Traveling with Children

September 22, 2018

An estimated 2.4 million children from the United States travel internationally each year, and the number is increasing. In general, children face most of the same health risks as their parents, but the consequences can be more serious. Some conditions can be difficult to recognize in children, especially in those who aren't talking yet. If you are planning to travel to another country with your kids, be familiar with the risks of travel to help them stay safe and healthy.

Pretravel Care

A visit to a travel medicine provider before your trip can help protect you and your children at your destination. Ideally, your family should see a health care provider at least 4-6 weeks before your international trip to get needed vaccines and medicines. Your doctor or nurse will also counsel you on other ways to reduce your family’s risk of illness or injury during travel.

Vaccines

If possible, children should complete their routine childhood vaccines on the normal schedule before traveling overseas. However, some vaccines can also be given on an “accelerated” schedule, meaning doses are given in a shorter period of time. Some travel vaccines cannot be given to very young children, so it's important to check with a travel medicine doctor, who should consult your child's pediatrician, as early as possible before travel.

Diarrhea

Diarrhea is among the most common illnesses experienced by children who are traveling abroad.

Prevention

For infants, breastfeeding is the best way to prevent diarrhea. Older children visiting developing countries should follow basic food and water precautions:

  • Eat only food that is cooked and served hot.
  • Eat fresh fruits and vegetables that you peeled or washed yourself in clean water.
  • Drink only beverages from sealed containers or water that has been boiled or treated. This includes water used to prepare infant formula.
  • Wash their hands or use alcohol-based hand sanitizer frequently.

For short trips, you may want to bring a supply of safe snacks from home for times when the children are hungry and the available food may not be appealing or safe.

Treatment

Diarrhea can be serious in infants and small children because of the risk of dehydration. The best treatment for diarrhea in children is to give plenty of fluids; there is usually no need to give medicine. 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, and 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.

If your child appears to be severely dehydrated, or has a fever or bloody stools, get medical attention immediately.

Malaria and Other Diseases Spread by Bugs

Diseases spread by mosquitoes, such as Zika, chikungunya, malaria, dengue, and yellow fever, are common throughout Asia, Africa, South America, and Europe.

Prevention

Help your children prevent mosquito bites and use insect repellent:

  • Children should wear insect repellent and long pants and sleeves. Permethrin can be applied to clothes for extra protection.
  • Do not use insect repellents on babies younger than 2 months old.
  • For babies younger than 2 months old, protect them by draping mosquito netting over their carrier or car seat. Netting should have an elastic edge for a tight fit.
  • Do not use repellents containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children younger than 3 years old.
  • At night, children should sleep in screened, air-conditioned rooms or under a bed net.
Malaria

Malaria is among the most serious and life-threatening infections that can be acquired by children abroad. Children visiting friends and relatives in developing countries may be at higher risk because they are more likely to be in areas where malaria is commonly found.

Children who travel to areas where malaria is present should take medicine to prevent malaria, just like their parents. Your health care provider can tell you which malaria medicine is best for your child. Many of these drugs 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. Malaria drugs are not 100% effective, and other diseases are also spread by insects, so children (and their parents!) should avoid bug bites, even if they are taking malaria medicine.

Rabies

Rabies is spread through animal bites or scratches. Although it is rare, rabies is almost always fatal if not treated promptly. Rabies is more common in children than in adults because children are more likely to try to pet strange animals. Tell your children to stay away from all animals, but reassure them that if they do get bitten, they should tell an adult immediately. Any animal bite should be washed thoroughly with soap and water and must receive medical attention as soon as possible.

Road Safety

Car crashes are the leading cause of death in children who travel abroad. In general, children are safest traveling in the back seat, but no one should ever travel in the back of a pickup truck. In many developing countries, cars may lack front or rear seatbelts.

When using transportation or renting vehicles in other countries:

  • Make sure there are seatbelts and other safety features.
  • Children should always ride in age-appropriate car seats when traveling.
  • Plan to bring car seats because they may not be available in many countries or meet US safety standards.

Drowning and Water-Related Illness and Injuries

Drowning is the second leading cause of death in children who travel abroad. Children should be supervised closely and should always wear a life preserver around water. Children should not swim in fresh, unchlorinated water such as lakes or ponds, because some infections (such as schistosomiasis and leptospirosis) are spread by contact with fresh water.