Do your kids know when to hug a tree?
1. When planning family travel and outdoor activities, include telling young children what to do if they lose sight of you. (Avoid the word “lost;” It seems to scare children.) Generally, young children panic when they don’t see you and realize that they are in an unfamiliar setting. They look all around and then run as fast as they can in whatever direction they happen to be facing. This greatly complicates retrieving them. Being lost is an extremely frightening experience for young children, often remembered into adulthood.
2. Teach them to stay put when they don’t see you. Tell them that you will be right back. The “Hug a Tree” program teaches them to literally hug the nearest tree, enabling you to retrace your steps to reunite. Hugging a tree may also help reassure them that the situation is under control. Or teach them “Freeze,” a game in which children run about until a designated caller yells, “Freeze!” The children stop in their tracks (freeze) and remain in place until someone gives the all-clear signal. Play this game with them.
3. Or tell them to approach “another mommy” (a woman with a young child). Mommies are easily identifiable by young children and easy for them to relate to. Telling them to approach security personnel and police officers is obviously OK, but such people may be more difficult for young children to identify and to feel comfortable with.
4. Try not to frighten children when speaking to them about “becoming separated.” Intermingle your message with reminders of the fun they will be having wherever you are going. Tell them that sometimes you, the parent, can become separated from them, and that if that happens you will return promptly. And don’t scold them when you find them. Use the situation as a teaching opportunity. Tell them what you and they did wrong to have created the predicament.
5. Envision situations where separation may occur. Elevators are one example. Children run into elevators as soon as doors open, and the doors may close before you get in. They should hold your hand when entering. Should they find themselves riding alone, they should remain in the elevator until it returns to your floor. Otherwise, they usually get off as soon as the door reopens, often on another floor. Pressing the elevator button will return the elevator to your floor eventually.
6. Pin identification tags on young children. In crowded areas attach a tag with your cell phone number to the child’s outer clothing. Law enforcement officials say such identification speeds reuniting parent and children, and in no way encourages abduction. Random abduction of children from public places is an extremely rare occurrence, says the FBI, and is usually committed by family members. Stories that this happens frequently at amusement parks, airports, and other such venues are untrue.
7. Place a leash on toddlers. You may get some disapproving stares and, rarely, some uncalled for sarcastic remarks from total strangers, but leashes do prevent toddlers from wandering off. They are especially helpful if you have an active child or more than one toddler in your charge. See KidsTravelDoc/Leashes.
8. Electronic surveillance systems allow you to “see” your children when you cannot. Most consist of a transmitter and receiver. Transmitters are lightweight, may resemble small teddy bears, and attach to a child’s clothing. You hold the receiver. Transmitters send signals if a child wanders further than a predetermined distance. Receivers have maps that display the direction and distance of the location where the child is at that moment, and may have a beeper that becomes louder as you approach the child. Some receivers can activate the transmitter to set off a loud alarm to alert adults in the vicinity of the lost child. See KidsTravelDoc/Surveillance Systems.
9. For older children, check that they understand where you will meet them. They may not be listening when you tell them, especially if they are excited about the place you are visiting. Write down the meeting point and see that they put the paper into their pocket. Check out the meeting point. Stores and arenas may have more than one exit. Landmarks change from one visit to the next. Many amusement park rides have exits not in view from the entrance. Cell phones are invaluable for helping older kids reunite after becoming separated. In wooded areas consider supplying them with a whistle.
10. Report missing children to security officials immediately. Don’t spend time searching alone. Most public places have protocols for missing children alerts including security personnel with two-way radios and surveillance cameras. Report back to security when you find your child. Dressing children in items that stand out in crowds helps find them. If you have more than one child, dress them identically. And once they are dressed for the day’s outing, take a picture of them so that you can show security personnel in the event you become separated.
In restaurants where you question the sanitation, choose foods that arrive at your table too hot to eat immediately.
1. This rule is especially important when visiting developing countries. In such countries, intestinal illnesses among travelers are quite common. Most of the illnesses are due to viruses and other intestinal disease-causing microorganisms present in the food you eat. The neatness of an establishment, how busy it is, or who eats there are not particularly reliable guides for judging sanitation.
2. Sufficient heat kills organisms. The fact that food is piping hot tells you that it has just been heated to a temperature sufficient to kill the organisms, and that the food did not remain standing after preparation to be contaminated by flies or people’s hands. (Very rare exceptions to this rule are large reef fish found in the tropics: snapper, grouper, amberjack and others. These fish occasionally produce toxins resistant to heat. Properly prepared smaller fish are safe.)
3. Don’t contaminate your own food. The worse the sanitation, the more important becomes hand washing. Disease-causing organisms may be present on objects in gift shops, doorknobs, faucets in restrooms, and on peoples’ hands you shake. Soap and water is the best way to sanitize hands. Alcohol-containing hand cleansers are generally adequate when soap and water is unavailable.
4. Choose items such as hot soups and stews containing only small pieces of solids. Large pieces may remain insufficiently cooked in the center. Thin omelets and items boiled in oil or water are generally safe.
5. Avoid items that are difficult to clean in the kitchen. Removing all particles of soil from leafy vegetables is near impossible. Soil is a frequent reservoir for organisms. (Some major hotels in developing countries soak vegetables in disinfectant solution, making them safer to eat.) Avoid fruit that has been peeled by someone else. Peel your own fruit – after washing your hands.
6. Also avoid hors d’oeuvres, sandwiches and other items that require much handling in the kitchen. Food handlers in poor countries rarely use gloves, use gloves incorrectly, or may not have access to soap and water. Hors d’oeuvres and such are often prepared hours before serving, contain numerous ingredients including raw vegetables, and may be stored at room temperature.
Foods that ” turn” your stomach do not necessarily upset your stomach. Properly prepared and stored ultra exotic items such as snake soup, earthworms and insects may be difficult to get past your lips but are no more likely to make you ill than equally well prepared hamburgers, pizza and chicken wings.
7. Be among the first in line at buffets, especially outdoor ones in the tropics. Buffet-type food requires much handling to prepare and then remains on tables for hours, increasing the risk of lapses in sanitation. Outdoors, food is exposed to heat and insects. Placing large casseroles on beds of ice does not ensure sufficient cooling of the upper layers. Sternos may keep food only lukewarm. Desserts are generally eaten last, but are often placed on the table at the same time as other items. Organisms multiply rapidly in creamy products.
8. Never season foods with uncooked spices.The methods used for gathering, preparation and storage of spices contribute to contamination by rodents and insects. Folklore in Mexico and elsewhere claims that spicy sauces and lemon juice kill organisms and make food safe. Not so. Only spices added before cooking are safe. Be leery of dips such as guacamole; they often contain raw vegetables.
9. In poor countries street food deserves its negative reputation,says the World Health Organization (WHO). While the food may be appealing, authentic and cheap, sanitation is a serious problem. Stalls, carts and equipment are generally dilapidated and virtually impossible to keep clean. Vendors have little or no knowledge of sanitation, buy the least expensive raw products available, lack refrigeration, and rarely have access to safe water for cooking, dishwashing or hand washing.
Ceviche, a cold, raw fish soup popular in parts of South America and often served by street vendors, causes more intestinal illness than any other single food anywhere, says the WHO. To start, fish are often caught in nearby polluted water.
10. “Conventional/unexciting” restaurants may be safer than “quaint” local ones. International hotel chains, for example, have strict rules on avoiding food contamination and have experts overseeing operations: buying from reliable retailers, purifying water, using refrigeration and mechanical dishwashers, and teaching employees the principles of hygiene, for example. But power outages, difficulty in maintaining equipment, and staff vague on hygiene require careful food selection even at such restaurants.
You can avoid most of the errors in sanitation made in local restaurants by preparing your own food when traveling. Many hotels that cater to families offer kitchen facilities. Many children who find food shopping at home “boring” find it is fun overseas.
With spring and summer just around the corner, it’s time to review how you protect your kids (and yourself) from mosquito bites. While most bites are merely annoying, there is a tiny percentage of mosquitoes that carry disease-causing viruses, a percentage that may be increasing slightly with the emergence of Zika, West Nile and other viruses.
1. Your first line of defense against bites is ridding your surroundings of mosquitoes. This was the subject of our previous posting. To read it, go to http://kidstraveldoc.com/global-warmingdisease-carrying-mosquitoesprotecting-children/
Next is the use of insect repellents. Applying repellents and doing it correctly is not fun and games for children – or for you. It is time consuming, messy, expensive and annoying for all involved. Prepare yourself for frowns and complaints.
2. Use repellents containing one of the following active ingredients.
No repellent bears the name of these ingredients. Check ingredient labels to see if they are present. These repellents have been tested and approved by government agencies, are safe for young children when used correctly, and are effective against mosquitoes – and some against ticks, fleas, and chiggers. (Repellents offer minimum, if any, protection against bees, wasps and hornets.) Little is known about the safety and effectiveness of the numerous other products on the market. Anyone can produce a substance and call it a repellent.
3. Read application instructions carefully. Check lower age limits and recommended concentrations of ingredients. DEET, for example, should not be used on infants less than two months of age; oil of lemon eucalyptus, not on infants under 3 years. The skin of young children is especially permeable to substances applied to it. DEET is the only approved repellent that comes in various concentrations; for children, use products that contain between 20 and 30% DEET.
4. The terms “natural” and “chemical free” have little meaning. Oil of lemon eucalyptus, for example, is “natural.” However, this doesn’t make it safer/better than repellents formulated in laboratories. (Poison ivy and deadly mushrooms are 100% natural. Vitamin C taken from oranges is identical to that synthesized by chemists.)
5. To apply repellents, smear or spray products on your hands and then rub it on your child’s skin. No need to place it under clothing; long pants and sleeves reduce the amount of repellent required. Wash off when no longer needed. Thin coats suffice; thicker coats do not increase protection. Avoid eyes, mouth, wounds or rashes. If accidentally applied to such areas, rinse with soap and water. Apply outdoors or in well-ventilated indoor areas. Seek help immediately if a child swallows a repellent.
6. Avoid products that combine insect repellents and sunscreens. While many situations call for both, the intervals of applications and other considerations make combinations impractical. Generally, apply sunscreens at least twenty minutes before exposure. Apply repellents just before going outside. Repellents may reduce the effectiveness of sunscreens. If both are needed, consider using a stronger sunscreen.
7. Familiarize yourself with one or two repellents. Products come in the form of lotions, creams, gels, aerosols, sticks and towelettes. Contact manufacturers, if necessary; most have websites. Know how long protection lasts; duration of effectiveness is generally shortened by hot weather, perspiration, swimming and other factors. Know how to store repellents. Most products have expiration dates. Using extremely old repellent may cause skin irritation and rashes.
8. It is not practical to use repellents on children every minute they are outdoors. Base your decision on season of the year, amount of vegetation in the play area, and amount of time the child spends outdoors. Check with local authorities regarding insect control programs, mosquito activity forecasts, and disease alerts. Mosquitoes are most active around dawn and dusk.
9. Use permethrin on clothing. Permethrin helps prevent insects from crawling under or biting through clothing. Once correctly applied, permethrin remains effective on clothing through many washings. Permethrin can also be sprayed on camping gear such as tents. Use permethrin for visits to areas with heavy concentrations of insects, like swamps and woods.
10. Miscellaneous. Buy repellents at home before traveling overseas. Especially in developing countries, products may be counterfeited and labels may not be in English. Repellents may be confiscated at airports if in carry-on baggage. Tell children to avoid areas that attract insects, garbage cans, flowerbeds and orchards, for example. Spray products may be flammable, should not be inhaled or used near food. Stop using a repellent if children start scratching or develop a rash.
Blame global warming and world travel for the hullabaloo about protecting your family from biting mosquitoes.
1. Mosquitoes love global warming. Higher temperatures allow them to multiply more rapidly and expand their habitat. It may also make them more robust and, in temperate climates, lengthen their breeding seasons – and their biting seasons.
2. Travel brings new diseases from the tropics to your ever warmer, more mosquito-friendly backyard. Mosquitoes thrive in the tropics. So do viruses (and other disease-causing organisms). Mosquitoes spread their viruses only locally. Until recently, many mosquitoes and viruses were mostly confined to remote, rarely visited areas in the tropics. Now mosquitoes, some carrying viruses, hitch rides on airplanes and, within days, establish a beachhead in your backyard. The viruses can also reach your neighborhood via already infected returning travelers. Local mosquitoes can do the rest.
3. Ridding your neighborhood of mosquitoes, not repellants, should be your first line of defense. While repellents are important, applying them correctly and safely, especially on infants, is time consuming, expensive, messy, not foolproof and raises some health issues. (Repellents for infants and children will be the subject of our next posting.)
4. Know your local mosquitoes’ biting patterns and the diseases they may carry. Seasonally, biting begins soon after trees commence blooming and ends with the first frost. Mosquitoes breed in standing water and rarely fly far from their breeding grounds. Each species has a different time of day for peak biting activity, but generally the peak is around sunrise and sunset. Check with your department of health. Stay indoors at such times when mosquito-borne disease alerts are in effect.
5. Eliminate standing water in your neighborhood. Check that authorities apply chemicals to kill larvae in ponds, reflecting pools and other bodies of still water. Sometimes fish are placed in water to eat larvae. Keep family members with serious respiratory issues indoors during aerial sprayings. Health departments will supply dates and times. Report standing water in empty lots and uninhabited houses.
6. Eliminate standing water in your immediate surroundings. Mosquitoes breed in poorly maintained swimming pools and in standing water on tarpaulins covering pools. Empty children’s wading pools and birdbaths at least once a week. Check backyard toys, abandoned tires, flowerpots, and even bottle caps for standing water.
7. Dress children in appropriate clothing so you need to apply less insect repellent. Repellents need not be applied under clothing. Tuck shirts into pants and pants into socks. Have children wear closed shoes. Use head nets if you venture into areas such as salt marshes with high mosquito populations.
8. “Bug proof” your house/apartment. Cover gaps in walls. Use weather stripping under doors. Check bathroom exhausts. Make sure windows and chimneys are properly screened. Remove piles of wet leaves from yards and roof eaves. Air conditioning and fans are effective deterrents; mosquitoes prefer warmth and dislike turbulent air. Fans are effective on porches and terraces.
9. Be leery of devices that claim to repel mosquitoes. Sound and light devices attract mosquitoes to the device, but then attack people near the device, possibly increasing the risk of being bitten. Products that emit vapors may be harmful if inhaled indoors over prolonged periods of time, especially by children. Outdoors, vapor effectiveness varies depending on wind direction and other factors. Ultrasonic gadgets include products that are designed to be worn around the neck or wrist, or attached to a belt, to repel mosquitoes. The devices create sounds that mimic male mosquitoes or dragonflies but do not seem to frighten most mosquitoes.
10. Miscellaneous.“Bug lights” are not repellents but do not attract mosquitoes as many other types of lights do. Taking vitamin B or antihistamines may reduce itching from bites, making people think they are being bitten less. Avoid scented soaps, perfumes, and hair spray; these may attract biting insects. A popular belief is that mosquitoes prefer infants. (Maybe they taste sweeter?) In fact, no one knows if infants are bitten more often. If so, it may be because infants are unable to swat them away. Place nets over strollers and playpens outdoors.
The uproar regarding pregnant women visiting Zika-infected countries bolsters the opinion that travel during pregnancy is never without some risk. The fetus, the littlest traveler of all, the hitchhiker, so to speak, seemingly safely and comfortably imbedded in the uterus, is susceptible to many travel-related conditions and illnesses. Travel further complicates pregnancy by removing women by time and distance from their health care providers. Yet restricting travel during pregnancy is contrary to prevailing thinking that pregnancy is a normal phase of life and should not be overly “medicalized.
1. Discuss your travel plans, domestic or international, with your obstetrician. Ideally, start discussion at least a month before trips. Choose destinations where emergency medical care is readily available and arrange to carry copies of your medical records. Familiarize yourself with possible effects of prolonged sitting on airplanes (see below), visiting higher altitude destinations, exposure to excessive heat and humidity, and other vagaries of travel.
2. Overseas travel may present dilemmas. Immunizations recommended for specific destinations (against yellow fever, for example) can be problematic during pregnancy. The same is true regarding medications to treat malaria, altitude sickness, seasickness, and intestinal upsets.
3. Most airlines and cruise lines have websites with detailed information for pregnant travelers. Generally, travel is discouraged or denied in the last two or three months of pregnancy. If you look “very pregnant” earlier, carry a note from your obstetrician. Security machines at airports and shipside are safe for fetuses. In flight, walking helps prevent swollen legs and possibly blood clot formation. Move your feet up and down when seatbelt signs are lit. Wear loose, non-restrictive undergarments. Ask your doctors regarding elastic stockings. Ships have medical staff trained in stabilizing basic pregnancy issues and access to telemedicine backup ashore. Seek assistance when transferring from large ships to smaller boats. Choose cruises where rough seas are unlikely as severe vomiting/diarrhea can affect the fetus.
4. Travel is least likely to become problematic during the second trimester. Issues tend to arise in the first and last three months. By the second trimester (the fourth month), most future complications have surfaced or are picked up by lab and imaging testing, morning sickness is largely over, and moving about is still reasonably comfortable. In the last three months, fatigue and balance issues set in, and premature labor may occur. Every year, a handful of infants are born en route on airplanes and cruise ships.
Recently, a 28-year-old, 23-week pregnant woman passenger on a Caribbean cruise gave birth to a one-pound, five-ounce (600 grams) boy. Her obstetrician had told her that it was safe for her to travel. The ship, not equipped to handle premature infants, immediately changed course for San Juan, Puerto Rico, about 14 hours away. The infant spent several days in a San Juan hospital to be stabilized, and then was transferred by air to a better-equipped Miami hospital. He arrived home in Utah at age three months.
5. Review your health and accident insurance policies. Many policies exclude pregnancy-related medical events occurring while traveling, particularly events occurring overseas. Exclusions include certain activities (skiing and scuba diving, for example) as well as newborn care if delivery occurs prematurely. Such care is extremely expensive. Specific travel assistance insurance (check web) may cover some pregnancy-related problems. Presently, many travel insurance companies are refusing to give refunds to pregnant women who cancel trips to countries infected ith the Zika virus, even when that country is on the CDC list of countries not to visit during pregnancy. However, some airlines will give refunds. Always check hotel and air travel cancellation rules.
6. Carry a medical kit. Have on hand medications you have used in recent years and are likely to need again, plus medications specific for your trip. Check that all items are compatible with being pregnant. Carrying medications minimizes buying them overseas where names and doses may be confusing. Moreover, in developing countries, medications are often counterfeited, outdated, improperly stored or otherwise adulterated.
7. Be sure you can check symptoms with health providers back home. Is your cell phone operable where you travel? Does it contain the telephone numbers of all your health care providers? Are they available 24/7?
8. Recognize symptoms that could affect your pregnancy. Swollen legs, abdominal pain, vomiting/diarrhea, shortness of breath and weakness/dizziness, for example, are fairly common travel-related conditions, often due to air travel, bad food, altitude or hot weather. But such symptoms can also be pregnancy-related and, regardless of the cause, can affect the pregnancy. Reasonable exercise, safe food/water selections, and air conditioning help minimize these conditions.
9. Presently, the Centers for Disease Control (CDC) recommends that women who are pregnant or contemplating becoming pregnant postpone travel to areas of the world where the Zika virus is circulating. While the virus has little or no effect on the mother, it may cause catastrophic and permanent damage to the head and skull of the fetus. (For the very latest on Zika please see http://www.cdc.gov/zika/pregnancy/)
10. There is no vaccine or preventative medication for Zika virus disease. The disease is acquired by being bitten by an insect infected by this virus. The proper use of an effective pregnancy-approved insect repellent is extremely important. Products containing the following active ingredients are deemed safe for use during pregnancy, says the CDC: DEET, Picaridin, Oil of Lemon Eucalyptus and IR3535. For further information on repellents, please see http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropods
Some years ago a reader wrote “I place a leash on my toddler at airports and amusement parks. Strangers have complimented me for safeguarding my child and cursed me out for humiliating her… ” What did I think?
Thinking back, my reaction to seeing kids on leashes was merely amusement, neither humane or humiliating. Does anyone really care? But if people do care, this “dilemma” would make a great article. So I did what one does nowadays, I Googled, “children/leashes.” Amazingly, people do care. There were 342,000 entries. Comments were both pro and con, wise and other-than-wise, many extremely emotional, some with strong language. Great for an article. I selected the more interesting comments. More amazingly, my leashing article turned out to be the most popular of the hundreds I’ve written.
It’s time to update the article. Stay with a winner. Again I Googled, children/leashes. Now 8,310,000 entries! Here are some representative comments, some from the original article and new ones. At the conclusion my “expert” opinion – now that I am a know-it-all on leashing.
“Likely, children are far more comfortable on a leash versus walking with their arm yanked above their shoulder and hand tightly held by an adult.”
“Parents who leash their children should either be shot or beaten to a bloody pulp. So I have started P.A.C.O.L. – People against Children on Leashes. We intend to put a stop to this embarrassment!!!! No longer will children’s self-esteem be put to shame.” (Ed. this article is no longer on the web.)
“If you use a leash, don’t be surprised if total strangers give you dirty looks, wag a finger at you or say ‘I leash my dog, you leash your kid’ or
‘Next you’ll teach your child, sit, stay, roll over'”
“Leashes give children a sense of freedom while providing security in crowded places.”
“My pediatrician suggested I get a leash after I twice dislocated my son’s arm while walking with him. Dislocation occurs at the elbow. I was holding his hand tightly and he twisted to go in a different direction; another time he fell while I held his arm. I had to take him to the ER to reset the arm.”
“Leashes come in a wide variety of designs, some in the forms of cartoon characters. Many have Velcro straps that attach to the child’s wrist while others are harnesses that fit over the chest. Both types can be retracted and extended, as needed. Also, consider inexpensive leashes found, yes, in pet stores. Large size dog collars are sturdy, color-coordinated and long lasting.”
“Parent of multiple toddlers experience situations where kids simultaneously take off in separate directions while parents stand frozen in horror, not knowing which one to chase after first!”
“Leashes save lives – mine. I have a bad back and my daughter is overweight. I am tall and have to bend to hold her hand. It hurts. It also hurts when I have to carry her when she wants to be picked up. Luckily, she likes her leash better than her stroller or walking.”
“Are leashes any more restraining than keeping kids strapped into a stroller? My kid is extremely active and fights to get out of the stroller but happy with his leash. Leashes allows him to lead, which he likes, but I control the boundaries. To busybodies, I say “thanks for your advice – and do what I think is best.”
“What kind of people have we become that we put children on leashes, treating them like dogs? I don’t care how uncontrollable kids are. Haven’t these parents heard of books on improving parenting skills? I feel like running up to these parents and slapping them. Leashes convey an inappropriate message, using physical force instead of words to keep children under control.”
“Leashes are essential to keep dogs out of trouble. Kids deserve the same consideration.”
“Are parents using leashes because their children are excessively impulsive or have special needs or because of the parents’ own anxieties? If parents have no well-thought-out rationale for using a leash, they should examine their motivations. If it is anxiety, they may be communicating to the child that they don’t trust themselves to keep their child safe.”
“Explain to children why it’s important to stay close. Going leash-less may be harder in the short run, but in the long run you’ll help children develop skills that will make them more responsible when they face dangers that cannot be avoided.”
“I lost my toddler in a mall. When we reunited, the terror in his eyes made me a ‘leasher’.”
My opinion? I still can’t get emotional about leashing. And I can’t imagine leashing inflicts psychological trauma on young children.