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Important Advisories to Remember

Traveling with baby

Travelling with baby

Common Tropical Diseases in SEA

Singapore:
1) Dengue
2) Chikungunya

Southeast Asia:
1) Malaria
2) Hepatitis A
3) Hepatitis B
4) Typhoid

Symptoms to look for

Dengue symptoms
  • Sudden, high fever
  • Severe headaches, pain behind the eyes
  • Severe joint and muscle pain
  • Fatigue, loss of appetite
  • Skin rash (usually 3-4 days after fever starts)
  • Mild bleeding (such a nose bleed, bleeding gums, blood in stool)
Chikungunya Symptoms
  • High fever, skin rash, joint pain
  • Fatigue and body aches can persist for a few weeks
  • No bleeding risk

Important to remember

Dengue, Chikungunya and Malaria are all mosquito-borne infections that can be potentially fatal.

Dengue and Chikungunya are viral infections, which are caused by viruses that are transmitted by the bite of the female mosquito Aedes aegypti. This mosquito is black with white stripes and bites in the daytime.

Malaria is a parasitic infection that is caused by transmitted through the bite of the female Anopheles mosquito that usually bites at night.

Hepatitis A – viral infection, causes inflammation of the liver, contracted from contaminated food or water.

Hepatitis B – Viral infection causes inflammation of the liver, contracted through blood, blood products, and bodily fluids. Modes of transmission include dirty needles, blood transfusions, and sexual contact.

Typhoid – a bacterial infection transmitted via contaminated food and drink.

Other less common tropical diseases include rabies, Japanese encephalitis and cholera. Yellow fever is present primarily in Africa and South America.

Travelling with baby

Travel Vaccinations for babies

  • Childhood vaccines (usually includes Hepatitis B) – ensure these are up to date
  • Hepatitis A – from the age of 12 months
  • Typhoid – from age two years
  • Tetanus/ Diptheria/Pertussis – safe
  • Polio – safe
  • MMR – safe
  • Hepatitis B - safe
  • Hepatitis A – insufficient knowledge, immune globulin can be given if exposed
  • Cholera – insufficient knowledge, consider benefits vs risk
  • Typhoid - used when the risk of exposure to typhoid fever is high
  • Yellow fever – Avoid, however, must be given if travel to high-risk yellow fever-endemic areas is unavoidable.
  • Rabies – insufficient evidence, but no harm observed in breast-feeding mothers who have been given this vaccine
  • Anti-malarials – small amount may pass through the breast-milk – so risk vs benefit must be discussed with your doctor

What other measures can I take to protect my baby and me from mosquito bites?

  • Mosquito nets on travel cots/ car seats/ prams
  • Minimize the area of exposed skin by wearing light cotton clothing that is light-coloured. This attracts fewer mosquitos than dark or brightly-coloured clothes.
  • Stay indoors during dusk and dawn
  • Stay in air-conditioned rooms or use a fan, use a pram fan
  • Reduce stagnant water in and around the home
  • Use of mosquito repellent – natural vs chemical, spray

Chemical mosquito repellent:

  • The most effective is DEET (N,N-diethyl-meta- toluamide). DEET of up to 30% can be used safely in children older than 2 months.
  • 10% DEET provides protection for 2 hrs, 20% effective for 4-5hrs.
  • Picaridin 7%, which lasts 2 hours and is less irritating and smelly. It is equivalent to using DEET 10%.

Natural remedies:

  • Lemon Eucalyptus oil 30% is equivalent to 10% DEET.
  • Citronella oil, has the least anti-mosquito activity, and does not last long so reapplication is required. Can be found in a spray or impregnated bracelets and patches
  • Use of mosquito plug-ins with citronella oil or use of mosquito coils
  • Use of essential oils
  • Homeopathic medicine

General Travel Advice for Mums and Babies

  • Drink bottled water, avoid tap water
  • Avoid drinks/smoothies with ice-cubes made from tap water
  • Consume well cooked food
  • Avoid salads or fruits that are washed in local water, eat fruits that can be peeled
  • Bring your own baby food

Flying to the Other Side of the World With Baby

Take-off and landing builds pressure in baby’s ears. Breast or bottle feeding, using a pacifier can help baby to clear their ears. It is the suck and swallow action that helps to clear. If your baby is chronically snuffy talk to a physician about nose drops and possibly other medications to help clear congestion that can help ease the pressure.

What to Pack in the Carry-On Bag

Handful of diapers
Change (washable) cloth to lie baby down for diaper changes
Plastic bags
Clean wet face clothes in a Ziploc bag
Dry face cloths in a Ziploc bag
Wet wipes
2 sets of clothing for baby
1 set of clothing for Mom (diaper blow out does not always stay on the baby)
-make sure the clothing is light and does not take up too much room
Medications: Any prescribed meds for baby with labels, Paracetamol, Neurofen.
Formula powder separated into portions in small containers or Ziploc bags, labelled
Cloth baby sling
Clean empty baby bottles x 2
Favourite small toys or snuggle thing, pacifier, soft book
Bottled water can be purchased at the airport or on the plane

Practical Ways To Conquer Jet Lag

  • Start your journey with a good night sleep the night before
  • If possible, make sure children have been involved in physical activity before the flight
  • Move your watch immediate to the destination time zone on boarding the plane
  • On arrival at your destination, if it’s still daylight, don’t be tempted to take that immediate power nap at the hotel if it can be avoided
  • Avoid the long afternoon nap, if a little something is needed to get everyone through, set an alarm for 20 minutes (before you/they go into a deep sleep) then get everyone going again even if it’s just a quick walk around the block to get re-energized ready for the evening it will help
  • Equally if you arrive at night and it’s already bed time, get everyone settled as quickly as possible (I always pack PJ’s at the top of our luggage, or even better get them changed before the plane lands so the bedtime cues are there – it may also pay at this point to feed them before leaving the plane/airport or having a pre-packed dinner with you)
  • If possible, try not to share a room, so that one person’s early waking doesn’t impact on everyone
  • Try to eat at local meal times as quickly as possible, even if not hungry, and a good meal right before going to bed so you don’t wake early with hunger pangs
  • If everyone’s still sound asleep at your usual breakfast time, it’s well worth waking them early and getting the day started. (I also bring little cereal containers with me now in case nothing is immediately available of they don’t like breakfast selection they’ll eat something straight away and get the body kick started)
  • Don’t spend your recovery day cooped up inside, try to get out and about and some natural daylight and physical activity. Most important to do this around the point in the day that is normally bedtime so the body sees it’s not getting dark, I need to be awake. This might be the time when a little sugary snack to get them through the last couple of hours until bedtime may pay off
  • If little ones are waking exceptionally early and you’ve given in (do tell them it’s still sleepy time and try to resettle first), keep activity in a quiet, dimly lit room if you can to carry on the perception of night-time
  • Flying at night should increase the chances that your child will sleep on the plane, therefore be somewhat rested on arrival, meaning there is only one day to get through at your destination before trying to get to bed at the right time
Travelling with baby

Sun Protection

Skincare.org recommends that babies under 6 months of age be kept in the shade and to avoid direct sun exposure sun the sun’s hottest hours because melanin in baby’s skin is still forming.
Using light UV Protection clothing is best for baby’s skin.
Brimmed or bucket hats to protect the nose and ears from sun damage.
UV filter sungalsses are also recommended, so invest in a pair for baby as well.

Sunscreen

Can be used for babies older than 6 months of age.
Consider a broad-spectrum, water-resistant sunscreen that offers a minimum sun protection factor (SPF) of 15.
Active ingredients such as zinc oxide and titanium dioxide are good choices as these physical filters don’t rely on absorption of chemicals and are less likely to cause a reaction.
Consider testing the sunscreen on a small area on the inside of your baby’s wrist. If there is little irritation then choose another sunscreen. Use sunscreen on all exposed areas, include the back of the hands, face, ears and neck.
Apply 30 minutes before going out and reapply it every two hours or more frequently if you take your baby into the pool or if he or she is sweating.
Continue to wear UV protection clothing and brimmed hats.

Travelling with baby

Swimming

Most parents find swimming for the first time to be daunting or worrisome, however there is nothing to worry about.
There are swimming lessons created for infants from three months of age, although babies can start swimming from birth. Do note that babies can chill easily, thus consider the temperature of the pool.
Check with your physician when you should start swimming with baby
Before going to the pool, prepare baby with playing in the bathtub, immersing baby in water and splashing the water. Build confidence in the bathtub and carry that on while in the pool.

Benefits of Swimming

Family time together, in today’s busy schedules, this is uninterrupted family quality time
Builds water confidence early. Going into the water together will build parents’ confidence of water. Also, baby’s confidence also develops as baby sees parents in water assures them this is a safe place in and around water.
Teaching water safety early
Improves coordination and balance. Babies need to focus on balance in the water, thus makes it easier on land.
Builds muscles, strengthens muscles effectively
Physical activity also strengthens hearts and lungs
Bonding time with parent and baby in the water.
Swimming improves sleep, as exercise and physical activity helps for a more restful sleep
Improves appetite. Lots of gentle exercise in warm water makes a baby hungry. Bring a snack for directly after pool time.

Wild Animals and Illnesses

Diseases like rabies can be transmitted from animals to humans.
Children are considered at higher risk of rabies because they often play with animals, are less likely to report bites or scratches and are more likely to be bitten in the head and neck area.
Warn children about the dangers of approaching animals; however, reassure the child that if they get bit or scratched, they won’t get into trouble and they should immediately tell an adult.
If your child is bitten, scratched, or licked on broken skin or mucous membranes (eyes, nose and mouth), it is important to clean the area thoroughly by washing and flushing with soap and water for at least 15 minutes and seek medical assistance immediately to assess the risk and discuss treatment options.

Travelling with baby

Travel-Related Stress in Children

Children feel parents’ stress and the change in routine, some more than others
While packing and preparing for the trip try to maintain a similar routine and slowly incorporate the idea of traveling to your child.
Use the same clothing, foods, small toys to minimize the change.
Traveling to unfamiliar environments can create additional stress. Maintain usual habits and reassure the child often.
For older children, familiarize them in advance with the food, customs, and language of the destination and involve them in developing the travel itinerary.
For younger children, a favorite toy or special snacks may help them adjust to a new environment.

Please speak to your doctor or your well-baby nurse today if you are unsure or have any questions regarding safe travel with baby.

Complete Healthcare International
An integrated Medical Centre
350 Orchard Road #10-00 S238868
Tel : (+65) 6776 2288
enquiries@CHI-health.com.sg
www.chi-health.com.sg



Complete Healthcare International Pte Ltd reserves all rights of copywriting of the above article – Singapore April 2018

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