Travelling With Children

Travelling with children requires more preparation, vigilance and flexibility, with two of the key considerations being the age of the children and availability of good quality healthcare while away.

Often, while travelling, there is a heightened risk of accidents or animal bites, as well as illness occurring, so the routine vaccinations for kids (http://www.immunise.health.gov.au/) may not be enough for all standards of trips. Consult with your travel medicine provider six to eight weeks before travel to ascertain if supplemental vaccines may be needed to prevent diseases such as Typhoid, Hepatitis A, Tuberculosis, and Rabies.

Where to Stay

Choose places to stay with the kids in mind – bungalows with verandahs, an area of garden or access to a swimming pool can provide welcome relief for them (and parents!). Children should also carry some type of identification on them in case of separation. It is important that you anticipate and prepare for delays, irregular meals and disrupted napping schedules, and come prepared for entertaining children in confined areas. It may be beneficial to take a familiar object such as a blanket or toy on the trip.

Eating and Drinking

The basic rules for safe eating and drinking are much the same for children as for adults. Here are some useful guidelines:

Wash utensils in boiling water with soap.
Sterilise bottles and dummies through chemical treatment or by boiling for 5 minutes and store in a clean container.
Offer only boiled or bottled drinks.
Brush teeth with bottled or treated water only.
Serve cooked food, eaten hot.
Avoid raw salads and ice.
Serve fruit that has been peeled.
Select clean-looking restaurants and always wash hands before eating.

Breast-feeding is much easier than attempting to mix formula. Long-life milk and packaged juice in sealed cartons are safe and available. Toddlers can be fed safely on fruit, noodles, rice, soup, scrambled eggs and beans. Carry snacks (e.g.dried fruit, soft drink) on bus, car and train trips. A few jars of baby food are a good backup.

Take a plastic bowl, spoon, and knife for peeling fruit, a trainer cup (fewer spills), and bottles for impromptu feeds. Antiseptic handwash or hand wipes are very useful if it’s difficult to find clean water for washing hands.

Avoiding Insects

Insects can carry Malaria, Dengue fever, Japanese encephalitis and other diseases.

Young children are at increased risk of severe Malaria, which can be fatal if not treated rapidly. Protect children from insect bites – even if they are taking antimalarial medication - as these preventative medications may not be 100% effective. In fact, the only truly effective Malaria protection is avoiding insect bites. Only a limited number of preventative anti-malarials can be taken by children. Always keep medications out of reach of children and ensure that they receive the correct dosage, at the right time. Anti-malaria medications should always be taken with food. (Discuss medication options with your Travelvax doctor)

Use effective insect repellents containing up to 30% DEET, Citriodiol or Picaridin as directed. Light-coloured clothing and long-sleeved shirts, long trousers, socks and screened or air-conditioned quarters or mosquito nets impregnated with a contact insecticide are advisable. Insecticides such as permethrin are safe and effective against mosquitoes, sandflies and ticks and can be applied to children’s clothing. They will last for several weeks – even with washing.

Seek urgent medical aid for any illness with fever if you are in, or have been in, a malaria-infected area.

Animal Bites

Animals may carry and transmit Rabies through saliva. Encourage children to avoid touching any animals – wild or domestic. Animal bites should be washed with lots of soap and water, alcohol or iodine solution applied and medical advice sought immediately. Do not bind the wound tightly. Vaccination should be considered if travelling to risk areas.

Common Travel Health Problems

Diarrhoea

Dehydration is the main danger. Manage this by immediate fluid replacement (preferably with a commercial rehydration fluid such as Pedialyte or other rehydration salts added to water): at least one litre of water/day for a toddler (i.e. 2 glasses after each loose motion). If a commercial preparation is not available, a suitable solution can be made up by 1) adding 6 teaspoons of sugar or honey plus 1 level teaspoon of salt to one litre of water or 2) give plain water and juice along with pretzels, salted crackers, peanuts or potato chips.

If the child is vomiting, administer frequent small quantities (1 teaspoon every 1-2 minutes).

Over the counter ‘stopper’ medications used to treat diarrhoea are generally not suitable for children. If the situation does not resolve itself quickly, seek medical attention.

Altitude Sickness

Acute mountain sickness (AMS) is a frequent, subtle, but often unrecognised problem in young travellers. It is compounded in infants and children by the fact that they are unable to articulate the symptoms. The incidence of AMS is believed to be the same or higher in children as in adults. Your Travelvax clinic can advise you on a medication, suitable for both adults and children, which can aid acclimatisation.

Heat and Cold Injuries

Infants and children are more prone to the effects of temperature change and are less able to anticipate and avoid heat and cold stress. Be sure to: maintain fluid intake, dress appropriately, and avoid heat stress and sunburn.

The US Center for Disease Control (CDC) also has some useful information for travelling with children. http://wwwn.cdc.gov/travel/contentChildTravel.aspx