Vaccines for children

Contact your child's healthcare provider about vaccines your child may need as early as possible before travel. The timetable for some vaccines may need to be moved up. And there may be other special vaccines needed, depending on where you are traveling.

Taking care with food, water, and insects

Be very careful about exposing children to different foods and water. Don't feed children any food that is uncooked. Also stay away from fruits and vegetables in developing countries, unless you peel them yourself. Children are at greater risk for traveler's diarrhea and other digestive infections. Take extra care when mixing infant formula with water. Use purified water to drink, make ice cubes, brush teeth, and mix infant formula and foods. You can use an alcohol-based hand sanitizer to disinfect objects. Take special care when cleaning pacifiers, teething rings, and toys that fall to the floor or are handled by others.

Keep children away from insects and animals to prevent the spread of disease. Some travelers question the safety of repellents in children. Reports of toxicity from DEET, the repellent in use since the 1950s, have been rare and were linked to incorrect use. The American Academy of Pediatrics and the CDC approve and support the use of DEET (10% to 30%) in children older than 2 months.

The CDC advises these tips to help protect your children against mosquito bites:

• Use clothing that covers your child's arms and legs.

• Use mosquito netting to cover cribs, strollers, and baby carriers.

• Don't use insect repellent on babies under 2 months of age.

• In children older than 2 months, don't apply repellent onto their mouth, eyes, or hands, or to broken or irritated skin.

• On children younger than 3 years old, don't use products that contain oil of lemon eucalyptus or para-menthane-diol.

• If using an insect spray, spray a small amount on your hands first and then apply it to your child's face. Don't put it on your child's eyes or mouth.

• Never spray the repellent directly on your child's face.

If your child has symptoms of fever, rash, joint pain, or red eyes, contact your healthcare provider and describe where you have traveled. A baby younger than 2 months of age with a fever of 100.4°F (38°C) or higher should always see a healthcare provider. Call your provider or get medical care right away if your baby is younger than 2 months old and has a fever.

Flying with children

Airplane travel can be exciting, frightening, and even painful for young children. Children are at greater risk for "popping" ears during takeoff or landing. It often causes pain. Due to an air pocket in the middle ear that is sensitive to air pressure changes, the changing altitude as the plane takes off or lands can cause discomfort in the ears. Small children are especially affected by blocked ear canals because their eustachian tubes are narrower than those of adults.

Swallowing or yawning usually helps "pop" the ears and ease the discomfort. Giving a bottle or pacifier to very young children can also help "pop" the ears. Try to keep the baby awake as the plane descends.

Older children can chew gum or drink a cup of juice.

Handling motion sickness

Children seem to be more prone to motion sickness than adults. An antihistamine can help prevent or relieve motion sickness, but its use is restricted by age. If your child gets motion sickness, discuss this with your child's healthcare provider before you travel and ask what medicine may help your child. Other ways to relieve motion sickness include:

• Eat a light meal or snack before and during travel.

• Sit in the area of a moving vehicle that has the least motion. In an airplane, this is over the wings. On trains and buses, it's near the front of the vehicle. On a ship or boat, the deck has the least amount of movement. The front seat of the car has less motion than the back seat, but it's not safe for children. They should always be secured in a car safety seat or a seat belt in the back seat.

• Encourage children to sleep during travel.

• Give children sunglasses to wear to reduce visual stimulation.

Other helpful hints for traveling with children

• Check with your travel agent about the best airplane seats for children. If traveling with young babies, ask for the bulkhead seats on long-distance flights. These often have infant beds that attach to the ceiling of the aircraft.

• Arrange for special children's meals ahead of time, especially if your child is a picky eater. Also carry along favorite foods and snacks, in case there is a shortage of meals. Be sure to take along enough infant formula and baby food for a 24-hour period.

• Unless you are certain that child safety seats are available at your destination, bring your child's seat from home. Many children also like the security of having their own car seat.

• Bring along plenty of games, toys, and books to keep your children quietly occupied. A child's rolling suitcase lets even young children carry on many of their favorite belongings.

• When visiting large attractions, arrange a family meeting place in case you become separated from other members of your family.

• Make sure your children know what to do if they get lost in a strange city, especially in a foreign country. Some experts advise giving children a necklace or card that includes your address and phone number while abroad. The children can keep the card with them at all times. But don't include their names.

• If your child has a chronic illness or a weak immune system, talk with your healthcare provider about special travel precautions you will need to take.

• If your child is an older teen traveling in a student group, consider the need for counseling about the treatment of common travel-related illnesses, the risks for sexually transmitted infections (STIs), prevention of sexual assault, and drug and alcohol use during international travel.

• If your children are visiting friends and relatives in developing countries, ask your healthcare provider about increased risks and prevention strategies related to such things as malaria, tuberculosis, and intestinal parasites.

• Consider taking a basic first aid course before traveling. Encourage older children to take the course with you.