Assessing Oral Ulcer Pain in HFMD
Painful mouth ulcers are the main barrier to feeding in HFMD.
- 5-10: Typical ulcer count (placeholder stat)
- Day 2-3: Peak pain day (placeholder stat)
- Tongue/palate: Common sites (placeholder stat)
- 5-7 days: Duration (placeholder stat)
Recognizing ulcer severity
Placeholder: check ulcer count, size, and refusal to drink.
Placeholder: severe pain drives poor intake risk.
Pain Relief Before Feeding
Giving analgesia ahead of meals improves intake tolerance.
- 30 min: Lead time (placeholder stat)
- Paracetamol: Common agent (placeholder stat)
- +25%: Intake gain (placeholder stat)
- 4-6 hrs: Dosing interval (placeholder stat)
Scheduling analgesia
Placeholder: dose before meals, not after refusal starts.
Placeholder: timing matters more than dose size.
Cold/Soft Food and Fluid Strategies
Cold, bland, soft textures reduce ulcer irritation during intake.
- Cold: Best temp (placeholder stat)
- Acidic/salty: Avoid (placeholder stat)
- Ice pops: Preferred (placeholder stat)
- Soft/pureed: Texture (placeholder stat)
Choosing feeding strategy
Placeholder: cold fluids and soft foods ease swallowing pain.
Placeholder: small frequent offers beat large meals.
Monitoring Dehydration Risk
Track urine output and mucous membranes for early dehydration signs.
- Dry mouth: Warning sign (placeholder stat)
- <4/day: Urine check (placeholder stat)
- High pain: Risk driver (placeholder stat)
- Every 4h: Reassess (placeholder stat)
Spotting early risk
Placeholder: fewer wet diapers signal rising dehydration risk.
Placeholder: pain level strongly predicts intake failure.
When IV Fluids May Be Needed
Persistent refusal despite strategies warrants IV fluid support.
- High risk: Trigger (placeholder stat)
- ED/clinic: Setting (placeholder stat)
- Bolus: Reassess after (placeholder stat)
- Rehydrate: Goal (placeholder stat)
Escalation criteria
Placeholder: escalate when oral strategies fail to sustain intake.
Placeholder: IV fluids bridge until oral pain subsides.