Tropical vacations can be a wonderful winter getaway for the whole family. But if young children are on the trip, extra steps should be taken to ensure a healthy holiday.
Children fall ill easily. After a long trip, perhaps involving a change in time zones, they may succumb to minor upsets. And, unless their vaccinations are complete, they are susceptible to serious childhood diseases. They also run the risk of contracting tropical diseases with more serious consequences than in adults.
The first step in planning a healthy tropical holiday is to review children's routine vaccinations with your family doctor, and possibly updating them. Vaccinations for common diseases such as polio, hepatitis B, whooping cough, tetanus, mumps, measles and rubella start at about two months of age in most provinces.
"Taking a newborn to visit family in the Caribbean or Mexico can expose him to these diseases," says Dr. Dianne Vosloo, a physician at Simon Fraser University in Burnaby, B.C., and at the Travel Medicine and Vaccination Centre in Vancouver.
Most doctors advise waiting until infants are at least six months old before taking them out of the country. By then, they'll have had their first run of shots and will be less fragile than newborns.
When the routine shots have been taken care of, Vosloo recommends talking to a travel health practitioner to find out whether health alerts for tropical diseases have been issued for your destination and how to protect your family against them.
Malaria is a major health risk for children, says Dr. Rick Rowland, manager of health services at Algonquin College in Ottawa. Parts of the Dominican Republic are currently considered malaria zones. "And so are parts of inland Mexico that can be accessed on day trips from the Mayan Riviera," he adds.
In addition to administering antimalarial medication, says Vosloo, "make sure hotel windows are covered by screens, or better still that rooms are air-conditioned. Use netting over beds and baby carriers. And make sure children wear long pants and sleeves outside. Clothing and bedding can be purchased that has been treated with permethrin, an insect repellent and insecticide.
"On children over two months use repellents with DEET," she adds. "Avoid applying repellent to cuts, lacerations and the eyes, and don't apply it to kids' hands, which frequently go into their mouths."
Bring along your own bug repellent because DEET levels may be higher outside Canada.
A nuisance for adults, travellers' diarrhea can be life-threatening in small children who easily become dehydrated. It's caused by contaminated water, so babies who are breastfed are protected. For infants on bottles, bring along packaged formula or powdered formula you can mix with boiled water. "Bring the water to a rolling boil," Rowland says.
Milk might not be pasteurized at your destination and should be avoided. Older children can drink packaged fruit drinks, commercial soft drinks, and bottled and boiled water.
Children can also take an oral prescription vaccine that minimizes the effects of travellers' diarrhea, two weeks prior to travelling, followed by a second a week later, Rowland adds.
If your child does come down with the malady, Vosloo recommends an oral rehydration solution to replace lost water and electrolytes.
"Don't stop feeding a child who is vomiting," she adds. "Continue breast feeding, formula and simple foods for older children.
"If a child is feverish, or has liquid or bloody stools, see a doctor," she says.
In many developing countries, dogs and cats are not pets and may have rabies.
"Kids are vulnerable because they're attracted to animals and will approach them," Vosloo says. "They're smaller in height, and may be injured around the head and neck."
A series of three pre-travel rabies' shots is fairly expensive and only recommended if you'll be visiting local communities.
"Teach children not to pet animals," says Rowland, who travelled extensively with his children when they were young.
"Have them tell you if they are bitten," Vosloo adds. "And see a doctor no matter how small the laceration is."
The sun's ultraviolet rays are stronger close to the equator, and children will need protection outdoors. Babies should be kept in shaded areas; they need to be fully dressed with hats. Children over six months should wear water-repellent sun screen with an SPF of 25 to 30.
"Many stores now carry sun-screening clothing designed to absorb the sun's most damaging rays," Vosloo says.
Mountain vacations are popular in inland regions of Mexico and South America, and children may suffer headaches, shortness of breath and lethargy from the higher altitudes. Unfortunately, there is no altitude medication children can take.
"Try not to fly directly to high-altitude areas," Vosloo says. "Take a few days to acclimatize at sea level, and travel gradually to your destination."
Motor vehicle accidents are the leading cause of death for Canadian travellers. Everyone in your party should wear seat belts -- if they're available -- and helmets in open vehicles.
And bring car seats from home for kids under 40 pounds. They may not be available at your travel destination.
Drowning is the second-highest cause of death for young travellers.
"Kids must be closely supervised near any water -- ocean or swimming pool," says Vosloo.
"Don't rely on others, certainly not life guards, to watch your children," Rowland adds. "Bring a favourite babysitter or a grandmother along if you think you'll need a break."