What To Know About Hand, Foot, and Mouth Disease During Pregnancy

Hand, foot, and mouth disease (HFMD) is an infection caused by the coxsackievirus. It's most common among young children, and it typically causes a fever, painful sores in the mouth, and a red, blister-like rash on the palms of the hands and soles of the feet.

HFMD is less common in adults because they often have antibodies from a previous infection. But if you're pregnant, HFMD might cause some worry about risks to both you and your developing fetus.

Here, we spoke with experts to learn about hand, foot, and mouth disease during pregnancy, including the possible complications, how to prevent it, and what to do if you've been exposed.

How HFMD Is Diagnosed

Health care providers typically diagnose hand, foot, and mouth disease by physical exam. They will examine the rash and consider factors like the person's age and their other symptoms to make the diagnosis. In some cases, they may take samples from the person's throat or feces and send those to a lab to be screened for the coxsackievirus to confirm.

Is HFMD Dangerous During Pregnancy?

Your growing baby will likely be fine if you become infected with HFMD during pregnancy. According to the Centers for Disease Control and Prevention (CDC), there is no clear evidence that HFMD causes adverse pregnancy outcomes, such as miscarriage or congenital disorders.

In one rare documented case of a patient at 34 weeks of pregnancy having HFMD, the baby was delivered at week 39 and was healthy with no complications. Although the gestational parent and baby were fine, doctors noted in the case that any time a pregnant person is positive for HFMD, they should be closely monitored in case any complications develop.

If you contract the infection close to delivery, there is a risk that you may pass it to your baby. These cases are often mild.

Possible Complications of HFMD During Pregnancy

While hand, foot, and mouth disease isn't likely to cause major health concerns for a fetus, there are some complications to look out for if you become infected while pregnant. Read about them below.

Dehydration

Blisters in the mouth can make eating and drinking downright painful, increasing your risk of dehydration. Dehydration is serious for anyone, but especially for pregnant people. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant people drink between 8 and 12 glasses of water daily to prevent dehydration.

Dehydration during pregnancy can lead to severe complications, including:

• Premature labor
• Low amniotic fluid
• Neural tube defects
• Low breast milk production

It's essential to stay hydrated. If the mouth sores are particularly bad, try hydrating with frozen popsicles made of 100% juice—the juice will hydrate, while the cold can help alleviate pain.

Viral meningitis and encephalitis

Although very rare, some people with HFMD can develop viral meningitis, which can cause a stiff neck, headache, and high fever. The CDC notes that babies under 1 month are particularly vulnerable; they can get severe symptoms since they don't have robust immune systems.

Encephalitis is another concern because it can cause brain swelling and paralysis. In one study, researchers found that encephalitis derived from HFMD led to significant damage to the thalamus and medulla oblongata, which are the parts of the brain located where the brain and spine connect, creating a highway for the nervous system to travel from the brain to various parts of the body. They also control the heartbeat, breathing, and blood pressure.

Onychomadesis

One rare complication of HFMD is onychomadesis, or the loss of fingernails and toenails. The separation of the nail bed from a finger or toe sounds rather unpleasant, but thankfully, the condition usually resolves on its own. While it is typically seen in children, there have been cases of pregnant adults experiencing onychomadeis as a complication of HFMD.

Treating HFMD During Pregnancy

Most cases of HFMD resolve on their own between seven to 10 days and there is no specific treatment. However, clinical trial research has shown that the antiviral medication known as oseltamivir, the active ingredient in Tamiflu, is effective at treating HFMD with no risk of adverse reactions in kids.

It is important to note that medical ethics prevent many clinical trials from using pregnant subjects. Talk to your doctor about whether using an antiviral medication to treat HFMD during pregnancy may be right for you.

Tylenol (acetaminophen) can help reduce fever as well as pain from mouth sores and flu-like symptoms. Talk to your doctor before taking any over-the-counter medications.

Staying hydrated will prevent dehydration symptoms. If you experience pain from mouth sores, try sipping small amounts of water or gently sucking on popsicles throughout the day .

Preventing Hand, Foot, and Mouth Disease

If you are routinely around young children, you're more likely to come into contact with HFMD during your pregnancy. Luckily, preventing HFMD is relatively simple and requires only a few simple measures.

Wash and sanitize hands frequently

One of the best ways to prevent catching hand, foot, and mouth disease, and most other bugs, is to maintain a solid hand-washing routine that includes using warm water and soap for 20 seconds. Make sure to wash your fingers, fingernails, palms, and wrists. After drying your hands, follow up with a squirt of alcohol-based hand sanitizer to kill any remaining pathogens on your skin.

Always wash your hands:

• Before you prepare or eat food
• After using the bathroom or changing a diaper
• After coming in contact with a sick person
• After coughing, sneezing, blowing your nose, or touching bodily fluids
• After coming home from a public place like work, school, or the grocery store
  

Disinfect high-touch surfaces

To prevent infections like HFMD, make sure to keep your home germ-free by wiping down high-traffic surface areas where bacteria and viruses can hang out. If someone in your home is sick, don't let used tissues, dishes, or things they've used, like screens or remote controls, go without a good wipe-down. A few items to make sure you disinfect include:

• Doorknobs and handles on cabinets, fridge, and faucets
• Screens, including cellphones and tablets
• Toys (especially shared toys)
• Bedding including pillowcases
• Pacifiers, teething toys, and sippy cups

Avoid touching your eyes, nose, and mouth

If you have been exposed to coxsackievirus, avoid touching your face. If the virus gets on your hands and you touch your face, your eyes, nose, and mouth will become the highways the virus will use to travel into your system.

Avoid exposure to people who are sick

If you are not routinely around young children, your chances of contracting HFMD are lower than someone who has daily interactions with kids. That said, if you know someone who has symptoms of HFMD, steer clear until they are better.

What To Do If You Are Exposed to HFMD

If you have been in contact with a person who has HMFD, be sure to thoroughly wash and sanitize your hands and do your best not to touch your face. If you develop symptoms including fever, flu-like symptoms, skin rashes or blisters, or sores in your mouth, call your doctor immediately. Your doctor may ask to see you in person to diagnose the infection and give you a plan for how to treat it.