The Pediatric Traveler

Will You Be Traveling With Your Children?

When you travel outside of the United States with your children, there may be an increased risk of exposure to childhood diseases. Ensuring that their immunizations are up to date is essential. Additionally, adding specialty vaccines that are necessary for travel can help to safeguard them against contracting a serious illness.

Everything You Need to Protect Your Children

You should always take a practical approach to traveling with children. Let us show you how to safely instruct your children in regards to food, water and the environment around them.

Pretravel counseling is especially important for children. They face the same disease health risks, but more serious consequences can result. Children become dehydrated quickly. We can discuss traveler's diarrhea treatment. Some childhood vaccines might be recommended on an accelerated schedule if traveling to high risk areas. Food and water, insect precautions and more are included in a counseling visit. Our goal is for you and your child to have a safe and healthy trip!

In addition to comprehensive education services, we’ll ensure your children are up to date on their immunizations and provide them with specialty vaccines as needed.

Traveling With Children

Children may face the same health risks as their parents during travel, but the health consequences can be more serious. For example, some illnesses can be difficult to recognize in children especially if they can’t talk yet to express what they are feeling, or children may be more likely to encounter health risks such as animals because of their size and curiosity. If you are planning to travel with children familiarize yourself with the information on this page to help everyone stay safe and healthy.

Make an appointment with your child’s primary health care professional or a travel medicine specialist at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing your itinerary and planned activities with your provider allows them to give more specific advice and recommendations.

Make sure your child is up to date on all routine vaccines. Routine vaccinations protect your child from infectious diseases such as measles that can spread quickly in groups of unvaccinated people. Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries.

Some routine vaccines for young children have different recommendations if you plan to travel internationally. For example, although the first dose of measles-mumps-rubella (MMR) vaccine is not usually given until after 12 months of age, infants 6 to 11 months old should get 1 dose of before international travel. Some travel vaccines can be given on an accelerated schedule, meaning doses are given in a shorter period of time. Not all travel vaccines can be given to very young children, so it's important to check with a travel medicine doctor or your child's pediatrician, as early as possible before traveling.

Plan for the unexpected. It is important to plan for unexpected events as much as possible. Doing so can help you get quality health care or avoid being stranded at a destination. A few steps you can take to plan for unexpected events are to get travel insurance,  learn where to get health care during travel, pack a travel health kit, and enroll in the Department of State’s STEP.

Diarrhea

Diarrhea is among the most common illness experienced by children who travel abroad. Diarrhea can lead to dehydration. The best treatment for children with diarrhea is plenty of fluids; there is usually no need to give medicine. If your child appears to be dehydrated, has a fever, or bloody stools, get medical attention immediately. Keep in mind:

• Oral rehydration salts (available online or in stores in most developing countries) may be used to prevent dehydration.
• Over-the-counter drugs that contain bismuth (Pepto-Bismol or Kaopectate) should NOT be used in children.
• Antibiotics are usually reserved for serious cases.
• Other common treatments for diarrhea, such as loperamide, are not recommended for children younger than 6 years old.

For infants, breastfeeding is the best way to prevent diarrhea and keep infants who have diarrhea hydrated. If you use formula, you may need to bring your own. Follow the manufacturer's instructions on how to prepare it. If there is poor water quality where you are traveling, you should use sterile water to prepare formula and to sterilize bottles, nipples, caps, and rings before using them. You can sterilize items in a dishwasher, boil in water for five minutes, use a microwave steam sterilizer bag or use bleach if none of the other options are available.

Everyone should choose safer food and drinks to prevent diarrhea. This includes eating foods that are served hot or are dry or packaged. Drink bottled, canned, or hot drinks and only drink milk that has been pasteurized. For short trips, you may want to bring a supply of snacks from home for times that available food may not be safe.

Wash hands with soap and water. If soap and water are not available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Use soap and clean water and to wash bottles, pacifiers, and toys that fall on the floor.

Diseases Spread by Bugs

Mosquitoes can spread diseases, such as Zika, chikungunya, malaria, dengue, and yellow fever. Ticks can spread diseases such as Lyme disease and Tick-borne encephalitis.

Children can be protected against most of these diseases by using Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients:

• DEET
• Picaridin (known as KBR 3023 and icaridin outside the US)
• IR3535
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

When using insect repellent on your child, always follow label instructions. Spray insect repellent onto your hands and then apply to a child’s face. Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children under 3 years old. Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin. If also using sunscreen, apply sunscreen first.

More steps to protect your child include dressing them in clothing that covers the arms and legs. Cover strollers and baby carriers with mosquito netting.

Malaria

Malaria is a serious infection that children can get while traveling internationally. Children visiting friends and relatives in areas with malaria may be at higher risk because they usually stay for longer periods of time.

Children traveling to an area with malaria should take malaria prevention medicine. Your health care professional can help you know which medicine your child should take. Many malaria prevention medicines have a bitter taste, but a pharmacist can crush the capsules and put the powder in a flavorless gelatin capsule. Because of the risk of overdose, malaria drugs should be stored in childproof containers and kept out of the reach of children.

Even if you are taking malaria medicine you should still use bug spray and take other steps to avoid bug bites.

Rabies

Rabies is spread primarily through contact (bites, scratches, or licks) with animals that can have rabies (mammal). Rabies is almost always fatal if not treated promptly. Children are at greater risk for rabies because they are smaller than adults, may play with animals and may not report bites.

Supervise children closely around animals, especially around dogs and puppies, cats and kittens, and wildlife. Any animal bite should be washed thoroughly with soap and water and you should seek medical attention immediately.

Road Safety

Children should always wear a seat belt or sit in appropriate car and booster seats. Research car seat guidelines for the country you are going to; a car seat from the United States may not be approved in another country for use. In general, children are safest traveling in the back seat. No one should ever travel in the back of a pickup truck. See Traffic and Road Safety for more tips to avoid getting in an accident.

Water Activities

When doing water activities, supervise children closely and have them wear a life jacket.