As a new parent we have so many questions and fears about travelling with our children for the first time. After travelling with my son to India on a 30 hour one way journey for a 2 week vacation, I now know that vacation or travel plans are not as easy as they were pre baby.  And while there are tons of tips on how to get there, there is not much advice for how to manage once you arrive.

In my last post How I survived a Long Haul flight with a Lap Baby I discussed my inflight experience/nightmare and shared some tips. And now, in this post we will be discussing on concerns related to our children’s health once you arrive to your destination.

Infants are at high risk for many food related and waterborne illnesses. This is not because they are travelling to India or any other country. It is simply because their immune systems are not developed. This post discuses some of the practical issues faced by us on our trip to India. I reached out to Dr. Abha Sharma a General Pediatrician and an IBCLC (International Board Certified Lactation Consultant) to talk more in details about precautions and measures parents can take while travelling to a new country with their child.

Dr. Abha practices and resides in Southern California with her Husband and 2 year old Daughter. I am very thankful that she was able to take out some time from her busy schedule to attend to this list of questions and give us advice on how to prepare ourselves and manage our kids while travelling overseas. Follow her journey on Instagram @healthymamadoc for some great tips and advice on healthy and nutritious meals.

My hope here is to help all my readers with vital information of caring for their child’s health while travelling abroad .

What is a good age to make a long distance travel?

Newborn babies and young infants have developing immune systems and are more susceptible to becoming ill from diseases spread by cough and sneeze.  I usually recommend that parents wait until their baby is at least 2 months old to travel – waiting till 6 months is ideal. The Centers for Disease Control (CDC) strictly cautions against travelling with a newborn younger than 48 hours old; most airlines prohibit babies younger than 2 weeks old to travel without a Physician’s clearance.

What medications do your recommend to carry, to avoid catching cold and flu in flight.

It has been thought that secondary to recirculated air and limited ventilation in a confined area over a long duration of time, airline passengers have a potentially higher risk of infectious diseases. But, the good news is that one study by the World Health Organization (WHO) suggests that because the spread of infection is usually by direct contact, the risk is no different than that if you were travelling by train or bus.

If you have an older infant or toddler and are travelling by plane, make sure you carry non toxic sanitizing wipes with you. Germ laden surfaces such as the tray table and arms rests should be wiped down frequently – your little one may want to lick and chew on these repeatedly!

Most OTC Cough and Cold Medications are labeled for use in children above age 6, secondary to the potential for serious side effects and overdose.  Sticking with your little one’s regular diet, keeping them hydrated, and nursing them if you breastfeed, will help prevent illness and help them cope should they come down with the sniffles inflight.

Three items that I would definitely recommend parents take with them when they travel is a Rectal Thermometer, Fever Reducing Medication, and Powdered Packets of Oral Rehydration Solution (i.e. Pedialyte).  For fever, stick with Acetaminophen (Tylenol) prior to 6 months of age, and after they cross 6 months you can use Ibuprofen (Motrin) as well. Consult with your child’s Physician regarding safe dosing of these medications.

Is giving Benadryl recommended to help the baby sleep?

It is not recommended to give Diphenhydramine (commonly marketed as Benadryl) to children for the purposes of the side effect of drowsiness.  Diphenhydramine has the potential to cause several side effects in children, the most serious being overdose and allergic reaction.

What precautions are a must when a child is taken to a different country for the first time? (Vir was on formula and even though we carried bottled formula and took good care of sanitizing bottles he caught a fever and had diarrhea. He lost weight and wasn’t eating properly.)

Strict attention should be paid to hand washing and cleaning bottles, pacifiers, teething rings, and toys that fall to the floor or are handled by others.  The water used to clean these items should be drinkable water.

Parents should be particularly careful to wash hands well after diaper changes, especially for infants with diarrhea, to avoid spreading infection to themselves and other family members. When  handwashing facilities are not easily available, an alcohol-based hand sanitizer (containing ≥60% alcohol) can be used; hands should be then washed with warm water and soap for 15 seconds as soon as possible.  Hands that have visible soiling are preferably washed right away.

Dr. Abha Sharma with her beautiful family.

Is it important to get the child vaccinated for travel like for Malaria? At what age do you recommend it?

Malaria is a disease contracted from mosquito bite in an area endemic to this disease. To prevent transmission, the first step is to identify if you are travelling to an area with a recent outbreak. The website Cdc.gov/travel and your Pediatrician or Family Physician are great resources to assist you in this. Your Physician will determine if it is recommended for your child to take medication to prevent transmission of this disease.

General preventive measures include:

• Wearing lightweight clothing that covers the arms and legs, and wearing socks.

• Mosquito repellents used on skin can also be applied to clothing; it must be reapplied after laundering.
• Apply lotion, liquid, or spray repellent to all exposed areas of skin; reapply frequently.
• Avoid the outdoors from dusk till dawn, as this is the peak time for mosquitos to bite

Which fruits or vegetables should be avoided in a new country? Do your recommend and food we should carry? ( I carried liquid formula bottle, cereal and snacks but ran out of it and switched to Indian Nan Pro formula which I mixed with bottled water)

Don’t offer your child food from street vendors, and stay away from food prepared and served in unclean conditions. Raw or under cooked meat should be avoided. All raw fruit and vegetables should be washed, peeled and cut by you before offering it to your child.

Safe beverages include bottled carbonated water, boiled water, and water treated with chlorine or iodine.

If your infant or toddler is formula fed, I do recommend packing more powdered formula than you anticipate you will need. The constitution of formulas abroad may not be the same as the one you regularly use. Additionally, pack plenty of dry snacks that you normally keep at home; if your child is picky they may not like what is available locally.

How to handle breast feeding strikes while travelling? My son stopped breast feeding completely in India. I tried to feed him in the night. Once we were back in US, it took him over 2 weeks to get back to his normal feeding schedule.

A nursing strike during or after travel is not an uncommon issue – you can maintain your milk supply AND eventually get your baby back to the breast. During the strike, pump or hand express the milk at the same frequency as you would breastfeed. This helps maintain the supply and prevent infection; this expressed milk can be fed to your baby.

To help get your baby back on the breast:

• Nurse the baby during the night or while napping –  babies who refuse to nurse when they are awake will most often nurse when they are sleepy.

• Switch up the position you use to nurse.
• Rock your baby or walk around while nursing.
• Nurse in a quiet, darkened room.
• Maintain skin to skin contact when nursing
• Keep the baby close to you in a sling or carrier in between nursing attempts.

How long do infants, toddlers generally take to get over jet lag? What is the best way to help overcome jet lag? Vir took over 10 days to get over jet lag .

 In general, count one day for each time zone crossed to give you a rough estimate of how long it may take your little one to recover from jet lag.  Of course, direction of travel impacts recovery time – eastbound travel, i.e. from the New York to London, may be prolonged in comparison to your westbound return trip.  In order to reduce jet lag, adjust your child’s sleep schedule 2-3 days before departure (Some sleep medicine experts recommend doing this upto 4 weeks prior to the trip).  After arrival, encourage your child to be active outside or in brightly lit areas during daylight hours to promote adjustment.  When returning back from a trip, the same applies – make a trip to the park as soon as you can after reaching back home.

Any other recommendations you will like to give to new parents travelling long distances with babies for the first time ?

Discuss your travel plans with your doctor at least 4-6 weeks prior to your trip, so as to allow any preventive medications that are prescribed to be effective.

Review your child’s immunizations with your doctor, and make sure he/she is up to date with the recommended immunizations necessary for their age.  Other immunizations, including those providing protection against Typhoid fever, Bacterial Meningitis, and Japanese Encephalitis, may be recommended depending on your destination.

Ear pain can be an issue for infants and children during the plane’s descent and landing Pressure in the middle ear can be equalized by swallowing or chewing.  You can nurse your little one, offer them a bottle to drink from, or for your toddler, a chewy snack.

Lastly, if you plan on using your child’s car seat on the plane, make sure it is approved for use. Children weighing between 22 lbs and 44 lbs can use an approved restraint system called the CARES Child Safety Device.

I definitely learnt a lot from this interview with Dr Abha. I am SO glad that she was kind enough to accept my email and request to collaborate on this post. Thank you once again Dr Abha for your advice!!!

We both hope that this post truly helps all the new parents and parents to be, who are excited to travel with their new born babies. Good luck and safe travels!!

You can also follow Dr Abha at her social media accounts on other Twitter and Pinterest.

Check out the  Healthy Travel Packing List by CDC (Centers of Disease Control and Prevention)