Children and Travel

Exploring the world is the best way to learn. Many parents travel around with their children. But do you know what you should be concerned with when travelling with your children?

Children usually have less resistance to illness although they adapt to time and climate changes better. Before departure, keep your children as fit as possible. Children with immune deficiency, diabetes, serious handicaps and conditions which require frequent blood transfusion are not suitable to travel to developing countries. .

Vaccines

Even when abroad, parents should ensure that the routine childhood immunization is up-to-date. By the age of 2, children should already have completed primary immunization.

Ask your family physician to see if the schedule is affected by the trip.

Some vaccines (BCG, oral poliomyelitis and hepatitis B) can be administered in the first few days of life. However, diphtheria, tetanus, pertussis, and measles vaccine should not be given before 6 weeks of age.

Measles is still common in many countries. Travelling in crowded area may favour transmission. In Hong Kong, children are given measles-containing vaccines at 1 year old and in Primary 1. For infants travelling to endemic areas, a dose of measles or MMR vaccine may be given at 9 months of age.

Immunoglobulin for protection against hepatitis A is recommended for children under 2 years old travelling to areas where the rate of hepatitis A is fairly high.

Breast feeding is likely to protect infants from typhoid and cholera. The new injectable typhoid vaccine is recommended for children over 2 years old. Cholera vaccine is almost never recommended for children.

Meningococcal vaccine may not be very effective in children under 2 years.

No yellow fever vaccine should be given to any infant under 6 months of age.

Malaria Prevention

Anti-malaria prevention is very important for children.

The first step is to take protective measures, like wearing long sleeves and trousers, use of mosquito net.

Insect repellent with DEET is effective to prevent mosquito bites. The concentration of DEET affects the duration of protection and the duration of protection reaches about 5 hours at approximately 30%. DEET is not suitable for children below 2 months of age. Repellent should be washed off after return to indoor area.

Most but not all anti-malarial drugs are safe to infants, so consult your family doctor first.

The symptoms of malaria in children may not be typical, so seek medical help immediately if a child develops a febrile illness.

Air Travel

Babies usually cry a lot during air travel because of the changes in cabin pressure. A bottle, as soon as the airplane descends, usually helps the problem. Sometimes, mild sedative for long flights is useful.

Most airlines can make special arrangements, like special meals, and provide cots for babies. Carry a 24-hour supply of food in case of extensive delays.

Air travel is not recommended for infants less than 7 days old or premature babies.

Diet

It is wise to breast feed infants as it is convenient and prevents against diarrhoea.

In preparing formula milk, make sure that the water is boiled.

Specific formulas may not be available locally so bring your own.

Local advice may be obtained about weaning foods. Millets, cereals and pulses can all be used. Care must be taken to avoid contamination. Feeds should not be stored. Germs grow rapidly in humid environment.

Travellers' Diarrhoea

Travellers' Diarrhoea is the commonest disease in travelling. It usually lasts for 3 to 7 days. Antibiotics are not recommended for prevention of travellers' diarrhoea as they can cause more problems.

If infants encounter diarrhoea, oral fluids, such as fruit juice, should be given. Infants should continue milk feeding.

If the infant is thirsty and restless, the use of an oral rehydration solution (ORS) is advised. ORS is a packet of salt and carbohydrates. It should be prepared with boiled water only.

Avoid dairy products and all beverages that contain water of unknown quality.

Seek medical advice immediately if bloody diarrhoea, high fever, dehydration, persistent, severe diarrhoea or vomiting occurs.

Others

Prickly heat causes more problems in children and can be alleviated by talcum powder, daily bath and loose cotton clothing.

Protect from ultraviolet radiation or sunburn by PABA-free sunscreens which usually do not cause irritation.

Children who stay in the pool for long time should wear protective goggles and earplugs.

Wear light cotton clothes and closed shoes to avoid infection from cuts, scratches or parasitic infestation of the feet.

Do not allow toddlers to play outside unattended.

Make provisions for possible separation during trip. It is a good idea to give children a necklace with address and phone number while abroad, as well as medical or emergency information.