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Pav Dhaliwal

Children and Travel

For young children, traveling to distant locations can be uncomfortable as well as potentially hard on their health.


Vaccinations:

Before departure, children should have had all standard childhood vaccines and also require all of the necessary travel-related vaccines just like adults. Depending upon the nature of your activities and itinerary or possible exposure to animals, less-often recommended vaccines such as rabies vaccine may also be appropriate for young children.

Malaria, Dengue and Chikungunya Fever and Zika Virus Infection:

Protective measures against mosquitoes (which transmit malaria, dengue, chikungunya, Zika and other infections) as well as other biting insects are indispensable, including the frequent application of insect repellent containing 20-40% DEET in children 2 months or older. Young children are particularly at risk for problems since malaria can quickly cause severe, potentially fatal illness; thus, infants and small children should only be taken to malarious regions if it is absolutely necessary.

Mosquito nets are particularly important and can be designed for children's beds as well as impregnated with insecticide (such as permethrin). In at risk areas, anti-malaria drug prophylaxis is just as important for all children as it is for adults. Mothers taking antimalarial drugs are protected but their breast-fed babies are not.


Chloroquine, atovaquone-proguanil and mefloquine can be administered to young children, depending upon their weight, with a doctor's prescription. Doxycycline should not be administered to children under the age of 8. Some antimalarial drugs are bitter-tasting and should be mixed with bananas or other food. Syrups do not keep well. Keep antimalarial drugs out of the reach of children.

When young children spend time (or have spent time) in a malarious region, any subsequent illness with fever should immediately be considered as malaria.


Air travel:

The change in cabin pressure can cause painful "popping" in the ears. In order to restore a balance in pressure in the middle ear, bottle-feed small children after take-off and especially during landing. Eardrops may also be administered to ease the pain (consult a physician). In the case of a cold, use a nasal decongestant.


Sun protection:

Children's skin is particularly vulnerable to sunburn. Serious cases of heat stroke and sunburn can have major health consequences later (risk of melanoma). A thick, water-resistant sunscreen is necessary. Make sure that children wear a hat and a good pair of sunglasses (under the age of 8, UV freely pass through the lens all the way to the retina).

Never expose infants to direct sunlight.


Outdoor Walking and Swimming:

Never walk barefoot in tropical countries. Do not swim in freshwater (e.g., lakes, ponds, streams, etc.).


Altitude

Like adults, children may also develop altitude-related illnesses at altitudes above 8,000-10,000 feet and may also benefit from short-term prophylaxis with acetazolamide (5 mg/kg per day total dose, given in two or three divided doses).


Diarrhea:

Diarrhea can be serious in small children. Consult your pediatrician about carrying anti-diarrheal medication and an antibiotic for self-treatment if the diarrheal illness becomes severe or persistent and medical help is not available. If a child has diarrhea and vomiting, dehydration can develop making it very important to quickly replace the lost fluids even if the child continues to vomit.


Additional Information

CDC Health Information for International Travel 2020, Traveling Safely with Infants and Children.

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