In general, the older the better if you have a choice! Babies have fewer preferences regarding what they see or do but need routine, which is difficult to maintain when travelling. In comparison, toddlers leave you in no doubt as to their likes and dislikes, but have boundless energy and require constant vigilance, their enthusiasm and interest in the world around them compensating somewhat for this! From 4-5 yrs on a happier balance is achieved and travelling with children becomes easier and more enjoyable.
Keep in mind the short attention span of children and the ease with which they tire – avoid too many long bus trips or consecutive days in museums. Whenever possible, break long journeys and leave some unstructured time each day for children to play. Choose places to stay with them in mind – bungalows with verandas, a bit of garden or supervised access to a swimming pool can provide welcome relief for child and parent alike.
Disposable best option – available in most major cities. Pack a small bag and replenish when possible – otherwise you will need a bucket, soaking solution etc or access to a laundry service.
The most important vaccines for children are the routine childhood vaccines given in early childhood. The most important one of these is measles, which can be brought forwards to 6 months of age for travel. For that reason we often advise parents to wait until their child is older than this before travelling overseas.
Travel vaccines are also important but many have minimum age restrictions and so are often not able to be given for this reason rather than not being relevant. Generally over age 2 most travel vaccinations can be used in children. Best seek up to date advice on this 6 weeks prior to travel.
Mosquitos can carry malaria and other diseases. Use effective repellents containing DEET 30% – safe once over 2 months old. Unless in air conditioned accommodation, infants and children should sleep under mosquito nets; burn mosquito coils. Worst time is dusk to dawn. If outdoors at that time, use repellent and cover up with pale coloured clothing.
Malaria tablets can be used in very small children but great care needs to be taken when visiting risk areas.
Generally most tropical illness is more risky for younger children, although these risks can be minimised with up to date advice.
Arrive at the airport early and request seats in front of the bulkhead, or near the exits for more leg room. Feed during take-off and landing (or supply sweets/dried fruit) to encourage swallowing and hence minimise ear discomfort. Always carry some prepared bottles or juice (this can be tricky if going international)– flying is dehydrating and even breast fed babies may need supplemental fluid. Carry some snacks for toddlers – airline schedules rarely coincide with children’s hunger pangs. Carry disposable nappies, plastic bags (for the former), wet-ones, a change of pants, comfort rug, change mat (often easier to use on your lap vs. aircraft toilet), a few toys/books/games. Phenergan can be useful for sedation or travel sickness but best trialled before travel.
Basic rules as for adults:
• Offer only boiled or bottled drink
• Serve cooked food, eaten hot
• Serve fruit that has been peeled
• Select clean looking restaurants
• Wash hands before eating / use hand gel
Breast feeding infants is much easier and safer than attempting to mix formula. Long life milk and packaged juice in sealed cartons are safe and available. Toddlers can be fed safely on fruit, noodles, rice, soup, scrambled eggs, and beans. Carry snacks (eg dried fruit, soft drink) on bus/train trips and a few jars of baby food as a backup. Take a plastic bowl, spoon, knife for peeling fruit, trainer cup, and bottles to facilitate impromptu feeds. Ensure teeth are cleaned with bottled or boiled water.
Animal bites can transmit rabies and children may not let you know they have been bitten or scratched. Encourage your children to avoid interacting with animals, especially monkeys and dogs. Animal bites should be thoroughly washed, antiseptic applied, and medical advice sought as soon as possible.
Travellers diarrhoea is relatively commom. Dehydration is the main danger. Manage fluid replacement (preferably with oral rehydration salts added to sterile or bottled water), aiming for at least a litre of water/day for a toddler. Try to replace what is lost. If the child is hungry, a light diet of crackers, bread, boiled rice, mashed bananas or clear soup is suitable; avoiding dairy products or fried food. If your child has high fever, is passing pus or blood or has diarrhoea for over 24hrs seek medical attention.
As a standard include:
• Infant Paracetamol e.g. Panadol
• Rehydration salts
• Phenergan (motion sickness, itches, sedation)
• Sun Screen
• Anti-itch cream
• Antiseptic e.g. Betadine
• Soothing cream for nappy rash
• Antibiotics (if off the beaten track or unsure of availability overseas)
• Bandaids, dressings,scissors/tweezers.