{"id":34881,"date":"2018-09-19T17:10:59","date_gmt":"2018-09-19T09:10:59","guid":{"rendered":"https:\/\/www.columbiaasia.com\/malaysia\/?post_type=health-article&#038;p=34881"},"modified":"2025-05-22T11:07:54","modified_gmt":"2025-05-22T03:07:54","slug":"the-lowdown-of-hfmd","status":"publish","type":"health-article","link":"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/the-lowdown-of-hfmd\/","title":{"rendered":"The Lowdown of HFMD"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"34881\" class=\"elementor elementor-34881\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4c3b95e e-con-full e-flex e-con e-parent\" data-id=\"4c3b95e\" data-element_type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cbda4d5 elementor-widget elementor-widget-text-editor\" data-id=\"cbda4d5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p><strong>ENTEROVIRAL<\/strong>\u00a0vesicular stomatitis, the medical term for hand, foot and mouth disease (HFMD), is a common infection in children and one that can affect any child regardless of demographic and logistic differences. Lately in Malaysia, there has been an outbreak of HFMD cases in major pandemic proportions.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f493fb elementor-widget elementor-widget-spacer\" data-id=\"5f493fb\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-con{--container-widget-width:100%}.e-con-inner>.elementor-widget-spacer,.e-con>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));--align-self:var(--container-widget-align-self,initial);--flex-shrink:0}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container,.e-con>.elementor-widget-spacer>.elementor-widget-container{height:100%;width:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty,.e-con>.elementor-widget-spacer.elementor-widget-empty{position:relative;min-height:22px;min-width:22px}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon,.e-con>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon{position:absolute;top:0;bottom:0;left:0;right:0;margin:auto;padding:0;width:22px;height:22px}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c8043d elementor-widget elementor-widget-heading\" data-id=\"7c8043d\" data-element_type=\"widget\" id=\"subtopic01\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h3 class=\"elementor-heading-title elementor-size-default\">Causes<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5d4a9cf elementor-widget elementor-widget-text-editor\" data-id=\"5d4a9cf\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>HFMD is caused by the coxsackie virus of the enteroviral group of virus that belongs to the Picornaviridae family, which includes poliovirus. The most common virus is the one that is causing HFMD Coxsackie A followed by Enterovirus 71. The Picornaviridae virus thrives in human body secretions such as saliva and stool.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e170618 elementor-widget elementor-widget-spacer\" data-id=\"e170618\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bbb0e60 elementor-widget elementor-widget-heading\" data-id=\"bbb0e60\" data-element_type=\"widget\" id=\"subtopic02\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Symptoms<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c5492d3 elementor-widget elementor-widget-text-editor\" data-id=\"c5492d3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The most common symptoms are fever and a general feeling of being unwell (less active and lethargic).Within 24 to 48 hours of fever, skin manifestation is noted on the extremities (around the mouth, hands, palms, feet and soles) and ulcers in the oral cavity (tongue and palate). Fever can start at a low grade but commonly, it spikes up to 40 degrees especially in the first 24 hours. The skin manifestation is commonly flat and discoloured spots or bumps. The skin manifestation is not itchy but for some children, it can be painful thus their refusal to bear weight (stand and walk) if the abundance of lesions are on their feet and soles. The mouth ulcers would result in a refusal to swallow, hence the drooling and inability to tolerate either liquid or solid intake orally.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-72f10c1 elementor-widget elementor-widget-spacer\" data-id=\"72f10c1\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-38bb9d1 elementor-widget elementor-widget-image\" data-id=\"38bb9d1\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"500\" height=\"293\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-01.jpg\" class=\"attachment-large size-large wp-image-34954\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-01.jpg 500w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-01-300x176.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ef5f534 elementor-widget elementor-widget-spacer\" data-id=\"ef5f534\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d7d7680 elementor-widget elementor-widget-heading\" data-id=\"d7d7680\" data-element_type=\"widget\" id=\"subtopic03\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">How HFMD spreads<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2d5aee2 elementor-widget elementor-widget-text-editor\" data-id=\"2d5aee2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The HFMD is mainly transmitted through nasopharyngeal secretions, which are directly in contact with virus particles of the body secretions, especially the saliva of an affected child. It can also be transmitted through faecal-oral transmission due to poor hand hygiene after coming in contact with the stool of an affected child. Therefore, it is common for outbreaks to take place in nurseries, playschools or classrooms. Another example of how HFMD can spread to other children is through direct contact with contaminated saliva from swimming pools and playgrounds.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-20c3bbb elementor-widget elementor-widget-spacer\" data-id=\"20c3bbb\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e77bb0 elementor-widget elementor-widget-heading\" data-id=\"8e77bb0\" data-element_type=\"widget\" id=\"subtopic04\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Diagnosis<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e21d7a9 elementor-widget elementor-widget-text-editor\" data-id=\"e21d7a9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The only laboratory method to diagnose HFMD is through viral detection from infected secretions but this process is tedious, expensive and slow in getting results. The main diagnostic tool is the clinical features of the skin rash and oral ulcers. The doctor can easily diagnose HFMD based on a clinical assessment.<br \/><br \/>A good history can also help in diagnosis especially if a child has been in contact with an affected child.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e5c9b91 elementor-widget elementor-widget-spacer\" data-id=\"e5c9b91\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-737b02e elementor-widget elementor-widget-image\" data-id=\"737b02e\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"500\" height=\"293\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-02.jpg\" class=\"attachment-large size-large wp-image-34955\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-02.jpg 500w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-02-300x176.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-083e733 elementor-widget elementor-widget-spacer\" data-id=\"083e733\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76781e1 elementor-widget elementor-widget-heading\" data-id=\"76781e1\" data-element_type=\"widget\" id=\"subtopic05\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Treatment<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f87064 elementor-widget elementor-widget-text-editor\" data-id=\"5f87064\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The mainstay of treatment is to ensure adequate hydration. This means the child should be able to drink fluids and still be able to pass urine. Reduction in solid intake is not a major concern, though.<br \/><br \/>Other symptomatic treatments include antipyretic, topical drop or cream for oral ulcers. On occasion, if the symptoms are florid (red or flushed complexion), some clinical centres advocate intravenous antiviral. Topical cream is not needed for the skin rash as this has proven to be ineffective to treat the HFMD skin rash. We should totally avoid administering antibiotics as the illness is due to a viral infection.<br \/><br \/>Admission to the ward is mainly for intravenous hydration, when a child shows a reduction in intravascular volume, such as tears and urine.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c9b862 elementor-widget elementor-widget-spacer\" data-id=\"3c9b862\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-939fa5e elementor-widget elementor-widget-heading\" data-id=\"939fa5e\" data-element_type=\"widget\" id=\"subtopic06\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Prevention<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2cf3850 elementor-widget elementor-widget-text-editor\" data-id=\"2cf3850\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>The main prevention method is to ensure good hygiene especially of the oral cavity. No vaccines are available to date despite the 2015 vaccine for Enteroviral 71 which was implicated, but there has been no further development since. Prevention of contact with affected children should be put in place if outbreaks occur. Avoid going to nurseries when this happens.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e507c6 elementor-widget elementor-widget-spacer\" data-id=\"8e507c6\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bc26103 elementor-widget elementor-widget-image\" data-id=\"bc26103\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"500\" height=\"293\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-03.jpg\" class=\"attachment-large size-large wp-image-34956\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-03.jpg 500w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2024\/05\/health-articles-the-lowdown-of-hfmd-03-300x176.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-75ab1e8 elementor-widget elementor-widget-spacer\" data-id=\"75ab1e8\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cf18400 elementor-widget elementor-widget-heading\" data-id=\"cf18400\" data-element_type=\"widget\" id=\"subtopic07\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">What should parents do<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-84b9b07 elementor-widget elementor-widget-text-editor\" data-id=\"84b9b07\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul><li>As parents, we would want our children to be as healthy as they can be. Ensuring good hygiene is crucial such as practising oral hygiene, taking frequent baths and avoiding crowded areas such as swimming pools and playgrounds.<\/li><li>Bring your child to the doctor if the child shows symptoms of HFMD. Make sure your child is able to drink healthy fluids while waiting to be treated at the clinic. Parents should provide adequate hydration including cold milk. Also check the presence of urine by checking the child\u2019s diapers. Poor hydration will reduce urine output.<\/li><li>Antipyretic (drug to reduce fever) can be given to the child but due to the difficulty in swallowing because of the pain, administrating suppository via rectal antipyretic is another option. Parents should not worry if the child refuses to eat. Hydration and fluid intake are more important than food intake. Do note that having your child hospitalised for intravenous hydration to boost appetite is not useful. Intravenous hydration is mainly to rehydrate due to loss of fluid and not because of the child\u2019s refusal to eat. The application of topical (localised) oral gels or creams which help to heal oral ulcers can help accelerate the increase of oral fluid intake.<\/li><li>Avoid unnecessary treatments like skin creams and antibiotics as these measures are of no effect and may even cause side effects. Administering multivitamins to increase appetite is also not indicated and unnecessary.<\/li><li>Currently, the Ministry of Health (MOH) has authorised hospitals to inform MOH regarding cases of HFMD so that the ministry can pin down the source.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6b2d9a4 elementor-widget elementor-widget-spacer\" data-id=\"6b2d9a4\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2aec698 elementor-widget elementor-widget-text-editor\" data-id=\"2aec698\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"color: #999999;\"><em>This article first appeared in <a href=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2025\/05\/health-articles-20180809-malaymail-the-lowdown-of-hfmd.pdf\" target=\"_blank\" rel=\"noopener\">Malaymail, 9 August 2018<\/a><\/em><\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>During pregnancy, many factors contribute to the baby\u2019s well-being. Dr Haw Wan Lye, consultant obstetrician and gynaecologist at Columbia Asia Hospital \u2013 Cheras, shares his concerns about the increasing body mass indices (BMIs) in the population, especially that of pregnant women.<\/p>\n","protected":false},"author":2,"featured_media":34898,"template":"","topic":[98,159],"language":[137],"class_list":["post-34881","health-article","type-health-article","status-publish","has-post-thumbnail","hentry","topic-children","topic-pediatrics","language-en"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Lowdown of HFMD - Columbia Asia Hospital I Private Hospital in Malaysia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/the-lowdown-of-hfmd\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Lowdown of HFMD - Columbia Asia Hospital I Private Hospital in Malaysia\" \/>\n<meta property=\"og:description\" content=\"During pregnancy, many factors contribute to the baby\u2019s well-being. 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