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Travel Safety

We have all been there. Standing in a long line at the airport and sitting on an airplane with a young child – or maybe taking a long road trip in the car to a fun destination.

Travelling with children can be exciting and fun for the whole family, yet a plane or car ride as well as eating in unfamiliar restaurants and sleeping at hotels can not only be stressful for us parents but can pose potential hazards for our children.

The following information provides safety tips for travelling with children by plane or car and how to avoid germs in restaurants and hotels. Also, just in case you have to visit an unfamiliar hospital’s emergency room (ER), you will be better prepared.

Hopefully this information will allow for less stress and avoidance of accidents and infections while enjoying time with your child away from home.

For specific information on travel abroad with children, including specific illnesses and vaccines, go to International travel. Airplane safety is only covered here in Travel safety.

Planning for your trip

Supplies Just in Case

Preparation is very important before taking your child on a trip. Depending on your destination, consider these supplies to take along on your trip:

1.  First aid kit

2.  Your child’s regular medications

3.  Water and snacks

4.  Alcohol-based hand sanitizer

5.  Child-safe hand wipes

6.  Baby formula

7.  Diaper rash ointment

8.  Diaper changing supplies

9.  Children’s Benadryl or another antihistamine for allergic reactions

10. Insect repellent

11. Acetaminophen (Tylenol) rectal suppositories

12. Acetaminophen (Tylenol) or ibuprofen (Motrin) for oral use

13. Topical antibacterial antibiotics (Neosporine)

14. Sunscreen

15. A portable high chair. A compact, easy-to-pack high chair is invaluable on the road.

16. A new bag of safe toys for the car or plane.

17. A combination stroller/car seat.

Also, consider creating a medical history form for your child in case you end up in an ER that includes the following information:

•   child’s and parent’s name, address, and home phone number

•    blood type

•   immunizations

•    doctor’s name, address, and office and emergency phone numbers

•    health insurance information

•    a list of any ongoing health problems

•    a list of current medications 

•   a list of allergies to medications, food

A couple of useful planning tips I found from www.travelforkids.com include:

  • Involve the kids. Planning a trip carefully is the first step in insuring its success.
  • Plan for some down time every day of your trip. This could mean a leisurely bike ride, an afternoon matinee, a swim in the hotel pool or just reading a book.

Medical care

In all the excitement of planning a trip, it is easy to forget about what you would if your child needed medical attention.

Plan ahead:

  1. Check to see if a children’s hospital is near where you are visiting. If not, is their a facility where pediatricians evaluate children in the ER. If not, at least know the location of the nearest ER.
  2. Check to make sure the facility accepts your insurance.

For more information to prepare for a trip to the ER and what to expect, go to .

Traveling by Car

The following are a summary of recommendations from the American Academy of Pediatrics (AAP):

  1. Always use a car safety seat for infants and children under 40 pounds.  A rear-facing car seat should be used until your child has reached one year of age AND weighs at least 20 pounds.  Once your child is at least one year of age and at least 20 pounds, he can ride in a forward-facing car seat, but it is better to keep him rear-facing to the highest weight and/or height allowed by his car safety seat.
  2. A child who has outgrown their car safety seat with a harness (they have reached the top weight or height allowed for their seat, their shoulders are above the top harness slots, or their ears have reached the top of the seat) should ride in a belt-positioning booster seat until the vehicle’s seat belt fits properly (usually when the child reaches about 4’ 9″ in height and is between 8 to 12 years of age).
  3. All children under 13 years of age should ride in the rear seat of vehicles.
  4. Never place a child in a rear-facing car safety seat in the front seat of a vehicle that has an airbag.
  5. Children can easily become restless or irritable when on a long road trip.  Try to keep them occupied by pointing out interesting sights along the way and by bringing soft, lightweight toys and favorite CDs.
  6. With my kids, we play a game where you get points based on the type of animal or object that you see while driving (e.g., a cow is worth 5 points). We also play “I Spy” where they have to find something that I spot from the car while riding.
  7. Plan to stop driving and give yourself and your child a break about every two hours.
  8. Never leave your child alone in a car. Temperatures inside the car can reach deadly levels in minutes, and the child can die of heat stroke.

Travelling by airplane

Before travelling

  • Plan ahead: Take all essential items for the children in carry-on luggage: Take enough food, diapers, medicine, and other items to last through possible flight delays and lost luggage.
  • Bring along safe toys: Try to avoid bringing along toys that are sharp, heavy, or that break easily.
  • Consult your pediatrician before flying with a newborn or infant who has chronic heart or lung problems or with upper or lower respiratory symptoms.
  • Consult your pediatrician if flying within 2 weeks of an episode of an ear infection or ear surgery.
  • Sedative medications may cause over sedation or sometimes agitation. Benadryl can be useful for some children but, similar to any medication for sedation, should be administered as a test dose before travel to determine the effect on the individual child.

In the airport

Stressed about security lines at the airport? You’re not alone. Here is a summary of tips form the Transportation Security Administration (TSA) to make the screening process with your child a little less stressful:

The Screening Process

  1. Allow yourself and your family extra time to get through security.
  2. Talk to your children before coming to the airport about the security screening process.
  3. Let them know that their bags (backpack, dolls, etc.) will be put in the X-ray machine and will come out the other end and be returned to them.
  4. Discuss the fact that it’s against the law to make threats such as; “I have a bomb in my bag.”  Threats made jokingly (even by a child) can result in the entire family being delayed and could result in fines.
  5. All child-related equipment that will fit through the X-ray machine must go through the X-ray machine. Examples include: strollers, umbrella-strollers, baby carriers and car and booster seats.
  6. When you arrive at the checkpoint, collapse or fold your child-related equipment.
  7. Secure items that are in the pockets, baskets, or attached to the equipment and place it on the X-ray belt for inspection.

The Walk-Through Metal Detector

  1. If your child can walk without your assistance, we recommend that you and your child walk through the metal detector separately.
  2. If you are carrying your child through the metal detector and the alarm sounds, our Security Officer will have to additionally screen both you and your child.
  3. Remove babies and children from their strollers or infant carriers so that our Security Officers can screen them individually.
  4. You may not pass the child to another person behind you or in front of you during this process.
  5. Do not pass your child to our Security Officer to hold.

Baby Formula, Breast Milk, Juice, and Other Liquids

  • Medications, baby formula and food, breast milk, and juice are allowed in reasonable quantities exceeding three ounces and are not required to be in the zip-top bag. Declare these items for inspection at the checkpoint.
  • All items including formula, breast milk, and juice will be inspected, however, you or your infant or toddler will not be asked to test or taste breast milk, formula, or juice.
  • Our Security Officers may test liquid exemptions (exempt items more than 3 ounces) for explosives.
  • All liquids, gels and aerosols must be in three-ounce or smaller containers.
  • Larger containers that are half-full or toothpaste tubes rolled up are not allowed.
  • Each container must be three ounces or smaller.

Before getting on the plane

  • Ask if your flight is full when checking in. Some assistants will block out the seat next to you in a less full flight or offer you the option of seating next to a vacant seat.  This is particularly valuable if traveling with a toddler under 24 months without a seat.
  • Get on the plane first to get a better chance of assistance from cabin crew.

During plane travel

Injuries and deaths can occur in children held on adult laps during turbulence and nonfatal crashes. The AAP recommends:

  • children should be placed in a rear-facing Federal Aviation Authority (FAA)-approved child-safety seat until they are at least 1 year old and weigh at least 20 pounds.

  • children older than 1 year of age and 20-40 pounds in body weight should use a forward-facing FAA-approved child safety seat, while children weighing more than 40 pounds can be secured in the aircraft seat belt.

Based on analyses of dozens of aviation incidents and accidents involving children, www.airsafe.com provides the following tips that can make the trip safer for children.

1. Child safety seat as above

2. Seat your child away from an aisle: Small children enjoy reaching out and exploring, but if they are on the aisle they could get hurt if their arms get bumped by a person or serving cart passing down the aisle.

3. Supervise your child at all times.

5. Keep your child belted or in a child restraint system at all times as turbulence can happen at anytime.

6. If emergency oxygen masks deploy, put your mask on first so that you will be of sound mind to help your child.

7. If your child has a medical condition that may become an issue during the flight, make a flight attendant, counter agent, or gate agent aware of that possibility before the flight.

8. Pay attention to the standard preflight emergency briefing

Another tip from the AAP

  • In order to decrease ear pain during descent, encourage your infant to nurse or suck on a bottle.  Older children can try chewing gum, filling up a glass of water and blowing bubbles through a straw (4 years of age or older), or blowing up balloons (8 years of age or older).

Diaper changing

  • Pack a small bag with just one diaper, a few wipes, a perfumed nappy sack and some rash cream if needed and place it in the seat pocket in front of you.
  • Some planes have a larger bathroom at the very rear of the plane with a correspondingly larger change table. Wait for this to become free if you have a larger baby to change, as airplane change tables are small.

Eating and meals on board

  • Always test the temperature of food heated in the aircraft galley before you give it to your child.
  • Take your own baby food, bowl and utensils for an infant.
  • Disposable bibs are a great idea for infant mealtimes on board an airplane.
  • Disposable bottle liners that are pre-sterilized in a roll are excellent for long plane journeys. Carry a bottle of pre-boiled water with you too, then make up the bottle in the pre-sterilized bag and ask the attendant to warm it by standing briefly in a bowl of hot water.

    Ask for bottles and meals to be warmed well in advance of when you need them. Cabin crew don’t have a microwave and have to heat using hot water in the galley.

    Because airplane bathrooms are small, keep a nappy, small pack of wipes/cotton wool, tube of lotion, lightweight plastic change mat/hand towel, flannel and nappy sack in a side pocket of your cabin bag.
    Take only these essential items into the bathroom for each nappy change and restock the side pocket once you have resettled your baby.

    Take extra precautions for children traveling alone:

    • Escort the child onto the aircraft and check the area around the seat for hazards such as heavy carry-on items in the overhead storage bins.
    • Inform the flight attendant that the child is traveling alone.
    • Ensure that the person meeting the child at the destination will have proper identification.
    • Make it clear to the child that they should report any problems to a flight attendant. This could range from feeling sick to having a suspicious character seated next to them.
    • If the child has to change planes, make arrangements for the child to be escorted between gates.

    After travelling on a plane

    Travel to different time zones, “jet lag,” and schedule disruptions can disturb sleep patterns in infants and children, as well as adults. Attempts to adjust sleep schedules 2-3 days before departure may be helpful. After arrival, children should be encouraged to be active outside during daylight hours to promote adjustment.

    Staying in a hotel

    From the nicest five-star resorts to more modest accommodations, hotels offer refuge, a place to unwind and lay your head for a good night’s sleep. But, beware: There could be some unwanted guests nesting with you or some unwanted stains present.

    Tips to Stay Healthy in Hotels

    Experts say the risk of getting sick from hotel germs is relatively low but if you want to reduce your risk, here are some suggestions:

    • Remove the hotel bedspread. That’s typically the most germ-laden thing in the whole room.

    • Travel with sanitizing wipes. Wipe things that people touch a lot, such as the phone and the remote.

    • Wash your hands. The main way you can get sick is by getting lots of germs on your hands, then putting your hands in your mouth.

    • Look for rust-colored stains on sheets and bedspreads. It can be a sign that bedbugs are present. For details on bedbugs, go tohttp://kidemergencies.com/bedbugs.html.

    Eating at a Restaurant

  • Almost 50 billion meals are eaten in restaurants and cafeterias each year in this country. The nation’s restaurants expect sales to reach $530 billion in 2007, according the National Restaurant Association. More than 70 billion meals and snacks will be served in 2007.
    According to the U.S. Centers for Disease Control and Prevention (CDC):

    • an estimated 76 million cases of foodborne disease occur each year in the United States.
    • the great majority of these cases are mild and cause symptoms for only a day or two – most people do not see a doctor for their illness.
    • some cases are more serious, and CDC estimates that there are 325,000 hospitalizations and 5,000 deaths related to foodborne diseases each year.
    • the most severe cases tend to occur in the very old, the very young, those who have an illness already that reduces their immune system function

    The most common foodborne infections are caused by the following bacteria:

    • Campylobacter: which comes from eating undercooked chicken.
    • Salmonella: which comes from the intestines of birds, reptiles and animals.
    • E.coli: which typically comes from food or water contaminated with cow feces.

    Because these bacteria do not affect the appearance, smell or taste of food, detecting contaminated food by the consumer is very difficult.

    Although you as a parent do not have control what goes on back in a restaurant’s kitchen, you can minimize your risk of contracting a foodborne disease when dining out.

    Pay attention to restaurant inspections

    You can protect yourself first by choosing which restaurant to patronize.  Restaurants are inspected by the local health department to make sure they are clean and have adequate kitchen facilities.  Find out how restaurants did on their most recent inspections, and use that score to help guide your choice.  In many jurisdictions, the latest inspection score is posted in the restaurant.

    Avoid ordering risky foods

    According to the U.S. Food and Drug Administration, the riskiest foods include:

    • Rare or medium-rare hamburger and turkey burger.
    • Unpasteurized fruit juices.
    • Raw sprouts.
    • Raw or undercooked eggs.
    • Raw shellfish, such as oysters.

    When ordering a hamburger, ask for it to be cooked to a temperature of 160oF and send it back if it is still pink in the middle.

    Before you order something that is made with many eggs pooled together, such as scrambled eggs, omelets or French toast, ask the waiter whether it was made with pasteurized egg, and choose something else if it was not.

    Wash your hands

    • You can greatly reduce your risk for foodborne illness and many other contagious diseases by washing your hands often with soap and water, particularly before eating.
    • After washing your hands, dry them thoroughly with a paper towel, if available. On your way out of a public restroom, avoid touching the bathroom door with your hand (push it open with your foot or hip, or use a paper towel, a piece of toilet paper or a shirtsleeve to turn the knob).

    Signs of possible food safety issues in a restaurant

    Here are some things to look for in a restaurant or cafeteria that may indicate how seriously management regards food safety:

    Clean bathrooms. A clean, pleasant bathroom suggests employees are probably paying attention to detail elsewhere in the restaurant, such as the kitchen. If there are no paper towels or soap in the bathroom, if the hot-air drier is broken, if the sink drain is stopped up or if the garbage pails are overflowing, report the problem to the manager.

    Clean dining room and tables. Clean floors and sparkling surfaces suggest management is concerned with cleanliness, orderliness and has a sense of pride.

    Tidy servers and busboys. Servers’ and busboys’ uniforms and aprons should be reasonably clean, their hair should be up or netted and they should be washing their hands often. Open cuts or sores on hands can harbor bacteria that potentially can be transferred to food, plates and eating utensils.

    Spot-free utensils and dishes. Forks, spoons and knives should be clean and free of water stains.

    Temperature control. Salads and cold entries should be crisp and cold to the touch. Wilted or brown-edged lettuce leaves do not bode well for the freshness and safety of salad-bar items. Hot foods should be steaming when delivered to your table. If food that is supposed to be cold or hot is served at room temperature, send it back to the kitchen or order something else.

    For a food safety quiz for kids, go to www.fda.gov/oc/opacom/kids/html/wash__hands.htm


    AAP policy statement: Restraint Use in Aircraft http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/5/1218

    AAP: Car Safety Seats, A Guide for Families http://www.aap.org/family/carseatguide.htm
    Airsafe.com: www.airsafe.com. Accessed 4/27/08.
    Travel for Kids: www.travelforkids.com. Accessed 4/27-4/29/08.
    Transportation Security Administration website: http://www.tsa.gov/traveler/. Accessed 4/27-4/29/08.