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Wellness Center

Please Help Immediately

10/26/2009

Question:

My 3 year toddler son has developed red sores on his hands. It has developed to his feet as well. He had slight fever 2 days before. And since then he is very irritated and cranky. he is not sleeping well at nights. I searched it online and found about the disease called "hand foot and mouth disease". I just dont know what to do. He has got the appointment with the doctor for day after tommorow. I feel bad for my son as he seems to be in pain and restless. I dont know what to do and how he could have got this! He is not going to school. Please advice immediately as what I need to do for him. Is there anything I can do from home that can ease this disease and pain? Please advice immediately!!! thanks.

Answer:

I know you are very worried about your son, but if it is hand-foot-and-mouth disease, which it sounds as though it is, it is a viral infection that resolves over 2-7 days on its own. There is not  lot you can do except to give acetaminophen every 4-6 hours per day for a maximum of 5 doses per day (e.g., tylenol) or ibuprofen no more than 4 times per day(e.g., Advil) in a dose closest to his weight. 

He likely has sores in his mouth that are making him most miserable. It helps to mix one part Maalox with one part diphenhydramine liquid (e.g. Benadryl), mix well, and paint on the sores in his mouth using several Q-tips bunched together. Do this after he has had something cold to eat or drink so that it sticks around in the mouth.

Usually ice cream, very cold yogurt or frozen yogurt, popsicles, and milkshakes are well accepted by young children. Don't worry about eating as much as about drinking. Dehydration is the most common reason young children go to the emergency room with hand-foot-and-mouth disease. Salty, sour, carbonated liguids are not usually comfortable for young sufferers. Also avoid anesthetic mouth washes because they may cause the young child's gag reflex to be depressed or absent. 

If his rash itches, buy a colloidal oatmeal bath (Aveeno makes a good product) and have him soak in a tub of oatmeal water every 4-6 hours. Be very careful not to overdo doses of Benadryl. Avoid combining a dose of Benadryl by mouth with Benadryl cream on the rash or Maalox-Benadryl wash in the mouth.

The Coxsackie virus is extremely contagious. Summer and early fall are the times of year it is most common. Your son could have gotten it from going to the playground or the mall. It incubates for 2-6 days before the symptoms appear. So keep him home until he has no fever and the rash is gone.

If your son's fever is 102 degrees or higher, he should receive urgent care. If he is unable to drink liquids, is listless, has very dry lips and mouth, and is passing little or no urine, he should be taken to the emergency room.  

Thankfully children recover well from this virus.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University