Travelling with Infants and Children

There was once a time where I could travel at the drop of the hat. A deal would pop up and I’d be on a plane the next week. These days, with a 2 year old at home and another baby on the way, travelling takes a little more preparation. You’re not alone if the thought of taking your 2 year old on a flight to a foreign country feels daunting. What do you pack? How do you keep them entertained on the flight? What are the health risks? Are vaccines needed? If any of these questions have crossed your mind, keep reading our latest blog for some planning tips and considerations when travelling with infants and children.

 

The dreaded flight

A quick google search gave me some great ideas for activities to keep my busy toddler entertained on our recent 5 hour flight to Ottawa. With limited space in our carry-on bag the key was to pack small and light activities. After a trip to the dollar store I was equipped with stickers, colouring books, new crayons, a miniature etch-a-sketch, a compact pop-up book, window stickers, a toy car, and pipe cleaners. The pipe cleaners were used to make cheerio bracelets with one of her many snack options. I wrapped each item in newspaper so every new activity felt like a present for my child and unwrapping was an activity in itself. The other key to keeping her busy were snacks galore. When she grew bored of her new activities and snacks, Peppa the Pig saved the day (I’m all for screen time in desperate situations!).

Infants and toddlers can often experience ear pain when flying caused by ear pressure in the middle ear, especially during the descent. Swallowing or chewing can help to equalize the pressure and decrease the pain. Depending on the age of your child, some things you can encourage kids to do to help minimize ear pain include yawning, chewing gum or sweets, swallowing (breast or bottle feeding for infants), sucking on a pacifier, or drinking from a cup. Fortunately, our toddler didn’t seem affected by ear pain at all, but I think her first ever lollipop at 11:30pm probably helped!

 

Health risks at your destination

Fortunately, we didn’t need to consider any additional health risks for our trip to Ottawa, besides the potential exposure to COVID-19 in airports and on the flight (thankfully we made it there and back COVID-19 free!).  But if you’re travelling internationally, there may be other potential health risks, such as hepatitis A, traveller’s diarrhea, malaria, zika, typhoid, and yellow fever to name a few. I’ll tell you more about some of the health risks in the next sections of this blog.

 

Oh crap – traveller’s diarrhea

The most common travel related illnesses affecting adults and children include diarrhea and other gastrointestinal illnesses. Diarrhea can cause infants and children to become dehydrated more quickly than adults. Some things you can do to reduce your child’s risk of traveller’s diarrhea include:

• Breast is best! Breastfeeding is the best way to prevent illnesses spread through contaminated food and water. If your infant is formula fed consider bringing formula from home as those available abroad may not be the same.
• Drinking water (and water for brushing teeth and preparing infant formula) should be bottled water or treated by boiling or another method of purification. Methods to purify water can be found her Avoid ice, fountain drinks, and anything that could be mixed with untreated water.
• Food should be cooked fresh and hot. Avoid salads, and any raw fruits and vegetables that are not peeled by the caregiver. Cooked vegetables are safest as are fruits that peeled immediately before giving to your child.
• Avoid dairy products as they may be diluted with untreated water or may not be pasteurized.
• Take care to ensure proper hand washing and cleaning bottles, pacifiers, teething rings and toys that fall to the floor or are handled by other people. Use bottled or treated water to clean these items. Wash hands well after diaper changes. Bring an alcohol-based hand sanitizer to use when soap and water is not available but keep in mind that it is not effective against all germs so wash with soap and water as soon as possible.

 

A few ways to treat traveller’s diarrhea:

• The biggest concern for an infant or child with diarrhea or vomiting is dehydration. Oral rehydration salts (ORS) packets such as Pedialyte or Hydralyte are available at pharmacies and should be brought from home to add to clean water to give to the child. Continue breast or formula feeding in addition to ORS. Older infants and children should continue to eat solid foods in addition to ORS.
• Seek medical attention if your infant or young child has:
• signs of moderate to severe dehydration
• bloody diarrhea
• temperature >38.6º C
• Persistent vomiting or diarrhea (unable to keep down ORS)
• Do not give children bismuth subsalicylate (i.e. Pepto-Bismol) to children younger than 12 years of age. Breastfeeding mothers should also avoid this.

 

Don’t forget about mosquito risks like malaria

We are fortunate that in BC that we generally don’t need to worry about the bite of a mosquito causing disease. But if you’re a mosquito magnet like me and travelling to certain at risk-countries, then you need to think about malaria. Malaria is a disease caused by the bite of an infected mosquito. Children are at an increased risk of severe complications of malaria. If possible, avoid taking young children to areas where malaria is present. Otherwise, the best way to avoid malaria is to avoid being bitten by mosquitos!

• Sleep in rooms with air conditioning or screened windows or bed nets
• Use mosquito netting over infant carriers
• Dress children in long sleeve, light coloured clothing and avoid strongly scented products
• Apply Icaridin 20% or DEET 10% to exposed non sensitive areas of the body to children 6 months of age and older
• Give your child an antimalaria medication. The type and dose depend on your child’s age, weight, and your travel destination. Your health care provider (especially the consultants at TravelSafe Clinic!) will best advise regarding choice of antimalarial medication for your child.

 

Kids love to get dirty – but infections from soil can happen!

This past summer my toddler spent hours on a local beach digging a hole in the sand with her feet. Children are more likely to have contact with soil and sand where various infections and parasites can be transmitted, especially in more tropical countries. Be mindful:

• That your child wears protective footwear and plays on a sheet or towel rather than directly on the ground.
• Clothing should be hung to dry and not be dried on the ground.

 

Preventing injuries

Sadly, vehicle related injuries and drowning are the first and second leading causes of death in children who travel.

• Children weighing ≤ 40lbs should be restrained in age-appropriate car seats or booster seats when travelling in vehicles, which must often be brought from home. Transportation should be arranged in vehicles with seat belts and other safety features.
• Ensure close supervision of children around water and ensure protective footwear is worn. Read our blog for more water safety tips for both adults and children.

 

Sun day, fun day

I passed down my fair complexion to my toddler so we need to think seriously about sun protection when we travel (and during the sunny BC summers!).

• Children age > 6 months should wear sunscreen with at least SPF 30 which should be reapplied as needed and after sweating and water exposure.
• Infants < 6 months should be kept in the shade and wear clothing that covers the entire body.
• Consider sun-blocking clothing as well as hats and sunglasses

More tips about sun safety can be found here!

 

The travel kit

We didn’t need to worry about packing a travel kit for our trip to Ottawa, but we will definitely be packing the essentials for our next trip to Mexico as a family of 4. Here are some items that I’ll be packing in my travel kit:

• Insect repellent containing DEET 10% or Icaridin 20%
• Oral rehydration salts
• Water purification device (i.e. chlorine tabs, filter, UV light, etc.)
• Medication recommended by your health care provider for fever or traveller’s diarrhea
• A waterproof sunscreen with at least SPF 30
• A thermometer
• Basic first aid kit for minor injuries (gauze pads, bandages, alcohol swabs)
• Mosquito net (depending on your itinerary)
• Hand sanitizer
• Masks (if your child is older than 2 years of age)

 

Don’t forget about vaccines!

If you’re travelling internationally, make sure your child’s routine immunizations are up to date, including COVID-19 vaccines (if eligible), and influenza. Visit a travel clinic 6-8 weeks before your departure for health advice and travel vaccines. The vaccines we recommend will depend on your destination, length of travel, type of travel, and your child’s age. If you are travelling to an area with risk of measles, the measles, mumps, rubella (MMR) vaccine can be given as early as 6 months of age, and then repeated with the routine vaccines at 1 year of age. Some possibilities for travel vaccines that are not included in the routine vaccines include:

• Hepatitis A
• Typhoid
• Traveller’s diarrhea and cholera (Dukoral)
• Yellow Fever
• Japanese Encephalitis
• Rabies
• Meningococcal meningitis A,C,Y,W-135

 

Pre-travel consultation

If you’re planning to travel with your family, consider booking a pre-travel consultation. The pre-travel consultation is conducted by an expert in travel health who is up to date on the latest disease outbreaks and recommendations for adults and children. The consultation is tailored to your specific itinerary, travel plans and health history, and we can answer any specific questions you might have about travelling with your children.

To book a pre-travel consultation simply call us at 604-251-1975 or complete our online booking form.

 

Kristin Cain, RN, BSc, MSc(A) – Clinical Nurse Educator, Nurse Consultant, eager to begin a life of travelling adventures with my family of four.