July 31, 2008,
S.D. asks from Santa Monica, CA on July 28, 2008
Hand Foot and Mouth Disease???
Does anyone know about Hand foot and Mouth (HFMD) disease? My sister's kids (one is two and the other is 8 months old) were exposed to HFMD. She is visiting all the way from New Zealand. We only get to see each other once a year and she is here to see my newborn son for the first time (he is 3 months old). I'm so upset because what I've read sounds like if I see them I'm basically exposing my baby to the disease even if they don't have symptoms. Any advice? I've been hearing more and more about kids getting this. I'm airing on the side of having to not see them and they came all this way to see us.
1 mom found this helpful
So What Happened?™
To all the mom's that replied to my question (all 34 of you!) Thank you so very much. I was blown away by all the advice, support, and personal stories that you shared regarding HFMD. It was a very difficult decision for me to make but after weighing all the risks I decided to keep my baby away from my sister and her kids for 7 days. I visited them a few times during that week but my sister and I told her 2 year old that I was not feeling well and didn't want to get her sick so no hugs or kisses until I was better. After a week her kids never showed any signs of having HFMD so we were able to be with them for the last 4 days of their visit. I feel like I'm an expert on HFMD after getting so much information from you all and doing my own research, so if anyone has any questions about it just ask:) Thanks again. I Love Mamasource!
Y.W. answers from Las Vegas on July 29, 2008
My son got this from daycare when he was 2. HAND WASHING is the best defense. I took him to the peditrician and she told me normally adults do not get this but I had just got braces on and got it. It was miserable. it is not suppose to be contagious unless the sores break but I did not see any broken ones on my boy. My daughter was 5 when this happened and got a mild case. I suggest keeping the kids away from the baby and sterilizing everything and using hand sanitizer everytime anyone touches the baby...err on the side of caution....
R.L. answers from Los Angeles on July 29, 2008
HFMD is caused by a nasty little virus called coxsackievirus (type A). It is spread through nasal secretions, saliva and feces. The best way to try to avoid infection is through rigorous hand hygiene, especially after eating, doing diaper changes, using the toilet, sneezing, coughing, etc. It is most infectious during the first week of illness. Since this typically begins with a couple of days of flu-like symptoms before the rash appears, you can end up being exposed before you know what the infected person is actually sick with. Because the virus is primarily transported by hand contact from the infected person, anything they touch can end up being contaminated. This means toys, utensils, etc. The CDC site has a good set of fast facts you should take a look at:
Fortunately, the virus is self limiting (active symptoms last no more than a week, although the virus can hang around in the blood for months while the immune system is getting rid of it). Severe complications are rare and infection never becomes chronic.
However, your 3 mo-old has no immunity and may not receive it through your breast milk if you are not immune to the virus (have never been exposed to it, or do not generate an immune response to new exposure, or if the virus is a substantially different variant than the one you were exposed to originally). The biggest problem with an infant is that the mouth sores can be so painful that they prevent good feeding and hydration. Tylenol can help reduce the fever and pain, but if the baby becomes dehydrated, hospitalization may be necessary to administer IV fluids. This is also pretty uncommon.
Personally, I would be cautious of a visit by the exposed children. It would be best if your sister visited without her children, and she should wash her hands very well after leaving her children and again before entering your house or coming in contact with your baby (in case she has already unknowingly spread virus on other surfaces she or her toddler may have come in contact with, such as the car door, etc.) That way, if her children are shedding virus she is less likely to carry it into your home. Also, incubation of the virus before symptoms appear is from 2 to 10 days. So, if it has been at least 17 days since they've been exposed, they're probably clear and OK to visit(either they did not contract the virus or have cleared the prime infectious period). I would still insist upon rigorous hand washing, though, and I would avoid letting the 8 month old come in contact with your baby at all, since babies of that age spend a lot of time with their hands in their mouths! Also, don't allow anything the toddler might stick in her/his mouth (including hands) to come in contact the baby.
BTW, about 50% of kids with coxsackievirus have no symptoms, and symptoms in many others may be very mild. Sometimes a child will have only a fever and no rash or blisters, or the rash appears only on the hands and feet and never in the mouth or throat. For this reason, it can spread rapidly through daycares and nursery schools. It is theoretically possible for most of the children in such an environment to have the virus and never know it. If your baby is in daycare, he may have already been exposed to the virus and is immune to it. The problem is, you can't know. Because the virus is so mild (relative to coxsackie B), I don't believe an easy blood test is available. Tests are usually only done if a case is unusually severe and serious complications have developed. This involves testing for the viral DNA, which can be pretty expensive (several hundered dollars/test).
Sorry -- I hope this isn't too much information. At least it's given me a break from the hepatitis article I've been working on! I hope you find a way to visit comfortably with your sister.
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J.W. answers from Los Angeles on July 29, 2008
Definitely call your pediatrician and ask for advice. When I gave birth to my now 1 year old daughter, my niece and nephhew had HFMD. Even though my sister and brother-in-law were symptom free and never got the disease, my ob-gyn and pediatrician ordered the whole family to stay away from me and my newborn. If a little baby contracts the disease it can be a real problem with his/her ability to feed.
C.W. answers from Los Angeles on July 29, 2008
HF&M is a very common illness in babies, and most "day care" babies have had it. My son contracted it in daycare when he was about 6 months old. Other than some discomfort (sores in the mouth and throat can make the child uncomfortable when they're eating) and the weirdness of the blisters on the hands and feet (didn't bother my child at all, just looked strange) there were no harmful effects. My other son (then 2 years old) did NOT get it, even though others in his day care class had it as well, and I made no effort to keep my two children away from each other when the younger one had it.
I would suggest speaking with your pediatrician about whether there is any reason to keep your newborn away from the niece and nephew, or any possible detrimental effects to having HF&M at the age of three months. (There were 3 month olds in the day care who had it, so I wouldn't think there would be.) I realize that because my children are in daycare I am much more casual about baby illness than some other parents may be, but ultimately kids get sick, and they get each other sick - I would go ahead and have everyone see each other!
Hope this is helpful!
C.M. answers from Los Angeles on July 29, 2008
Goodness! Don't miss out on the chance to see your sister!! Given that your son is so little, you can control this by making sure they don't handle the same things. You say your sister's kids were exposed to it, but don't acutally show syptoms? I highly doubt you have a problem. That said, I wouldn't want a 3month old to get it, but it's not a terrible illness even if he does. I urge you to contact your pediatrician and get some advice on how far to keep them apart and whether you need to clean things they handle or just wait for germs to die.
I hope you will go ahead and have your visit with your sister. Alternative suggestion -- perhaps someone in the family could be with her little ones while you & sister visit and you introduce your new baby boy to her.
All the best,
M.D. answers from Los Angeles on July 31, 2008
It's one of those annoying childhood diseases...I think once they get it, they are contagious for about a week after. My son had it around 8-9 months. It wasn't the end of the world...honestly we didn't even realize he had it until it had pretty much passed. We thought he was teething really badly and then another kid at daycare got it and we realized that's what he was dealing with...My son's symptoms were pretty much low grade fever (like teething) and didn't want to eat or suck, really fussy. We figure he had the sores in his throat because he didn't have any on his hands, feet or bottom like you usually do. Poor guy, but we made it through...
D.W. answers from Los Angeles on July 29, 2008
Relax. It is extremely common and at some point your baby will be exposed to it. It sounds and seems worse than it is. My son got it and it scared me because I didn't know what it was. Once I found out I was totally reassured. He didn't even notice that he had it- it didn't bother him at all it just looked terrible. We still don't know where he got it from- no one we know had it at the time. It's so common though he could have gotten it from anywhere. The doctor was very reassuring. It is a harmless childhood illness. Be sensible about the visit- lots of handwashing- but don't freak out. They've come too far to not see them and at least you know about it so you are prepared. Enjoy it as much as you can.
J.S. answers from Los Angeles on July 29, 2008
My son was exposed to it last year. The friend he was playing with didn't show signs of it the day we were together. Sure enough the next day she broke out. I kept watching for it and w/in a week, my son got it. We stayed sequestered in the house for about a week hoping to not expose anyone else. I would definately not let the cousins be around your little guy. What a bummer!
E.C. answers from Los Angeles on July 29, 2008
My son got it when he was 7 months old. Blisters on the hands and feet (tiny ones) and a terrible soar throat - never saw blisters in his mouth. The worst part was that he was nursing exclusively at the time, and he WOULD NOT nurse for almost 36 hours straight at the worst of it, because his throat hurt so bad. So...I had to pump around the clock to get through it.
It is a yucky illness, but not entirely dreadful. I would NEVER expose my kids on purpose now, knowing what it is like, but if my daughter gets it (let's hope not) I know we'll survive it. There is no medication for it...