Taking children with you on your trip

Sometimes it is necessary to speed up routine pediatric vaccines to get them all in before travel. Also, some vaccines, like measles, may need to be given earlier than if you were staying at home since the children might be exposed to the disease while traveling.

Could they get diarrhea and what should I do?

Children, like adults, frequently get diarrhea while traveling. It tends to be more severe for children. Children often have more vomiting along with their diarrhea. Children, like adults, should avoid certain foods (see the diarrhea handout). In addition, if they are breastfed before travel you should continue to breastfeed throughout your travels because it will protect the baby from harmful bacteria (germs). If using formula, the water should be made safe before preparing the formula. Boiled water is the safest water. With older children who drink milk, make sure it is safe. If you bring milk to a boil and let it cool down it is safe. Boxed milk (“irradiated milk”) is also safe.

· If your child gets diarrhea, you should encourage fluids and continue to let them eat a regular diet as long as they are not vomiting but if they begin to become dehydrated beginning clear fluids as below is recommended.

· If they are vomiting you should change to clear fluid such as oral rehydration fluids like Pedialyte™. These replace fluid and important things lost in the diarrhea. You can take some with you or buy these in most pharmacies in any country in the world. They are made available by the World Health Organization and are called “ORT or ORS”, meaning Oral Rehydration Therapy or Solution. You can simply mix these by direction on the package with clean (boiled) water and give to your child.

· In the child who is vomiting, may be very thirsty and may drink too much very quickly, when fluids are offered causing them to vomit more. It is very important to give them small amounts of fluid very often. You should give them a teaspoon of fluid every two to three minutes. If they swallow this you can increase the amount or give it more often. If, while you are increasing the amount of fluid, they vomit you should go back to very small amounts.

· Diarrhea treatment. In children older than five years, like adults, bismuth subsalicylate may be used to decrease diarrhea (see diarrhea handout). Younger children should NOT use loperamide. Also, your children should be given an antibiotic that you can take with you that they can take in case of severe diarrhea.

Do I have to worry about malaria?

YES. Malaria in children, especially those who have never been in an area of malaria can make them very sick. In fact, with the bad type of malaria, children, or anyone who has never had malaria before, can die in less than 12 hours from their first symptoms. Speak to your doctor/nurse (and see malaria handout) about malaria, how to protect your child from mosquito bites and what medication they should take to prevent malaria.

What is the most likely bad thing to happen to my child while we travel?

Injuries and accidents are the most likely bad things to happen to your child.

· Be very watchful around traffic & roadways, use car seats and seatbelts whenever possible. You likely will need to bring your car seat with you. The safest place in the car for a child is the middle of the back seat.

· Watch you children closely around water because drowning is very common.

· There are things that children may not see in your home that you have to be careful about, such as exposed electrical wires, rat poison, and exposure to animals such as cows and chickens that might carry disease.

· Inspect any area your child might play to be sure it is free from dangerous things.

Is there a medication I can use if they can’t sleep during the airline flight?

There are no magic medicines that will make your child sleep during the airline flight. Benedryl (diphenhydraine), which is used for runny noses and allergy symptoms can make kids sleepy if they are ready to sleep. It will not make a wide awake child sleep, but it can be useful if the child is ready to sleep but keeps being awoken by activity around them. If you want to try this, test it at home first as some kids (3 in every 100 kids) will become hyperactive instead of sleepy. This medicine can be purchased at any pharmacy without a prescription (doses are below).

What about my babies or young child’s ears when they fly?

About 15 in every 100 babies and young children who fly will have ear pain. This usually occurs when the plane is landing. During descent you can breastfeed, give a baby a bottle or a toddler something to drink as this will usually relieve the pressure in their ears (make their ears pop).

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Things to remember while you Travel (Carry with your travel documents):

Diarrhea: If your child has more than two times the number of stools he/she regularly has, and they are watery, use the antibiotic you were given by your doctor/nurse. This is especially true if the child has fever, blood in the stool or abdominal pain. If only diarrhea, continue regular diet.

Vomiting and/or Diarrhea: Use Oral Rehydration Therapy/Solution. You can buy this at most pharmacies overseas. Mix as directed with clean water. Give small amounts like one teaspoon every 3 to 5 minutes. Increase amount as tolerated. If the child vomits start over with small amounts. Change to regular diet as soon as tolerated.

Severe illness or unable to give adequate fluids: Seek good local healthcare. If you have travel insurance they may assist you in finding good care. If your child needs an injection or IV therapy make sure the needle is sterile and has never been used before.

WASH HANDS OR USE HAND SANITIZING LOTIONS AS FREQUENTLY AS POSSIBLE.