There we were in Paris, my teenage daughter and I. I had looked forward to this trip— to the rare opportunity of time alone with her, to many colorful macarons, and to as many bistros, museums, and winding side streets as we could squeeze in between bakeries.
Instead, a few days after we arrived, I woke up in the emergency room at Hôpital Pitié-Salpêtrière, Paris’ largest medical center, frantically looking for my kid, who was just fine sitting at my bedside. I, on the other hand, was disoriented with one side of my face swollen to twice its normal size. Apparently, I tripped and slammed face-first onto the cobblestones outside Notre Dame Cathedral, breaking my facial bones in two places.
Now that my daughter is grown, we laugh about the fall— it inspired her to become a nurse. Mostly about my ignorance: I did not bring our insurance information on the trip, or copies of our current medical records or prescriptions. I had not purchased trip insurance. All of which would have really helped my providers—or hers if she’d needed medical care.
I tell this story to prove the point: traveling abroad with kids at any age can be a wonderful adventure, but a little preparation and planning go a long way when emergencies arise for you or your child. That’s why I asked Mollie Greves Grow, MD, MPH, a pediatrician with Seattle Children’s Hospital, what parents should consider, medically speaking, when going international with kids. Grow said she’s fielded this question quite a lot in her practice. Here’s what I learned:
1. Do your research.
“Do some homework about where you’re going and the things you are going to be experiencing and encountering, then do the prep work around recommendations for travel to that country or area,” Grow said. The CDC Yellow Book, which provides travel information and alerts, is a good resource.
There’s no single source for domestic health alerts. Check the CDC Outbreaks page, state and county health department websites, and the National Weather Service for disease outbreaks or heat, wildfire smoke, and hurricane alerts.
2. See a travel medicine clinic early.
The American Academy of Pediatrics (AAP) recommends seeing a travel medicine specialist 4–6 weeks before international travel outside north Americaa to ensure vaccinations are up to date and to obtain required medications for your destination. Both Passport Health in Seattle and Lynnwood and the Travel Medicine Clinic at UW Medical Center – Northwest are good options. “This is one of the best preventative things people can do–being prepared around what things they might be exposed to in traveling,” Grow said.
3. Use precautions.
Be sure the kids practice hand hygiene and consider wearing masks on planes or whenever you are in close proximity with people, especially if a child or parent has a high-risk condition.
4. Assume there will be gut stress.
Americans are likely to run into stomach and other GI bugs while traveling, which means be prepared for nausea, vomiting, and traveler’s diarrhea. On this point, Grow added: “Know about sources of water and what water your family should be drinking when traveling. That’s particularly important for young children. Younger children are more likely to get dehydrated more quickly from vomiting or diarrhea.” Currently, for example, bottled water is advised in most of Asia, Africa, Latin America, the Middle East, and parts of Eastern Europe—that includes more than 160 countries where tap water may contain unfamiliar bacteria.
Water quality can shift anywhere in the U.S. as well, depending on weather and infrastructure. Check local county health department advisories or go to GoBLUTech.com and provide destination zip code.
5. Bring OTC and prescription travel medications with you.
Grow recommends taking antidiarrheal medications and antibiotics. Some medications are not recommended for infants or have specific dosing guidelines by age, so be sure to discuss all medications you plan to bring, prescription and over-the-counter, with your pediatrician or a travel clinic before dosing a child.
6. Be sure you have ready access to your and your child’s medical records.
Minimally, said Grow, “I think having screenshots of important medical records feels safe to many parents.” She added, “I am a big proponent of having access to a child’s records through electronic medical record apps, because they provide a lot more medical history.”
7. Have a clear plan for any medications kids take regularly.
This is especially needed for conditions like asthma and allergies, including food allergies.
8. Bring written prescriptions for any medications.
Just do it. Trying to get a written prescription when abroad can be fraught, given time and health system differences. Bring script for at least one refill of your child’s vital medications. Note that some drugs are not available in other countries.
9. Give yourself ample time to plan and prepare.
Grow recommends starting research and scheduling a visit with the pediatrician six months before traveling. “So many of the vaccines for travel need to be given in advance to allow for the effects on the body,” she added.
A last word to the wise
It might be tempting to give your child a Benadryl or some other cold or sleep remedy to help them through a long flight. Grow advises against this—kids’ reactions vary widely, from too sedated to wired.
On the plus side, although I didn’t have insurance in Paris, the hospital never sent me a bill. Even so, you can bet I won’t take grandkids to Paris without it.
*The original posting of this article included an image of an inhaler being used without a spacer. Please note that inhalers cannot deliver needed medicine to the lungs without a spacer.
