, so we keep out a close eye on both and are more likely to treat sooner for him.  Liquid pain reliever is the most common method for reducing fevers. We reserve Tylenol (acetaminophen) for extremely high fevers that we want to break fast. It is faster acting, but also lasts less time, needs to be administered more often, has very few dye-free options, and can be more toxic to the system of a little one (which is why we choose to use it as sparingly as possible. It's rare that we do at all.). Ibuprofen is a better choice for babies' systems, lasts longer, is widely available dye-free, but also takes longer to kick in.  Natural remedies for fever management and reduction are cool baths and washcloths on the head, a few drops of lavender on the bottom of the feet, and peppermint oil (please note, peppermint oil is widely regarded as a "take caution" oil on little ones, some suggest anywhere until 6 years old, and because of that, I do not use it topically on my little ones.  I use it aromatically and either diffuse it or rub it in my palms and tell them to smell.).
  • RELIEF FOR BLISTERS: Virgin Coconut Oil has antiviral properties and can be applied directly to the skin as a salve for the blisters. Lavender Oil is used for its healing properties of skin issues like bites, burns, rashes, itching, and pain. A few drops added to the bathtub can provide relief (and calm baby down before bed!). You can also dilute it in the Coconut Oil and apply directly to the skin.
  • PAY ATTENTION TO INTAKE: Dehydration can be a major concern if baby refuses to eat or drink because of the discomfort in his mouth.  Pay attention to diapers to make sure he's still peeing.  Offer sips every few minutes; even little sips count! Also, sucking can irritate mouth sores, so if he regularly drinks out of a sippy cup, try helping him drink out of a regular cup and pouring small amounts of water in his mouth. Messier, yes, but #2 drank almost two full cups that way when he wouldn't take a single sip out of a sippy. If baby is old enough to not swallow whole or choke, give small pieces of ice. This will help hydrate as well as sooth the mouth.  Making popsicles, smoothies, or freezing yogurt can help him eat. (Both of my boys lived on refrigerated applesauce pouches!) If you're worried about dehydration, coconut water is an amazing alternative to sugar and dye filled sports drinks and electrolyte drinks.
  • RESTART SYSTEMS: After a particularly nasty virus, it's important to reboot in order to boost his immune system.  As soon as the blisters calm and the threat of being contagious has passed, take him for a chiropractic adjustment. Keeping baby well aligned helps keep systems working smoothly and can help with sleep disturbances, digestion issues, temperament, pain, and more.  Probiotics can also help normalize the gut as he starts to eat and drink again as normal (and can be especially helpful if diarrhea was a symptom). Using Thieves Oil can help protect from further illness while his immune system gets strong again. Diffusing alone or with Purification can clean the air in your home, and diluting and applying to the bottom of the feet can help keep him healthy. (Please note, while also used for wound care, Thieves is MUCH stronger than Lavender and should be diluted when using on Littles. Also, make sure there are no active blisters on the feet before applying.)
  • KEEP IT CONTAINED: While our family is living proof that it is almost impossible to keep one toddler from catching HFM if the other toddler has it, cleaning is the key to keeping it contained. Wash everyone's hands OFTEN! Disinfect toys, living space, soiled linens, and anything that has come in contact with saliva. Most people will run out to the store for bleach cleaner and Lysol; if that's your plan, please make sure to clean when the kids are not around and in an area you can leave/keep ventilated after, so no one is sitting and inhaling the fumes. Some natural options would be to use or make Thieves cleaner. White vinegar is also an extremely versatile cleaning choice, and the smell goes away when it dries. Adding Lemon Oil adds disinfectant properties as does adding Melaleuca (Alternifolia)- tea tree oil. (Please note, Tea Tree Oil should be kept away from children and pets, as it can be toxic. ALWAYS dilute and consult an oils manual or herbal expert before using it topically on children) The Mayo Clinic suggests limiting exposure to anyone showing active symptoms and to keep children out of childcare until fevers are gone and mouth sores have healed.

HFM get your family down? Please comment below with any other natural remedies you've found to be helpful or question you still have!