Hand, foot, and mouth disease during pregnancy: Is it safe for you and baby?

Your toddler came home from daycare with a low-grade fever, pushed away their snack, and has tiny red spots on their hands and around their mouth. You are worried that you might be exposed to hand, foot and mouth disease especially when you are pregnant. 

Take a breath. It’s completely normal to feel anxious when you’re growing a baby and a virus is going around your house. However, the reassuring part is: hand, foot, and mouth disease (HFMD) is very common in young children, is usually mild, and most people get better on their own in 7 to 10 days. 

We spoke to Dr. Rachel Miller, an OB-GYN at Atrium Health to walk you through what to expect with HFMD, what changes for your baby by trimester, when to call your OB, how to treat it safely, and how to protect yourself.

Is hand, foot, and mouth disease dangerous for pregnant woman?

For most pregnant women, HFMD is mild and passes without affecting the pregnancy.

That said, HFMD can still leave you feeling run down, with a fever, sore throat, mouth ulcers, and a rash. In most cases the illness passes within a week to ten days.

What is hand, foot, and mouth disease?

HFMD is a common viral illness that usually causes fever, mouth sores, and a skin rash. It’s most common in children under 5, especially those going to daycare or preschool, but anyone can get it, including adults.

HFMD is caused by a group of viruses in the enterovirus family. Coxsackievirus A16 is the most common cause in the United States, coxsackievirus A6 can cause more severe symptoms, and enterovirus 71 has been linked to outbreaks in East and Southeast Asia.

Symptoms of hand, foot, and mouth disease

HFMD usually starts like a common cold and then develops its signature sores and rash. Most common symptoms include:

• Fever
• Sore throat
• Painful mouth sores that start as small red spots and blister
• A rash on the palms of the hands and soles of the feet, sometimes spreading to the buttocks, legs, and arms
• Feeling generally unwell, with less appetite

How symptoms can differ in adults?

Adults often have a milder illness than children, but the rash doesn’t always follow the textbook guidelines. Some strains, such as coxsackievirus A6, can cause blisters and rashes that are more extensive than the classic childhood pattern. Fatigue and a sore throat can make you feel worse overall.

What does hand, foot, and mouth disease look like?

The rash is easy to miss at first because it often begins inside the mouth. The mouth sores are small red spots, often on the tongue and inner cheeks, that blister and become painful. 

On the skin, the rash is usually not itchy and looks like flat or slightly raised red spots, sometimes with blisters that have a red base. It commonly appears on the palms and soles.

Hand, foot, and mouth disease vs. chickenpox

Both HFMD and chickenpox cause blisters, so they’re easy to mix up. HFMD sores concentrate on the mouth, hands, and feet and usually don’t itch. Chickenpox spreads more broadly across the body, starts at the head and moves downward, itches, and shows lesions at different stages at the same time.

Chickenpox in pregnancy needs prompt medical attention, so if you can’t tell which one you’re looking at, call your OB.

How does hand, foot, and mouth disease spread?

HFMD spreads easily, which is why it moves through daycares so quickly. According to the CDC, you can catch it from:

• Droplets released when a sick person coughs, sneezes, or talks
• Close contact such as kissing, hugging, or sharing cups and utensils
• Blister fluid and stool, for example while changing diapers, followed by touching your eyes, nose, or mouth
• Doorknobs, toys, and other surfaces carrying the virus

What are the possible complications of hand, foot, and mouth disease during pregnancy?

While HFMD is usually mild and serious complications rarely arise, which trimester you are in matters. If you’re infected close to delivery, there’s a small chance the virus could pass to your baby around birth.

Hand, foot, mouth pregnancy first and second trimesters

Research on HFMD in early pregnancy is limited, and there has been no clear pattern of any harm to your pregnancy or baby. As per the NHS UK, only in very rare cases, having a high temperature during the first 3 months of pregnancy can lead to a miscarriage. 

The practical steps are to contact your OB/GYN promptly and treat any fever.

Hand, foot, mouth pregnancy in third trimester

This is the stage doctors watch most closely. Dr. Miller explains how doctors handle that.

“If a pregnant mother gets infected in the third trimester it can potentially affect the pregnancy to a greater degree,” explains Dr. Miller, and adds, “Be sure to discuss with your physician if you suspect that you may have HFMD, as they may recommend increased testing like NSTs or ultrasounds. The recommendation may vary. Paying attention to your baby’s movements is crucial.”

Dr. Miller explains that transmission is possible but unusual. It is usually from contact and respiratory droplets.

So there are precautions to be taken, but nothing that should send you into panic mode.

Can hand, foot, and mouth disease cause a miscarriage?

It’s one of the most common questions, and the honest answer is that researchers haven’t reached a consensus. HFMD is uncommon in pregnancy, so most of what we know comes from individual case reports and small studies rather than large trials. 

• A 2022 review by Cureus noted that few studies have looked at infection in early pregnancy, and the link between HFMD and pregnancy or newborn complications is still an unanswered question. 
• Some older reports in the same Cureus review connect enterovirus infections in general with pregnancy loss and stillbirths, but they don’t establish HFMD itself as the cause. 
• On the other hand, the NHS UK notes that, only in very rare cases, having a high temperature during the first 3 months of pregnancy can lead to a miscarriage. 

What we can say with confidence is that HFMD is very common, most cases in pregnancy resolve without problems, and the NHS UK describes the risk to your pregnancy and baby as almost non-existent. If you have symptoms, treat fevers promptly and call your OB so they can guide you.

Stages of hand, foot, and mouth disease

HFMD follows a fairly predictable timeline, which can help you know what to expect. Here’s how it unfolds:

1. Exposure and incubation: Symptoms usually begin 3 to 5 days after the virus is caught.
2. Early symptoms: Fever, sore throat, and malaise come first.
3. Sores and rash: Mouth sores appear, and the skin rash often follows a day or two later.
4. Healing: Blisters clear and energy returns, and most people are better within 7 to 10 days.

How contagious is hand, foot and mouth?

Very. People are usually most contagious during the first week of illness, and you can start spreading it a few days before symptoms appear.

How long is hand, foot and mouth contagious?

The CDC says people can still spread the virus for days or weeks after symptoms go away, sometimes without any symptoms at all. The virus can linger in stool the longest, which is why hand-washing after diaper changes is important well beyond the first week.

How long does hand, foot and mouth last?

Usually 7 to 10 days.

How to treat hand, foot, and mouth disease during pregnancy

Since HFMD is viral, antibiotics won’t help. The best treatment is rest, hydration, and keeping fever down. Dr. Miller’s advice is straightforward.

Use this table as a quick guide to what to do at home and when to pick up the phone:

Symptom	Home care	When to call your doctor
Fever	Acetaminophen, rest, and plenty of fluids. Avoid ibuprofen.	If the fever doesn’t come down, or you’re unsure what’s safe to take
Mouth sores and sore throat	Salt water rinses, plus cool, soft foods like yogurt, smoothies, or popsicles. Skip acidic drinks and salty or spicy foods.	If the sores make it too painful to eat or drink
Rash and blisters	Keep blisters clean and avoid touching them. Wash your hands afterward.	If the rash is very itchy, spreading widely, or you’re not sure it’s HFMD
Dehydration	Sip fluids throughout the day	If you can’t keep fluids down or you’re urinating much less than usual
Baby’s movements	Keep track of your baby’s usual pattern	Right away, if you notice fewer baby movements or a change in pattern

How to prevent hand, foot, and mouth disease

With little ones in daycare and preschools, HFMD can feel almost impossible to avoid, but a few habits can help prevent it happening and its spread. Dr. Miller offers a realistic take.

“They should be sure to practice good hygiene, like washing hands and avoiding close contact with those individuals with the infection,” advises Dr. Miller, “I do realize that this can be hard to do if the sick kid lives in your own home.”

HFMD is most contagious during the first week of symptoms, so that’s when extra caution goes a long way.

The CDC recommends these steps:

• Wash your hands with soap and water for at least 20 seconds, especially after diaper changes, using the toilet, and coughing, sneezing, or blowing your nose.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Clean and disinfect toys, doorknobs, and other frequently touched surfaces.
• Avoid sharing cups, utensils, or towels with someone who’s sick.
• Skip kisses and hugs around the mouth while your child is contagious.
• Keep blisters clean.

There’s no vaccine in the United States for the viruses that cause HFMD, so maintaining hygiene is your main defense.

What to do if you’re exposed to hand, foot, and mouth disease during pregnancy

If you’ve been around someone who has HFMD, and feel fine, there’s no need to panic. Dr. Miller says the steps are simple and the treatment recommendations are still supportive care and reassurance.

Let your doctor or midwife know about the exposure.

Conclusion

That little one with the red spots on their hands and the untouched snack will be back to their usual self within a week or two, and so will you if you catch hand, foot and mouth disease during pregnancy. 

HFMD during pregnancy sounds scary, but as we have learnt it’s usually mild and temporary. Wash your hands, keep an eye on your temperature, and call your OB.

You may also like:

• Pregnancy 101: Can you take magnesium when pregnant?
• Ask the expert: What are the early signs of preterm labor, and when should you call your doctor?
• Ask the expert: What you need to know about postpartum preeclampsia

Sources:

1. HFMD is caused by a group of viruses in the enterovirus family. CDC. 2024. HFMD: Causes and how it spreads. 
2. People can’t catch the animal illness. CDC. 2024. HFMD: Causes and how it spreads. 
3. HFMD can lead to a miscarriage. Cureus. 2022. A rare presentation of HFMD during pregnancy.
4. HFMD can lead to a miscarriage. NHS UK. Hand, foot and mouth disease.
5. Hand, foot, mouth pregnancy in third trimester. NHS UK. 2024. Hand, foot and mouth disease.
6. How long is HFMD contagious. CDC. 2024. HFMD: Causes and how it spreads. 
7. How to prevent hand, foot, and mouth disease. CDC. 2024. About Hand, Foot, and Mouth Disease.