We all know that kids never get sick at convenient times but what happens when its really inconvenient? Like when you are traveling on your dream vacation to that bucket list destination?? I hope this post will help calm some fears and give you a few tricks up your sleeve so that you can still enjoy your trip and look back and laugh at the memory of it before you even unpack the suitcases.
The initiative to write this post happened when I took my family of five to Paris over the summer (read our entire trip recap here!) when one of my twins, Micah, got sick. He doesn't get sick all that often but he has always been pretty sensitive when he is exposed to any kind of respiratory illness because he and his brother Quinn were born prematurely and their lungs were a little underdeveloped. He doesn't have asthma but can have similar symptoms when he is sick, much more so then Quinn. I should also mention that I am a registered nurse with a background in the intensive care unit, so my comfort level dealing with sick kiddos is probably a bit different from most.
Now that you have some background information, flash back to the summer of 2015. We've just landed in Paris after a long but easy travel day. Micah is looking especially worn out and while I hold him waiting for our bags to arrive, I notice he is hot with a fever. When we get to our hotel at the airport, he is burning up and as he has gotten hotter he is also breathing loudly and starting to cough and it sounds like a seal barking. Those are classic symptoms of a respiratory illness and now I know what I'm dealing with so I go into nurse mode. I always travel with a thermometer, Tylenol (acetaminophen), Advil (ibuprofen) and Benadryl (diphenhydramine) as well as inhalers for the twins (medicines they breathe directly into their lungs). I get him some medicine for the fever, a fast but cool bath and a few puffs on his inhaler before I settle down with him for the night. The rest of the family including our nanny has been quarantined to our connecting hotel room in the hopes of keeping them from getting sick too. We make it through a rough night of fevers and coughing and in the morning he is no worse off but definitely not any better. We travel into the city, get checked into our rental flat and get Micah a nap while my husband and our other kiddos get in some light exploring. When he wakes up he still has a fever and his inhaler isn't helping as much as I would like. At this point, if we were at home, I would have given him a nebulizer treatment (a machine that turns a liquid medicine into a vapor that he breathes in slowly over 15 minutes to help make it easier for him to breathe). But we are not at home and I do not have the machine or the medicine he needs. When my husband gets back, I tell him we need to find a hospital for Micah. This isn't an emergency but it also isn't something we could have waited through another night to deal with. Thank goodness for our nanny! We left the two healthy kids with her and went to catch a taxi to the hospital. The taxi driver took us to Hôpital Necker – Enfants Malades and we received excellent care despite my dismal attempts at communicating in French. Luckily for us, one nurse and the physician both spoke very good English. Micah got the medicine he needed and a few extra prescriptions too. We were back home 3 hours later with all of us feeling much better. The experience left me wondering, though, what would a family do in the same situation but without my expertise and comfort with medical situations?
Back To Basics:
Preparation is crucial when traveling with kids, whether you are going to the park across the street, grandma's house across the state, or vacation across the world. If you take the time to pack all the essentials, chances are pretty high you won't be needing them, but that Murphy and his law can be a real son-of-you-know-what. Use this section as a reference for planning, what to pack and a quick info guide for help when abroad.
Before you go:
Depending on where you are traveling, you may need some extra medications to help keep everyone healthy. These types of medications can be discussed with your pediatrician or you might be referred to a travel clinic or infectious disease doctor that specializes in understanding the disease risks around the world. They will be able to provide you specific information about your risks based on the activities planned for your trip and the area of the world you are visiting. This can include antibiotics, anti-malarials, medicines to treat travelers diarrhea and vaccines beyond the recommended schedule for your home country. In some cases, certain vaccines may be required for you to be allowed to enter a country. It is best to look into this a minimum of 8 weeks prior to your departure date. Some require a series of doses to be taken at specific times or take time to allow for immunity to build up. A great resource to have is the Centers for Disease Control website. It is very user friendly and easy to find the information you need. Follow the link here and select your destination under the "Travel's Health" tab. If it's been a while since your kids were last seen by the pediatrician, call and get updated doses for your fever medications (you'll need to know how much the kids weigh currently).
Packing Essentials List:
- Any medication your child takes on a daily basis (and double check you have enough for the duration of the trip and a few days once you return).
- Any medication you use for your child routinely when they are ill (for example inhalers, Benadryl, eye drops, ointments, etc).
- Medication to treat a fever (in the USA, Tylenol or Advil are the most common) and the cup or dropper that comes with it.
- A digital thermometer.
- Hand sanitizer or sanitizing wipes.
- A first aid kit containing disinfecting wipes (such as alcohol or betadine), band-aids, gauze, adhesive tape, safety pin, and tweezers.
- Mosquito repellent containing DEET or Picaridin and mosquito nets for cribs and strollers.
- Diaper rash cream for kiddos in diapers or pull-ups.
- If you are traveling with a baby who is using bottles, bring some cleaning wipes along to wash your bottles if you are traveling to an area where the water may not be safe to drink.
Staying Healthy Tips:
- Wash your hands with soap especially after going to the bathroom, before cooking or eating and any time you have been around animals .
- Drink bottled water and ensure that the safety seal is not broken prior to you opening the bottle. Avoid ice. In areas where this is a problem, drinking sparkling water will ensure that the contents are safe to drink.
Resources to Find Help Abroad:
- Its a good idea to know the emergency number of the country you are visiting. Most numbers will work from any mobile phone and in some cases even without a SIM card present. Here are a few of the most common emergency numbers from major regions around the world:
-You can also use this link to a PDF file for individual countries emergency numbers.
- If you find that you are in need of medical care while abroad and your hotel is unable to help find you a hospital, the US Embassy website has a list of medical facilities and hospitals for most countries in which there is an embassy location. From the US Embassy homepage select the region of the world you are in, then the specific country from the list and finally look under the US Citizens Services tab (you'll have to do a little searching here as each country has its own choices from the pull down menu).
Worst Case Scenario:
Despite all your careful planning and packing your Wanderlittle has come down with something, now what? Take a deep breath, trust your gut and use these tried and true interventions to help soothe your kiddo until they are better or you get somewhere with more resources. (Obviously, we are not your doctor, so this is just general advice you should use under the guidance of your actual doctor!).
Scenario 1 The Fiery Fever:
Definition: A body temperature over 100.4 degrees F or 38.0 degrees C
Goal: Return body temperature to normal range (below 100 degrees F or 37.8 degrees C)
Interventions: Remove clothing and bedding until child is in light undergarments and thin bedsheet. Keep child in a cool environment. Offer chilled beverages. Give fever reducing medications. If fever is very high (104 degrees F or 40 degrees C) and has not come down with medicines consider a cool bath. Fill tub or sink with 2 inches of cool water, place child in bath and sponge water over back, neck and chest briefly.
Things to Remember: A fever is a good and natural effect of the body when exposed to a germ or virus. Fevers can come and go for 2-3 days on average.
Seek Emergency Help: A fever over 105 degrees F or 40.5 degrees C. Your child is difficult to wake up. They have a stiff neck or cannot put their chin to their chest. The fever is accompanied by a rash that does not whiten with pressure. Use the glass test: set a glass on the rash, if you can see the rash under the weight of the cup seek medical attention.
Scenario 2 The Tummy Troubles:
Definition: Vomiting (forceful emptying of the stomach) usually accompanied by abdominal discomfort or diarrhea (increase in frequency and looseness of stools).
Goal: Maintain hydration to replace fluids lost through vomit or diarrhea.
Interventions: Keep your child drinking, small amounts offered frequently. A good guideline is 1 spoonful of liquid every 5 minutes until 4 hours after the last episode of vomiting. This also means you may need to wake your child to have them continue to drink. Pedialyte or oral hydration salts are best, followed by half strength sports drinks. Fruit juice should be avoided due to excessive sugar. Safe drinking water can also be offered to maintain hydration initially. If no vomiting for 4-8 hours, increase amount of fluids given and after 8-24 hours of no vomiting offer small bites of white, starchy, bland foods (BRAT diet-bananas, rice, apples, toast).
Things to Remember: Usually caused by a virus and lasts 6-24 hours. Loose stools can persist for several days afterwards but should decrease in frequency after the first 24 hours.
Seek Emergency Help: Your child is difficult to wake up. They have not urinated in the last 8 hours. They complain of severe abdominal pain. Has vomited clear liquids more than 3 times and has had more than 3 diarrhea stools. There is blood in the vomit or stool.
Scenario 3 The Cantankerous Cough
Definition: A wide range of bacterial or viral illness that affect the airways (nose, mouth, throat and lungs). A cough is one symptom of such an illness and is the forceful expulsion of air from the lungs.
Goal: Make the effort of breathing easy and calm the cough so the child can rest.
Interventions: Position your child upright or on an incline to sleep. Perform saline nose rinses prior to sleeping to keep secretions cleared and airways opened. Encourage your child to keep drinking to help loosen secretions and soothe the throat. Honey may be given to children over the age of 1 year, 1 spoonful at bedtime. Warmed apple juice can also work well and can be given to kids under 1 year. Apply Vicks vapor rub to the soles of the feet. Have your child breathe humid air by running the hot tap in the bathroom to create a steam room. If able to, alternate the steam room with cold air (outdoors or from a mini bar fridge).
Things to Remember: A cough can last 2-3 weeks. A dry cough may become wet and productive of mucus just before it goes away.
Seek Emergency Help: Your child is working very hard to breathe, their breathing is very noisy or they are breathing very fast. If your child's lips are blue colored. Your child is difficult to wake up. Your child is not able to swallow anything, including their own saliva.
I truly hope you never need to use this post but it's great info to have in the back of your mind, just in case. If you have any questions, please consult your regular doctor so they can provide you with specific information according to their knowledge of your travel plans and in consideration of the health of your child. The bottom line is that we all love our kiddos, no matter where we are in the world, and we would do anything for them. Happy travels and stay healthy!
Have you ever encountered a medical emergency with your kiddos while traveling?? What did you do??
112 (emergency telephone numbers). (2016, February 29). Retrieved from https://en.wikipedia.org/wiki/112_(emergency_telephone_number)
Centers for Disease Control and Prevention. (2016). Retrieved from http://www.cdc.gov/
Emergencies 911 Abroad. (2016). Retrieved from https://travel.state.gov/content/dam/students-abroad/pdfs/911_ABROAD.pdf
International Travel and Health. (2016). Retrieved from http://www.who.int/ith/en/
Schmitt, B. (2005). Your Child's Health. New York, NY. Bantam Books.
Website of US Embassies, Consulates and Diplomatic Missions. (2016). Retrieved from http://www.usembassy.gov/