Advice for Child Travellers
Travelling with children requires practical consideration and careful planning. It is advisable to consult a travel health practitioner at least 6-8 weeks in advance of departure. The risks to health vary and many factors need to be taken into account such as destination, length of stay, planned activities, age and the general health of your child.
Vaccinations may be advisable for some destinations. The age of your child often determines which vaccines they may be able to receive and should have already received via the British National Schedule. Parents should be aware that some children may be too young to receive the vaccinations recommended for their chosen destination.Your health care practitioner can discuss additional preventative measures to reduce the chance of disease transmission in these circumstances, however you may be advised to change your travel plans.
The timing of vaccinations is important,some vaccines may offer disease protection within two weeks, whereas others may require over a month. Some vaccine schedules require two or more doses given over weeks or months before adequate protection is obtained.
Some vaccines are available free on the NHS, however, there may be a charge for some recommended vaccines. This should be taken into consideration when planning and budgeting for travel.
Children are at particular risk of severe and fatal malaria; parents are therefore advised to avoid taking infants and children to malarious areas. If travel is unavoidable it is imperative that infants and children are well protected against mosquito bites and receive appropriate chemoprophylaxis (antimalarials).
A) Awareness of Risk
Malaria is now predominantly a disease affecting Africa, South America, Southeast Asia, the Indian sub-continent and less so in Central America and the Middle East:
- individual country pages should be checked to determine the risk at the destination
- for further information see the malaria advice pages.
B) Mosquito Bite Prevention
- Parents and children must be aware of the risk and take precautions to avoid mosquito bites, including the use of repellents, nets and suitable clothing.
C) Chemoprophylaxis (antimalarials)
It is important to discuss antimalarial suitability with a qualified doctor, nurse or pharmacist:
- the choice of antimalarial is determined by the destination, age and weight of the child
- parents must supervise their child's antimalarial consumption and be careful not to exceed the recommended dose, overdosing antimalarials can be particularly toxic for children
- it is preferable to avoid crushing or breaking tablets, however, it may be necessary to crush some tablets in order to administer the correct dose. Qualified pharmacists should be able to offer further advice; tablet cutters can be purchased to help facilitate correct dosage
- infants and young children may resist taking medications, mixing tablets with jam, honey, chocolate spread or similar foods may make administration easier
- no antimalarial is 100% effective and should always be used in combination with mosquito bite avoidance
D) Diagnosis and Treatment
- Prompt diagnosis and treatment of malaria is essential and the importance of this should be stressed to all parents visiting malarious regions. Fever, occurring at least 7 days after exposure, is the most common symptom of malaria, but infection can develop even up to one year later.
- Symptoms in young children may be difficult to determine. Parents must be aware that any child returning from a malarious zone who seems ‘off colour’ or just ‘not their normal self’ should be screened for malaria promptly.
Rabies is spread through the saliva of an infected animal (particularly dogs, cats, monkeys and bats) via a bite, scratch or lick of mucous membranes or broken skin. There is no specific treatment available for rabies once symptoms develop and those that develop symptoms will die.
Children can be more likely than adults to be exposed to rabies. Natural curiosity and exploration may entice them to approach animals; fear of being chastised may make them conceal an exposure.
- It is important that children are aware of the need to avoid animal contact during travel and equally the importance of reporting any exposure that does occur.
Pre-travel rabies vaccination should be considered for children travelling to countries that are considered high risk for rabies. Please see the Rabies advice page for further information.
Children, especially young children may be more likely to be exposed to food and water borne illness during travel due to their natural exploratory nature and hand to mouth habits.
Risk can be reduced by frequent hand washing (or use of alcohol based hand cleansing gel when hand washing is not an option). Children should eat freshly cooked, hot food when possible and avoid raw food that cannot be peeled or cooked and unpasteurised dairy products.
Water for drinking, making up formula milk, diluting drinks and cleaning teeth should be bottled or boiled; see the Breastfeeding and Bottle-feeding advice page for further information.
Children and infants should be discouraged from drinking shower, bath or swimming pool water. Parents of toddlers may decide to take pre-packaged food with them.
Children suffering diarrhoeal illnesses can become dehydrated quickly, rehydration is a priority:
- clear fluids such as diluted fruit juices or oral rehydration solutions should be drunk liberally
- all rehydrating drinks must be prepared with safe water
- children with severe or blood/mucous stained diarrhoea, high fever or severe abdominal pain should receive medical attention immediately
Babies and children are particularly vulnerable to sunburn and over exposure to the sun can increase their risk of skin cancer later in life. Sunburn may also cause considerable pain and discomfort in the short term.
The safest way to protect children from sunburn is to use a combination of shade, clothing and sunscreen.
- use a sunscreen of at least SPF 15 which also has high UVA protection
- ensure sunscreens are applied generously to ALL sun exposed areas. Sunscreen should be applied 20 - 30 minutes before sun exposure
- remember that showering, swimming and sweating may remove sunscreen; ensure frequent application and consider water resistant sunscreens
- cover children up using clothing such as wide brimmed hat and long sleeved tops, closed weaved fabrics may offer better sun protection
- protect eyes from sun exposure, use sunglasses with a CE mark, UV400 label or that offer 100% UV protection
- seek shelter; avoid sun exposure between 11am and 3pm when sun is typically stronger
See the Sun Exposure advice page for further information.
Local health and safety regulations vary between countries and may not be at the same standard as parents are used to in the UK. Parents must be aware of this and make a judgement about the safety of their child using facilities abroad.
Equipment for young children such as high chairs, microwaves for heating food and changing stations may not be available at many destinations. Parents should be advised to thoroughly research the facilities available prior to travel.
Road rules vary country to country and age appropriate child seats may not be available at the destination. Parents should check this prior to travel and consider taking their own child car seats if necessary.
See the Accident Prevention advice page for further information.
Many countries do not provide the same access to medical facilities and treatments as the UK. Some countries may have reciprocal health care agreements with UK, see individual country pages for details.
All child travellers should be included in travel insurance policies, medical emergencies including repatriation should be included in the policy. See the travel insurance advice page for further details.
Parents should be aware of what to do if their child becomes ill whilst abroad including how to access emergency medical treatment. Parents should try and identify health care facilities prior to departure. Addresses for local services are usually available at larger hotels and from tour company representatives.
The Foreign and Commonwealth Office (FCO) provides details of the nearest British Embassy or Consulate that may be able to help locate health care facilities at the destination. Neither the FCO or Embassy will pay for medical care even in an emergency.
The International Society of Travel Medicine has a Global Travel Clinic Locator available on their website.