Paediatrics: Taking children on holiday

Taking children on holiday

Parents will often ask advice about taking their child on holiday. Here are some general guidelines to consider in well children. If a child has a chronic illness (e.g. diabetes, cystic fibrosis, CHD), consider whether they will re-quire access to special health needs and provide details of a local expert. Your local specialist should be able to help.

Travel vaccinations

International travel with babies and children has the added dimension of considering the right immunizations long before you go:

·  Babies in the UK receive routine immunization.

·  Exotic places usually means exotic diseases and therefore the need for immunization. Check with the National Travel Health Network and Centre (at M www.nathnac.org/pro/index.htm), country by country, in the travel itinerary.

·  Babies under the age of 6mths and many immunosuppressed children cannot be given yellow fever injection.

·  Babies under the age of 2mths can take antimalarial tablets if the family need to travel to an area requiring prophylaxis. Just as important for very young travellers are the use of a cot mosquito net, and other measures to prevent mosquito and other insect bites.

Flying with babies

Most international travel will require an airline flight. Mothers will not be allowed to fly if they:

·  have given birth in the last 48hr;

·  had a Caesarean section in the last 10 days.

Families may choose to fly after the baby’s 6-wk check. Modern commer-cial aircraft maintain ambient air pressure equivalent to 8000 ft (2500m) or less, even during flight at altitudes above 13km (43,000 ft). Healthy babies should tolerate this ‘altitude’ well, although children with respiratory dis-ease may need specialist consideration even if they do not usually require supplementary oxygen at home

Common medical problems encountered on holiday

Sunburn

This problem can be limited by the use of sun suits, hats, high-protection sunscreen, and being disciplined about exposure.

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Prickly heat 

This fine, red rash with tiny pimples is centred around imma-ture sweat glands. It can blister and be uncomfortable.

Diarrhoea

This can be serious in the very young if dehydration occurs. Children returning from abroad should be investigated with stool samples for bacteria, viruses and parasites if the diarrhoea is severe enough to present to hospital or has been present for more than 7 days. This is because some pathogens that require treatment with antimicrobial agents are more common in those returning from abroad (Giardia lamblia, Shigella and some Salmonella). (See NICE guideline).¹