Q: My daughter was just diagnosed with hand, foot and mouth disease. What is this?
A: Every fall and winter, children (and adults) are exposed to dozens of different viruses, each with unique characteristics. A few of these bugs cause mouth lesions that look like canker sores; they can be accompanied by little blisters on the palms of the hands, soles of the feet and even the buttocks—in other words, hand, foot and mouth disease. The mouth sores are the most problematic; because they hurt so much, a child may not want to eat or drink, which can lead to dehydration. The illness lasts anywhere from a few days to a week or longer and requires very patient parenting, because kids are so uncomfortable and can be very cranky. Breastfed babies will almost always stay well-hydrated, probably because breast milk is soothing, rather than irritating, to the sores. But even they can fall behind in their intake and look and act pretty sick. Older babies and formula-fed kids may only accept sips of water and are usually more at risk for dehydration. Maybe once each year I need to hospitalize a child for impending dehydration. Anti-viral drugs don’t work well for this virus, but small doses of the amino acid lysine are safe and may block the virus’s growth. As with most other bugs, I’ll also try a little echinacea tea and some elderberry syrup: Elderberry inhibits viral growth, while echinacea seems to increase the “killing power” of white blood cells. (If you use either of these, avoid types that contain honey if your child is younger than 1 year old.) Sometimes I’ll prescribe a numbing medicine for older kids, which can bring a few hours of relief; because it needs to be swished and spit out, babies can’t use it. I also recommend ibuprofen or acetaminophen to help with the pain, as well as fruit smoothies, which are a kid-friendly way of getting immune-boosting nutrition. Smoothies can also help prevent dehydration, and the coldness numbs the pain of the mouth sores. But talk to your doctor to see what she recommends.