Traveling with your child: get ready!

Dear Parents,
We know that traveling with children requires proper preparation and that this can often be difficult. To help you ease this task, we have put together some health advice addressing the special needs of your traveling children!


Where to start?

It is best to consult a health professional at least 6 weeks before departure. This assessment allows you to know the health needs according to your itinerary and chosen activities.


Should children be vaccinated before departure?
Traveling children are at high risk of contracting vaccine-preventable diseases. Find out about the recommended or required vaccines depending on the country of destination and make sure your child's immunization schedule (routine vaccine) is updated before you leave.

What health problems are most likely to occur during a trip and how to prepare for it?
1. Barotrauma

Your child may  experience ear discomfort or pain during pressure changes in the aircraft cabin, most often during landing. If this is the case, encourage infants and young children to chew, suckle or drink (suck, breastfeed, nursing bottle). Swallowing, chewing or performing the Valsalva maneuver (pinch the nose and gently blow through the nostrils) may be suggested to the older ones. Depending on the age of your child, the use of a topical nasal decongestant can also be considered 30 to 60 minutes prior to take-off and landing.


2. Time Difference
Your child may experience jet lag, especially if you have to cross several time zones. It can be more difficult to fall asleep at night, wake up earlier than usual, cause irritability or even make him or her sleepy during the day. Since it has not shown any benefit in children with jet lag, Melatonin is therefore not recommended in children for this indication.
These measures may be helpful: adjust to local time, spend time outdoors during the day and plan short naps if necessary.

3. Motion sickness
Children between the ages of 2 and 12 are at greater risk of discomfort while using a mean of transportation. Your child may experience nausea, vomiting, and dizziness. In prevention, you can advise your children to avoid reading while the vehicle is in motion, encourage them to look at the horizon and choose seats where movements are felt the least (eg. in mid-cabin of a plane or the lower deck of a boat).
Depending on the age of your child, using a drug such as Gravol® (dimenhydrinate) or Gravol® Ginger (ginger root) may be considered 30 to 60 minutes before traveling. Transderm V® (scopolamine) patches are not recommended for children under 12 years of age.


4. Mosquito bites
Insect bites can transmit countless diseases, including malaria (malaria), dengue fever, yellow fever, Japanese encephalitis, etc. Protect your child from bites by using physical barriers: mosquito net, long pants, neutral-colored and pale long-sleeved clothing. Chemical barriers, such as DEET or icaridine, can be used in children from the age of 6 months.

5. Malaria
If you plan to travel with your child to an area at risk of malaria, be sure to protect them from mosquito bites. Some medicines may be prescribed for prevention, such as Malarone® (atovaquone-proguanil), Aralen® (chloroquine), etc.

6. Elevation sickness
High altitude sickness can develop rapidly in children and can be difficult to diagnose because the signs and symptoms can be easily confused with other diseases (nausea, vomiting, irritability, etc.). In general, it is best to stay at an altitude of less than 2500 meters. However, if a trip is planned in an area where the altitude exceeds 2500 meters, a gradual rise of maximum 300 meters per day is suggested with rest days every 1000 meters. In some cases, the use of acetazolamide may be considered for prevention.

7. Traveler diarrhea
Travelers' diarrhea can cause more complications in children, as they dehydrate more quickly. If this happens, prevent dehydration with fluids or an oral rehydration solution such as Gastrolyte® in sachets. An antibiotic such as ZithromaxTM (azithromycin) may be prescribed before departure and should be used in case of persistent diarrhea. Depending on the age of your child, antidiarrhoeal agents such as Imodium® (loperamide) may also be considered.

8. Other food and water-borne diseases
To avoid the risk of contracting diseases transmitted by food and water, make sure your children:

  • Wash their hands often, for example: before eating, after using the washrooms, after being in contact with animals or sick people

  • Drink potable water: boiled, bottled and sealed, or having been disinfected. Objects should also be cleaned with disinfected water (bottle, teething ring, pacifier, toothbrush, etc.)

  • Avoid unpasteurized dairy products, undercooked meats, and raw or undercooked fish and seafood.


9. Sunburn, heat stroke and dehydration
Make sure that your children are well hydrated and that they are well protected from the sun: sunglasses, wearing a hat and long, ample and clear clothes, sunscreen SPF 30 and more (in children aged 6 months or more). In the event of a hot and humid day, it is recommended to avoid going out during the warmest time of the day (often between 10 a.m. and 4 p.m.) and to postpone activities requiring a lot of physical effort.

Other important information

Can my child approach animals?
It is preferable to avoid contact with animals, especially dogs, monkeys, snakes, rodents, birds and bats. These animals can transmit certain diseases, including rabies. In case of bite or scratches by an animal: if possible, clean and rinse the area with soap and water for 15 minutes and consult a doctor immediately. The rabies vaccine may also be considered before departure.

From what age can my child travel by plane?
To ensure that the child is healthy, most airlines require the child to be at least 1 to 2 weeks old before boarding. Contact the air carrier before purchasing the tickets to make sure.

Are there any contraindications to flying for a child?
Some children prone to hypoxia (eg, cystic fibrosis, cardiopulmonary disease, etc.) may be more vulnerable to decreased partial oxygen pressure in the cabin. A medical consultation is recommended before the flight to assess the need to receive oxygen on board the aircraft.
According to expert opinions, children with acute otitis media should wait 2 weeks after diagnosis before taking the plane if possible.


Should I prepare a health product package and if so, what should I include?
Some health products can be difficult to find upon arrival to the destination. Prepare a kit that suits your needs and those of your children. Here is a list of products that may be needed: https://voyage.gc.ca/voyager/sante-securite/trousse.

Are there any documents required for international travels?

  • Copy of the vaccination record and the original International Certificate of Vaccination or Prophylaxis as proof of vaccination against yellow fever if applicable (or other proof of vaccination required by the country of destination).

  • Letter of consent: allows your child to travel outside the country if traveling alone, accompanied by a single parent or guardian, or if traveling with friends, in a group, or with members of the kinship. Note that any Canadian under the age of 18 or 19 (depending on the province or territory of residence) is considered a child. For more information: https://voyage.gc.ca/voyager/enfant/lettre-de-consentement

  • Valid Canadian passport: mandatory from birth for any Canadian traveling internationally. For more information: http://www.cic.gc.ca/english/passport/children/index.asp

  • Document confirming your child's identity

  • A legal document that may be useful (eg court order for custody of children)


Good preparations and good trip to the whole family!


References

  • Advisory Committee on Tropical Medicine and Travel Medicine - Volume 36 DCC-3 (June 2010) - Declaration on Young Travelers: https://www.canada.ca/en/health_service/services/reports- publications / notes-communicable diseases-canada-rmtc / numero-monthly / 2010-36 / notes-communicable diseases-canada / notes-communicable diseases-canada.html

  • Canadian Pediatric Society - Air Travel and Children: http://www.cps.ca/en/documents/position/path-english-and-children

  • Health Canada - Health tips for traveling with children: https://voyage.gc.ca/voyager/sante-securite/enfants

Stephanie El-Chakieh