From The Straits Times    |

 

How to Cope with Hand, Foot and Mouth Disease

Credit: Varandah, 123rf.com

Hand, Foot and Mouth Disease (HFMD) is a highly contagious infection caused by viruses in the enterovirus family. The most common are the coxsackievirus and enterovirus. The viruses can hit people of all ages, including adults, but HFMD spreads most easily among children under five years old. 

Once your child is infected, it takes about three to seven days for the symptoms to appear. The first symptom is usually fever for one to two days.

Other symptoms may follow: sore throat, headache, ulcers on your throat, gums and inside the cheeks, and rashes and blisters on the hands, feet and buttocks. Your child may also feel tired or irritable. Some children may not show symptoms at all, or have only mouth ulcers or rashes. 

There is no specific treatment for HFMD. Your child may feel great discomfort. The mouth ulcers can cause much pain and he may find it difficult to swallow food or fluids, which can lead to dehydration. Here are some ways you can help your child cope. 

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How can I help my child cope with the discomfort? 

There are medicines that can help to ease the discomfort, says Dr Tan Kuan Yang, paediatrician from Thomson Paediatric Centre. Give your child paracetamol or ibuprofen to relieve pain and fever. Calamine lotion helps to soothe the blisters. Dr Tan also suggests using oral aid lotion to help numb the pain caused by the mouth ulcers. “Put oral aid on your child’s teeth or drop it directly into his mouth,” he says.  

Give your child plenty of fluids to stay hydrated. You can offer your child cold drinks and cold foods such as ice cream and jelly to lessen the oral discomfort, says Dr Tan. But avoid citrus fruit drinks or anything acidic, which can trigger pain, he adds.

Huan Chew Ting, TCM physician from Thomson Chinese Medicine, suggests giving your child room-temperature water or some herbal tea (liang cha), chrysanthemum tea, green bean soup or barley drink.

If he has a fever, bathe him in lukewarm water to cool down. Physician Huan adds that your child should rest in well-ventilated places where the temperature is moderate – neither too warm nor too cold.

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What can I do if my child refuses to drink? 

An effective way of getting your child to drink is to squirt a small amount of fluid into his mouth using a syringe, says Dr Tan. “By feeding him a bit of water each time, it is hoped that he will accumulate enough fluids over a period of time to prevent dehydration,” he adds. 

Should my child avoid any food?

In Chinese medicine, it is believed that HFMD is caused by ‘damp heat’ and toxicity that have accumulated in the body. Physician Huan advises your child to refrain from what are considered to be ‘heaty’ foods, like bread crusts, biscuits, chocolate, cakes and nuts. Your child should avoid cold, spicy and salty foods too, she adds.

She also advises children to gargle with room-temperature water before and after eating to reduce the irritation caused by food on the oral ulcers.

What foods can help?

Children with HFMD should consume light, ‘cooling’ foods that help the body detox, says Physician Huan. Examples of these ingredients: green beans, lily bulb, chrysanthemum, cucumber, melon, bitter gourd, water chestnut, lotus root, carrot and white radish. Common fruits include pear, kiwi, grape and strawberry. 

When should I bring my child back to the doctor?

HFMD is usually mild, and patients recover when the illness runs its course after seven to ten days. The most common complication is dehydration caused by insufficient fluids in the body, says Dr Tan. 

“If you think your child is dehydrated, don’t wait any longer, and bring him to the doctor,” he adds. “You’d rather err on the side of caution.” Your doctor may admit your child to the hospital for direct infusion of fluid into his body through a drip if he is at risk of dehydration.

In rare cases, serious complications may develop. Children may develop encephalitis or viral meningitis; both are inflammation of the brain that can lead to brain damage. There is also the risk of myocarditis, an infection of the heart. 

If you notice a change in your child’s behaviour, or find that your child has poor colour, which could be a sign of poor blood circulation and heart failure, it is prudent to take him to the emergency room, says Dr Tan. 

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How can I stop HFMD from spreading at home?

The virus spreads from from person to person through direct contact with nose and throat secretions such as mucus and saliva, fluid from blisters, and the stool of infected persons. 

To stop the virus from being passed on, says Dr Tan, practise good hygiene. This include disinfecting the toys and surfaces your child has touched. 

For parents, you may contract HFMD too. “Adults are not immune to HFMD. But because we tend to practise better hygiene, such as washing our hands before we eat or drink, we are less likely to get ill. But when we do, we get the same symptoms,” says Dr Tan.

Other precautions you and your child could take:

  • Don’t share food, drinks or utensils.
  • Cover your mouth and nose when coughing or sneezing. 
  • Wash your hands frequently – before preparing food, and after changing a diaper, wiping your child’s nose or mouth and using the toilet.
  • You may want to kiss or snuggle with your child when he feels uncomfortable, but close contact is not advised. 

How can HFMD be prevented? 

There are no vaccines for HFMD. “When you get HFMD, you develop immunity against the specific virus that causes that infection. But because HFMD is caused by different strains of virus, you may get it again,” says Dr Tan. The best protection is to instil good hygiene habits in your child. 

If your child has a ‘damp-heat’ constitution, Physician Huan advises, you can give them barley water or chrysanthemum tea two to three times a week. Fresh coconut juice on hot days will help to release the ‘heatiness’ from the body too.