How to manage sick twin toddlers

Twins relaxing

Disclaimer: I am not a medical professional. This post is based on my personal experiences.

My twin toddlers started half day child care at 15 months. Since then, they have become sick at least once a month. Yes, my twins’ vaccines are all up to date, and we maintain a reasonable level of hygiene by washing hands regularly, but this has not prevented us from continuous challenges with common childhood pathogens.

Here are some anecdotes and tips based on our experiences so far.

Hand, foot, and mouth disease (HFMD)

Interestingly, my twins contracted HFMD around 9 months–before starting child care. I suspect they came in contact with contaminated high chairs at a cafe.

My little girl first developed small, red spots on her knees, which I thought were an allergic reaction to the new floor cleaner we were using. She quickly developed the same spots on her hands, and her pediatrician confirmed that she had HFMD. Her brother caught it as well, and so did I. We experienced a mild case of HFMD, but the mouth ulcers were rather painful.


  • I instructed my husband and helper to wash their hands thoroughly after changing diapers. HFMD can be transmitted through contaminated stool.
  • Eating and swallowing can be painful, so offer frozen breast milk or fruit juice to prevent dehydration.
  • Avoid sharing food or utensils as soon as possible. I contracted HFMD from eating my children’s leftover food.


My baby girl came down with diarrhea before passing it to her brother, who later developed vomiting and diarrhea.


  • Again, I instructed my husband and helper to wash their hands thoroughly when changing diapers.
  • Keep infected children at home for at least 48-72 hours to prevent further spread of the responsible virus. (Confession: My son had one diarrhea episode on a Sunday and was fine the rest of the day, so I sent him to school on Monday. He then had diarrhea at school and then spread it to his classmate and teacher.)
  • For serious cases with persistent vomiting or diarrhea, see your pediatrician to ensure your child is not dehydrated. Oral rehydration solution or Pedialyte popsicles are immensely useful.
Acute respiratory infections (ARI)

My twins have encountered these almost every month since beginning child care. As a result, my husband and I have become sick regularly as well. Before kids, we were sick once or twice a year.

My girl twin usually develops more serious manifestations from ARIs. One pediatrician diagnosed her with reactive airway disease, a precursor to asthma. When she develops a persistent cough, she usually has to rely on a ventolin inhaler + chamber to alleviate her symptoms. In just two years, she has already had three chest x-rays, one bout of pneumonia, and completed two courses of antibiotics. Last week, she was admitted to Gleneagles Hospital for 3 days, due to an incessant cough and low oxygen levels.


  • Our most handy items for managing ARIs include a forehead thermometer, Nosefrida, baby Panadol (SG lingo) / Tylenol (US lingo), baby ibuprofen, and lots of tissues.
  • ARIs are extremely contagious. Expect everyone in the family to become sick. Queue lots of YouTube, and have plenty of porridge simmering on the stove.