“ Wherever you go, go with all your heart !! ” – Confucius
Summer vacations are approaching soon and for some of you they might have already started. Most of us would have already planned a vacation either to Nani/dadi house or just a regular vacation, either somewhere in India or abroad.
Google is loaded with tips on travelling with kids but very few focus on medical care/safety of your kids. Travel preparation is often taken lightly because it is fun. Safety (especially health related) is often overlooked or not talked about because it is NOT fun. Travelling with kids can either be a delight or a challenge. The proper planning and education can mean the difference.
Let me start with my example only..
I went on a long road trip with my family including my 8 yr old son to one of the most beautiful places in India, a dream destination….to Ladakh, an extremely high altitude area. Despite all the precautions and medications, unexpected illness still cropped up on day 3 of the trip but being a professional I could manage my child (including giving oxygen and injections) when hardly any medical care was accessible in the middle of night. But most of us are not doctors and have no clue about all these things especially when it involves kids.
This was just an extreme example which I quoted but even for easy trips, problems might arise when you least expect them and then you are at a loss what to do with no easily available medical care.
Why does it happen?
Your child is away from home’s usual eating and sleeping routines. They take time to adjust to the food, water, and air in a new environment. Therefore, in spite of your scrupulous hand washing habits, your diligence in choosing a safe and clean destination, and your careful selection of nutritious and appropriate food, your child still gets sick on vacation.
Some early planning including a visit to your pediatrician and smart packing can help you keep the trip healthy for your kids.
Common Travel Troubles ( we will be discussing only about health related issues and not other safety issues)
No matter how far you’re traveling, there are some common health issues that your child is likely to face, including diarrhea or tummy upset ( or food poisoning), travel (or motion) sickness, jet lag and ear discomfort (air travel) apart from the routine fever, infections ( e.g. flu) or bug bites, sunburn, injuries (cuts and bruises) etc. which can happen anytime.
This is not limited to children only but can be seen in anyone of us. Here are some things to keep in mind when your family prepares to travel especially when kids are along.
Diarrhea and other stomach problems are common during travel. Often, they’re caused by bacteria or other germs entering the digestive tract, usually from contaminated food or water. This is especially a problem for young kids and babies, who can become dehydrated more quickly than adults.
The best treatment for diarrhea in children is to give plenty of fluids; there is usually no need to give medicine.
Keep in mind:
- Oral rehydration salts (e.g Electral is available in stores in most places, better to carry along with you) and fresh coconut water may be used to prevent dehydration. Avoid dairy products and fruit juices (both packed and fresh) if your kid has diarrhea.
- Over-the-counter drugs like loperamide or those that contain bismuth should NOT be used in children, and antibiotics are usually reserved for serious cases.Take precautions to ensure the water is safe.
- If your child appears to be severely dehydrated, or has a fever or bloody stools, get medical attention immediately from nearest medical facility.
- Consider drinking only bottled water (from a genuine place) or if it’s a short travel carry your water when traveling.
- If you’re breastfeeding your infant, continue to do so. Use only purified/boiled water for mixing infant formula and foods.
- Remind kids to wash their hands well and often and if washing not an option, keep an alcohol-based hand sanitizer handy.
- Preferably avoid dairy products during travel and if necessary to use, make sure all dairy products are pasteurized.
- Fresh fruits and vegetables should be washed well and peeled and then consumed or cooked.
- Avoid food from street vendors.
Travel (or motion or car) sickness is caused by a conflict between the eye and ear: The inner ears detect movement, but the eyes — focused within a car or other vehicle — do not. These mixed signals coming into the brain can cause nausea, dizziness, vomiting, pain in tummy, paleness, and cold sweats or in younger infants just irritability.
Motion sickness can happen during any mode of travel including ships and boats, planes, buses, and cars.
Some ways to help combat it:
- Before leaving, have kids eat a light meal or snack, as motion sickness seems worse on an empty stomach. Provide foods that are easily digested and avoid fatty foods and milk.
- Try to avoid eating during short trips. For longer trips, sip drinks and eat light, small meals and snacks.
- Encourage kids to look outside the car, rather than inside. They should focus on still objects — not moving ones (like other cars) — or a distant point. Avoid reading and playing video games during travel in cars or buses.
- Keep the window open a little to allow fresh air to circulate.
- Use a headrest to minimize head movement.
- Make frequent stops, if possible, at places like rest stops and parks. And if your child complains of feeling sick and it’s safe to stop, a short walk for some fresh air might help.
- Ask your doctor about medicines to prevent travel sickness (these are usually started on a night prior to the travel).
When you fly across time zones, it can take time for your internal body clock to catch up with the local time leading to fatigue. In addition to tiredness, jet lag can also cause an upset stomach and even insomnia and irritability.
Here are some tips for dealing with jet lag:
- Try to adjust your kid’s sleep schedules 2-3 days before departure.
- Get plenty of rest before the trip. If possible, sleep on the flight.
- Dehydration contributes to the side effects of jet lag so make sure your child drinks plenty of water during the flight. Avoid coffee, tea, and other caffeinated beverages.
- On a long flight, try to stretch regularly and even walk up and down the aisles when it’s OK to do so.
- After arrival, encourage kids to be active outside or in brightly lit areas during daylight hours.
- Try to follow local time at your destination (for example, try to keep kids awake until their usual bedtime).
It’s common for kids to experience ear discomfort during a plane’s takeoff and descent caused by rapidly changing air pressure in the middle ear. Encourage kids to swallow, yawn, or, if they’re old enough, chew gum. It may help infants to nurse or suck on a bottle.
A pain reliever (on your doctor’s advice), 30-60 minutes before takeoff or, if it’s a long flight, before landing, might help.
Special Considerations for Travel Abroad
If you’re heading overseas, start preparing well in advance. For instance, it’s important to find out what vaccinations your kids (and even you) might need because:
- Different countries have different risks and therefore different requirements about specific vaccines. Depending on your travel plans and country you are planning to visit, your doctor may recommend that in addition to routine immunizations, your child be vaccinated against: typhoid, yellow fever, Japanese B encephalitis, meningitis etc.
- Most vaccines take time to become effective in your body, so consult your pediatrician well in advance, preferably 4-6 weeks prior.
Also, kids of any age can get malaria so if you’re traveling to a country with a malaria risk, talk to your doctor about preventive antimalarial drugs.
Be sure to take a copy or photo of your child’s immunization records with you if you’re traveling internationally.
- When you pack, include any medicines and other medical supplies you and your family use regularly because they may be hard to find at your destination. Don’t forget inhalers, allergy medication, and any other medicine required by your child (preferably carry a prescription by your doctor).
- First-aid kit that includes thermometer, antiseptic/antibiotic ointment, bandages/band-aids, antibacterial wipes, anti-itch gel or cream for insect bites and stings, elastic/compression bandage wrap for sprains and strains, and other OTC medications (including for fever, pain, vomiting, loose motions, allergies etc) your doctor may recommend.
- Sun safety: Sunscreen of at least SPF 15 if planning to stay in sun along with sun protective clothing. Sunscreens in children: to use or not ?
- Water safety: Watch kids at all times around any body of water. Because water safety devices ( of appropriate sizes for your kids)— such as life jackets and goggles — may not be available at your destination, consider bringing these from home if you’re planning to spend time on or near water.
- Insect repellent: Especially those containing DEET. Choosing the right mosquito repellent for your kid
- Alcohol-based hand rubs for when soap and clean water aren’t available
- Stay warm if going to cold areas. Cold temperatures can cause serious health problems, especially in infants. Stay dry, and dress them warmly in several layers. Even if going to a relatively warm area, keep one set of warm clothes and rain gear for children.(You never know when weather might change)
- Prevent injuries by keeping an active watch on kids.
Do some research before your trip to find the hospital or medical care facility closest to your destination, particularly if your child has a chronic health condition (carry your child’s detailed medical history including his blood type, doctor’s name and contact no., any long term medication, any allergies etc).
One thing which is an absolute necessity but no one advises is to learn basic CPR ( cardio pulmonary resuscitation) including what to be done for accidental choking. This may sound a bit extreme but mind you it really helps and is life saving when there is no immediate medical care nearby.
And Don’t Forget . . . (this is somehow given least importance in India)
- To buckle up. If possible, carry your child’s car seat along. Infants and toddlers should ride rear-facing until they reach the maximum weight and height limits recommended by the seat’s manufacturer. Kids who have outgrown their forward-facing car seat (usually when they’re between 4 and about 8 years old, but weight and height limits vary) should use a belt-positioning booster seat.
- Travel insurance: Especially when you are travelling abroad.
Therefore before you leave, consult your doctor for all the above information. This advance planning can help make sure that when the time comes, all you’ll have left to do is relax and enjoy your vacation!
Having kids is a reason to travel; not a reason to stop!! – Author unknown
Have a safe and healthy travel !!!
Dr Garima| themoppetsclinic 🙂
- CDC: Travelling safely with infants and children/yellow book-2018