Travelling with Children
Travelling with children, like all of parenthood, has its ups and downs. However, a little pre-departure planning will help make the experience a positive one for children and parents alike.
General Recommendations
Trips should be chosen with the child in mind. The developmental age of the child is obviously important because children have different needs at different developmental stages; the play needs of a 2 year old, 4 year old or 8 year old will be quite different.
Plan your trip so the schedule is not too hectic and there is time for the children to play. This will make everyone happier. Children do not tolerate long trips visiting museums very well. Children of all ages need routine and the trip should be organised so there is some predictability or routine to the days; e.g. always have a swim before lunch.
If going overseas, proximity to good medical care is important. The immune system of a child is more fragile than that of an adult. It may be preferable to wait until a child is two before taking non-essential trips to isolated parts of the developing world, but each case has to be taken on its merits.
The timing of trips can be important especially when planning car journeys. Travelling in a car with a screaming child is a misery and a potential danger. Some parents find children are easier to travel with if they travel after bedtime or around the time of the afternoon sleep; e.g. allow the child to run around all morning, have a decent lunch free of 'hyper-upper-ers' ( e.g. Coke ) and the child may hit the car seat and go to sleep. This makes it more pleasant for all concerned.
Some parents find it is easier to delay telling some children about the coming trip until only a day or week prior to the trip to avoid weeks of questions along the lines of 'Are we going yet?'. Is there anything they need to practice before they go? If the children are used to having a bath at night, and there will only be showers available on the trip, think about getting them used to showers before you go. If they will be eating out in restaurants, have some trial runs so they can practice their table manners, etc. It is particularly important that they practice what to do if they get lost, and telling their parents where they are going -- not slipping off to look at something.
Introducing the child to basic travel health concepts can also be a wise course of action, particularly where vaccinations are involved, or if travelling to a region where drinking water precautions are required.
Travelling With Newborns
It is best to wait until a baby is at least 6 weeks old before taking him on a plane and exposing him to the gamut of infectious organisms in air conditioning systems etc. The usual childhood vaccines can be started early if necessary.
If possible, breastfeeding is particularly helpful when travelling. It provides a convenient supply of clean and nutritious food, along with a constant supply of antibodies from the mother to help protect the child from illness. If planning to take medications while breastfeeding, remember to check that they will not get through the milk and harm the baby.
Vaccinations
Before any trip, ensure all childhood vaccines are up to date (Sabin, Triple Antigen - Tetanus, Diphtheria and Whooping cough - HIB meningitis, Measles, Mumps, Rubella).
Taking unvaccinated children anywhere, but especially overseas exposes them to serious risk. In Australia they are protected from disease by herd immunity. (Everyone around them is immune so they do not get exposed to the germs.)
The Council of the Faculty of Homoeopathy in London strongly supports the standard immunisation program for children and has stated that vaccination carried out in the normal way is consistent with homoeopathic principles.
More specialised 'Travel Vaccines' may be necessary for some destinations and should be organised at least 8 weeks before departure if possible. It is best to seek advice from a specialised Travel Medicine doctor if travelling with children, especially if visiting potentially malarious areas.
Travelling By Plane
Your travel agent can help you arrange children's meals prior to your journey, but if your child is fussy (and most are) take some favourite foods for emergencies.
If you are travelling with children, it may be preferable to order an aisle seat to allow for easier mobility and special fold down basinets at the front of each row are usually available, but book up quickly. Non-smoking seats can be ordered in advance, although many airlines are now non-smoking anyway.
Whether travelling with or without children you should start your journey well rested, if possible, and two good nights sleep before you go is ideal.
While travelling, infants may need to breast feed or suck a bottle as the aeroplane takes off and lands, with the swallowing helping their ears to equalise preventing ear pain. Older children may find it helpful to suck a lolly. Some children are prone to motion sickness, especially if they read or do puzzles during long car journeys.
Eating And Drinking
Please refer to our section on Drinking And Eating Safely for details on food precautions, and ensuring that your drinking water is clean. In summary, the basic rules are Boil it, Cook it, Peel it or Forget it. Children under 3 years of age tend to get diarrhoea which is more severe and lasts longer. As much as possible, watch what they eat and don't allow children to drink untreated water.
Carry 'wet ones', a wet washer, or antiseptic hand wash so you can clean their hands regularly, and try to regularly sterilise the utensils they use such as bottles, cups etc. Always use treated water for drinking, cleaning their teeth and washing toothbrushes.
Other Hazards
Whilst travelling, you have less control over a child's environment. Drownings, poisonings, burns, and falls are particular hazards so regularly carry out mental spot safety checks. Watch out for unfenced pools and waterways -- a one-year-old Australian baby recently drowned in Indonesia.
When choosing your destination, also be careful to protect children from extremes of heat or cold. Beware of frostbite on tiny fingers and toes. Children cannot regulate their body temperature as well as adults so dress them appropriately and offer fluids regularly. Children can dehydrate rapidly and their thirst sensation is unreliable. Use blockout when necessary.
Closely supervise children around animals as they are particularly at-risk -- they are low to the ground and fearless, and hence may get bitten quite severely, and in some countries rabies may be a risk.
Medical Kits
The following should be considered the basic components of a medical kit suitable for young travellers. This can then be added to cover the conditions and situations mentioned below. The child's regular medications, even if only used occasionally at home, should be included.
Many of these products can be purchased through our On-Line Product Catalogue:
Stomach problems -- Gastrolyte also stops dehydration (blackcurrant flavour is best).
Wounds and skin infections -- Dressings should include bandaids, elastoplast, opsite, non-stick dressing, gauze, crepe bandage, sling, steristrips, tape.
Antiseptic such as Betadine cream.
Fevers or pain -- Paracetamol (chewable paracetamol is now available).
Allergies and insect bites -- Calamine lotion or Stingose gel, and an Antihistamine for insect bites.
Medical equipment -- Scissors, tweezers, splinter probe. Sterile needle and syringes in different sizes if travelling in areas remote from medical care.
Digital Thermometer -- Mercury thermometers are difficult to read, and mercury is not allowed on some planes.
If travelling to an area where mosquitoes could be a problem, you will need several of the products available through our on-line product catalogue. A full kit should include:
Mosquito repellent for personal use such as Rid (avoid products with more than 20% DEET or diethyl toluamide).
Long sleeved, light coloured clothes for evenings.
Permethrin impregnated mosquito nets.
Mosquito coils.
Knock down insect spray to kill mosquitoes inside tents, etc.
Wrist and/or ankle bands sprayed with insect repellent.
Malaria tablets if prescribed.
To prevent sun damage:
Sunscreen (15+ at least) for lips and body
Sunprotection clothing
Sunglasses and hat
To ensure safe drinking water
Water purification - Iodine tablets, alum, vitamin C powder
Water purifier (PUR variety)
Clean and sturdy one litre water bottle
Clean straws
To treat coughs, colds, sinus problems, and ear infections:
Giving a child antibiotics without medical supervision is risky and not recommended, however occasionally may be warranted in children with repeated infections after discussion with their GP.
Medicine for colds or runny noses such as Dimetapp syrup.
Chewable cold tablets such as Action.
Throat lozenges such as Butter Menthols or Strepsils.
Aqua-ear to dry ear canal and prevent 'tropical ear' after swimming.
For emergency sedation on aeroplanes, an antihistamine may be valuable for very young children when one is feeling desperate. Available products include Vallergan and Phenergan, but make sure you test it on the child well before the day of departure -- occasionally individual children may get hyped up by it.
In addition, the following items are usually handy to have on hand if the child is feeling a bit off-colour:
Some favourite foods or snacks.
Some new and entertaining toys, and a familiar toy to bring out when they are restless.
Vitamin drops if food will be poor quality/fluoride tablets.
Large container to sterilise bottles etc plus sterilising tablets.
Nappy rash cream/teething gel if relevant.
Plenty of baby wipes, wet-ones, antiseptic hand wash etc.
A change of clothes (for adults) for the plane or bus in case the child vomits, etc. on you.
REMEMBER: Always keep drugs out of reach of children. This may be more difficult while travelling. Even just a few malaria tablets can kill a baby, and all drugs are best kept locked inside the suitcase.
Medical Treatment
Self treatment is for adults only and if children are sick they must be taken to a competent doctor. Children get sicker faster -- their reserves are smaller, and their immune system is immature. Giving antibiotics to sick children without medical advice is especially dangerous, so if your child becomes ill, you should seek medical advice without delay. Meanwhile, to assess the severity of their illness you should:
Take their temperature -- Normal is 37ºC (98.6ºF) and it is very serious if a child develops a fever persistently over 39ºC (102ºF). Regular paracetamol and sponging with tepid water (left to evaporate off their skin) should be undertaken to bring a child's temperature down while you seek medical attention. If the child has visited a malarious area, it could be malaria, which can be rapidly fatal in children if it is not treated.
Check their pulse rate -- The normal pulse rate for children is 80 -100 and for infants 100-140. A raised pulse rate is usually a sign of significant illness.
Are they eating and (especially important) drinking? If a child is eating normally, it is a good sign that they are not too sick. If they lose their appetite, but are still drinking fluids, they can usually hold their own. If they stop drinking fluids it is very serious and if a child is not passing urine normally, they must be taken to medical care urgently. Children dehydrate much more quickly than adults and the secret to getting fluids down is to offer small sips regularly.
A study of traveller's diarrhoea among Swiss travellers showed that the highest incidence, severest disease and longest duration of travellers diarrhoea occurred in travellers under the age of three.
If children get diarrhoea, they should not be starved. Babies should continue breast feeding or drinking formula plus be given oral rehydration fluids e.g. Gastrolyte. Older children should be given starchy foods e.g. cooked rice, maize, wheat, or potatoes. Bananas are also useful to supply needed potassium. Children who are dehydrated should not be given soft drinks as it may make their dehydration worse.
Reprinted with permission from "Travelling Well: The Essential Handbook For Healthy Travel" by Dr. Deborah Mills
For questions and comments about Worldtravelcenter.com, its World Travel Health newsletter, or its travel companion jetStream, contact Laura Bauer:
laura@worldtravelcenter.com
Phone: 1-800-234-1862
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