We want to send out a quick blast to let you know what we have been seeing in our office over the past few weeks. This will hopefully help you and your family avoid one of the more common “back to school bugs”!

Hand, Foot and Mouth (HFM) is a viral illness. As I am sure many of you know from experience, it is most commonly characterized by blisters occurring around and inside the mouth, and less commonly on the soles of the feet and palms of the hands. The blisters can occur in other areas of the body such as the groin and limbs—and we have been seeing this more often in the last several years. Significant irritability can accompany this illness, as kids can feel terrible. The blisters can develop in conjunction with cold symptoms such as a runny nose, congestion and cough or with gastrointestinal symptoms such as diarrhea, nausea and vomiting.

Approaching this from the “cup half full” mentality, let’s start with prevention and then move into treatment if you happen to be infected.

Prevention of Hand, Foot & Mouth Disease
Prevention of this viral illness is not unlike that of many others. Regular hand washing before meals and when getting home is the simplest and often most effective proactive measure. Hand sanitizer can be used when outside the home, before eating, or after playing with other children. If a child is prone to putting hands, fingers or objects in their mouth, consider a necklace, bracelet, or other toy that can hold up to chewing and may be less attractive to others’ germs.

Encouraging older children to avoid sharing drinks or food with their friends (I know right?) can also be helpful. In addition, avoid sharing food or drink at home as a family because adults can become infected too. Keep in mind, HFM can be contracted multiple times—it is not a “once I’ve had it, I am immune virus”.

Consider taking specific immune supportive supplements such as Immunoberry Liquid (1 ml per day), Vitamin C (doses vary by child’s age) and Zinc (10 mg daily).  Also make sure that your little one is taking their basic supplements like a probiotic (such as the Klaire Labs Therbiotic Complete 1/8 to ¼ tsp per day),  Xymogen’s Vitamin D3 (1000 iu per day) and Omega 3 fish oil (doses vary by child’s age). And always remember that getting plenty of sleep, spending time outside and eating as many fresh fruits and veggies as possible are always helpful for immunity.

Treatment of Hand, Foot & Mouth Disease
If you do see signs of HFM despite having tried the above, here are some ways to decrease the severity and make your child more comfortable. Increase Immunoberry Liquid to 1 ml up to 4 times daily, increase dose and frequency of Vitamin C (just watch for loose stools) and call the office for an appointment to discuss a more comprehensive plan.

Because dehydration is the biggest complication of HFM, encourage oral hydration in whatever creative manners you can…think popsicles, offering watered down juice, coconut water or rehydration tabs or drinks that are low in sugar.

If your child is refusing to take in fluids, consider a dose of Ibuprofen or Tylenol to relieve pain and then reattempt to offer fluids. In most cases getting adequate hydration is possible at home and your child should not need a visit to the office or hospital. If your child continues to refuse fluids and urinates less than 3 times in 24 hours, please call our office for a visit or to determine if IV rehydration is needed.

The sores can be painful and take some time to heal.  Most kids are much better after 3-4 days.  Call if any of the lesions begin to look infected (if they become more painful, red, swollen), or if your child develops a fever as the disease resolves. Applying moisturizer, as tolerated, to healing skin can also be helpful.

About Ara Haupt, PA-C

Ara Haupt, PA-C is a pediatric Physician Assistant whose interests have always incorporated practicing Western medicine with a balanced integrated approach, looking at the entire body. Adolescent care and integrated teen mental health have been particular areas of interest. Ara enjoys learning how the body can heal itself when given the right tools and coaching. Over the past few years in practice, her passion for learning more in integrated and complementary medicine has grown tremendously, leading her to Mindful Pediatrics.

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