By Cathy Lanigan, Lonely Planet
As well as the potential health risks of your destination, you should consider the age and temperament of your children, and what sort of trip you're planning.
It's a good idea to make sure your child is as healthy as possible before you go. Talk to your doctor about illness prevention and work out a plan of action for common problems. If your child has an ongoing condition like eczema, diabetes or asthma, be clear about what to do if the condition worsens while you're away.
It's worth making sure you child has a thorough dental checkup before going away and remember to leave enough time for any treatment to be carried out if necessary.
Children should be up to date for all routine childhood immunizations and they'll need the same travel-related vaccines as you. Most fully immunized school-age children won't need further doses of routine immunizations, but babies and younger children who haven't completed their normal childhood immunizations may need to complete the schedules earlier than normal. Ask your doctor about immunizations when you start planning your trip. Some vaccines have age restrictions and your doctor should be able to help you with these restrictions.
If kids are going to react to an immunization, it will usually happen about 48 hours after the injection and can generally be settled with one dose or two of acetaminophen (an over-the-counter drug such as Tylenol). Children can go on to have further reactions and sometimes develop rashes 10 days after the immunization, so the earlier you get kids immunized the better.
If you are traveling internationally, ask your doctor what vaccines are required and check the Center for Disease Control Travelers' Health page.
It's a good idea to take a child-specific medical kit as well as your own basic medical kit. If your child takes any medications regularly (for asthma, eczema or diabetes, for example) remember to take a good supply of these medications with you. Otherwise, a basic medical kit for children should include most of the following:
If you do need to give your child medication when you are away, remember children need a child-sized dose and not all medications are suitable for children. Follow the dosing instructions given by your doctor or on the packet. Doses are generally based on your child's weight. You should also check that your child's medication is legal at your destination.
Children can be very adaptable to climate and time changes but they are more susceptible to infections and accidents.
On flights, air pressure changes can cause ear pain in babies and young children. Older children can be given chewy sweets or drinks, or encouraged to blow their noses, which should help their ears to pop. If your child has an ear infection or bad cold, you should postpone flying until it is better.
This is extremely common in children and can turn even a short journey into a trauma. Ginger is a good remedy and you can buy ginger capsules from many health food stores; check that the capsule dosage will be suitable for your children's weight and age. You could also use promethazine. (Follow the dosing guidelines, and note that it's not recommended for children under 2 years.) Promethazine will often make your child sleepy, although the effects are very variable. A natural soothing alternative is chamomile.
You'll probably want to avoid giving children carbonated soft drinks, but packet fruit juices are usually available. Wash children's hands and faces frequently throughout the day, especially if you are traveling on public transport. Another good preventative measure is to discourage hands wandering into the mouth, eyes and nose as much as possible. A supply of wet wipes can be invaluable, especially on long journeys.
New foods are usually met with surprise and a reflex refusal, but stress and new surroundings can distract children from eating and hat often reduces even the healthiest of appetites. Try to introduce new foods gradually, perhaps starting before you leave. Even if your child doesn't want to eat, fluids are a must, especially if it's hot.
Biting insects carry a number of serious diseases so it's extremely important to protect your children from bites. Make sure your child is covered up with clothes, socks and shoes, and use insect repellents on exposed areas - either DEET-containing repellents or the new natural repellents containing lemon eucalyptus.
Try to discourage scratching of bites if they occur, as this often leads to infection. Keep fingernails cut short and use calamine cream or a sting-relief spray to ease irritation.
Children are accident-prone at the best of times, but the dangers are even greater when you're traveling, so you need to be even more vigilant than normal. Many hotel rooms and restaurants are not built with children in mind and may have a nightmare-inducing lack of safety features, particularly where windows and balconies are concerned. Some precautions to think about taking:
In hot, humid climates these can easily become infected and it can be difficult to keep children clean, especially if they are running around. You'll need to take a bit more care of abrasions than you would normally. Wash any break in the skin carefully with soap and water or antiseptic solution or antiseptic wipe and keep it covered with a sterile, non-stick non-fluffy dressing. It's probably worth checking your child carefully at the end of each day for cuts, scratches and potentially problematic bites.
Anyone can get sunburnt but little ones are especially vulnerable. Keep children and babies covered up (long-sleeved T-shirt, hat, etc.). Apply liberal amounts of the highest factor sunscreen you can find on any exposed skin and reapply it frequently. Keep your child out of the sun during the middle of the day when the sun is at its fiercest. Not only is sunburn miserably painful for your child, it's thought to be a major risk factor for skin cancer in later life.
Children are at risk of the same diseases as you are when you are away. Because children can't always tell you what's wrong and in many cases don't show typical symptoms of diseases. It's even more important to seek medical help at the earliest opportunity. Always get medical help if you have any concerns about their condition.
Children can quickly change from being well and active to becoming ill, sometimes seriously ill. In young children, especially, the signs can be quite subtle and difficult to interpret, which can be a worry.
As the parent, you will know your child best of all and any change in their behavior should be taken seriously - listen to your sixth sense. This is particularly true of young children.
Don't rely on a child's skin temperature as an indication of whether they have a raised temperature or not. Instead you should always carry and use a thermometer (preferably a digital one or a fever strip - less accurate but easier to use). It is important to have an actual reading of the thermometer. A child cold to touch may have a raging temperature. If you have any cause for concern, check the temperature and make sure your child is taking at least enough fluids to pass urine twice a day, even if they have gone off their food.
This is very common in children wherever they are and is always a cause for concern. In addition, a high temperature can sometimes cause a convulsion in babies and young children. If you think your child has a fever, for example if the child is flushed and irritable and obviously unwell:
Conditions like viral infections, colds, ear infections, urinary tract infections and diarrhea are common causes of fever. Take steps to lower the temperature and seek medical help urgently in the following situations:
Children - especially young children and babies - are more likely than adults to get diarrhea when they are away. They also tend to get more severe symptoms and for longer. It's partly because children are less discriminating about what they put in their mouths and it's hard to keep little hands clean, but it may also be because they have less immunity to disease-causing bugs.
Babies and children can become rapidly dehydrated through diarrhea and vomiting, and it can be difficult to make sure they drink enough. The best fluids to give children are oral rehydration salts (ORS). You need to start giving them as soon as diarrhea or vomiting appears. You can make ORS more palatable by adding flavors or look for ready-flavored sachets of ORS. Avoid food if kids are vomiting.
The World Health Organization gives the following guidelines for the quantity of fluid replacements:
If children are vomiting, allow the stomach to rest for about an hour before trying to give them fluids. Then reintroduce fluids very slowly. If your child is refusing to drink, try giving small amounts by teaspoon or syringe every few minutes. Seek medical help earlier rather than later, especially if you notice any of the following symptoms developing:
In children feces may take 10 to 14 days to return to normal (though sometimes longer). As long as the feces are not too frequent, you shouldn't worry about slightly loose feces in an otherwise fit and recovered child.
Note that symptomatic antidiarrheal medications are not recommended for children and should be avoided. If your child is ill enough to need antibiotics, you should seek medical advice.
This is a very common complaint among children and adults. The causes are many and varied, and some may be very serious. If your child is prone to tummy aches, the stress of traveling may make them more likely while you are away. Otherwise situations when you should seek medical help include:
Children are particularly likely to succumb to new germs in new places, so be prepared! Asthma (cough, wheezing) may occur for the first time while you are away and can be frightening, especially if your child has never experienced it before. You should seek medical advice if your child is having difficulty breathing.
If you suspect an ear infection consult a doctor as antibiotics will be required for a middle ear infection. If your child does get an infection try to avoid water getting in the ear for two weeks.
Consider getting a checkup for yourself and your children if you've been on a long trip or have been traveling rough. Make sure your doctor is aware you've been traveling and where.