Don’t be surprised when planning your baby’s first trip – whether across town or across the ocean – becomes a monumental undertaking, not unlike outfitting a cruise ship for a long voyage. For one, how do you carry your baby plus all the paraphernalia he or she requires?
1. “Wearing infants” is the most practical way to transport them. While wheeling or carrying them in a car seat may be somewhat safer, these conveyances have shortcomings. Wheels can’t go everywhere and seats are heavy, clumsy, and fatiguing for the adult carrier. The least safe way of transporting infants is in your arms. A squirming infant or toddler is a distraction and may block your view when you walk, which can affect your balance, causing you to stumble.
2. But infant carriers can be problematic. Issues arise when you wear carriers incorrectly, are unaware some types may be hazardous for certain infants, or have not been notified that your carrier has been recalled for a newly found defect.
3. Familiarize yourself with various models before buying one. There are chest, front and hip carriers, each with numerous variations. At purchase time, “test walk” a few. Find an object that weighs approximately the same as your infant. Practice assembling the carrier and walk it with the weight. Have someone with experience accompany you. Infants have been injured when they were improperly placed into a carrier or when an incorrectly assembled carrier came apart. Carriers come with written directions and, sometimes, videos. Read/watch carefully.
4. Prior to purchasing one, make sure that you are comfortable wearing it. Some salespeople tell you that aches experienced when first wearing one are temporary. Not always so. Select one that is comfortable immediately and doesn’t tilt or pull you to one side, affecting your balance.
5. Match infant to carrier. Most carriers have minimum/maximum weight limits and need replacing as infants grow. Sling-types keep infants’ heads upright. Backpack carriers are the most comfortable for adults, especially when carrying older infants, and for long walks/hikes, but should not be used until infants can sit unassisted. Many carriers come with headrests. Front strap-on carriers tend to cause back and neck strain for the adult. Generally, the most practical ones for younger infants are front-carriers; they allow you a full view of the baby.
6. Take special care when using carriers with very young infants. Infants cannot support their heads until four or five months of age. They bend their chins onto their chests, possibly compromising their airways and reducing the amount of oxygen that gets into their lungs. This also impairs their ability to cry for help, increasing the risk of suffocation.
7. Check frequently that an infant’s nose and mouth are free. Many carriers consist of soft fabric, which can contour over the infant’s face, impairing breathing. Even if the fabric only partially covers the nose/mouth, the infant’s ability to inhale oxygen-rich air is impaired and forces him/her to re-breathe air with less oxygen. A similar situation can arise if the infant’s head is covered with a blanket (for breastfeeding, for example).
8. Certain infants are at risk for additional breathing issues. This includes infants born prematurely or with an unexplained low birth weight, or who were one of multiple births or experienced significant heart/lung problems at or soon after birth. Such infants, for the first year of life, even if they appear healthy, have less heart/lung reserve when their breathing is compromised. (They are also more likely to have breathing issues with upper respiratory infections and during air travel as lower cabin oxygen levels require more forceful breathing.)
9. Be leery of hand-me-down carriers. Products for young children are frequently modified for safety reasons. Previously used carriers may lack the latest safety features and may have been recalled by the manufacturer. Register warranties with the manufacturer at time of purchase so you can be notified if recalls occur. The US Consumer Product Safety Commission maintains a website, https://www.cpsc.gov/recall-products/baby-carriers/ where recalls and other problems are posted. You can also sign up to get recall notices by email. Go to www.cpsc.gov/cpsclist.aspx.
10. Unusually cranky infants in carriers may be asking for help. “The sun is shining in my eyes.” Sunshade attachments are available for some carriers. “I’m hot.” Most sling carriers consist of thick fabric that acts like a blanket, increasing an infant’s temperature in hot weather. Some slings have mesh sidings or flaps to allow air in. “I just touched a rose bush. My finger is bleeding.” Be aware of your surroundings. And “my foot is caught under my backside.” Ensure infants are placed properly.
Miscellaneous facts about infant carrying. Carriers are not substitutes for car seats. Don’t use carriers while cooking or in other potentially hazardous places. When picking up an object from the floor while wearing a carrier, bend at the knees rather than at the waist. Keep an eye out for carrier wear and tear. Small infants can fall through leg openings of carriers designed for an older child. Baby carrying is not safe while you are riding in a car.
When planning family vacations, check that everyone is up-to-date on their vaccinations. Adults included. Travel increases the risk of catching a host of preventable diseases: measles, mumps, rubella, meningitis and whooping cough (pertussis), to name just a few. And you need not visit Equatorial Africa to become infected. Anyone not fully vaccinated can become infected without leaving this country, especially if you frequent places where travelers congregate such as theme parks, on flights and on cruise ships. Rarely, you can catch one of these diseases in your own eighborhood.
1. Travelers spread diseases. Already in the 14th century, passengers arriving in Venice by ship from plague-infested countries were forced to stay aboard ship for about forty days, until it was clear that the disease was absent. (“Quarantine” comes from the Italian word for forty days.) When Europeans first came to America they brought with them diseases previously unknown in the New World, decimating local populations.
2. More people are traveling than ever before. Every year, millions enter the US, lots of them from poor countries with less than optimal immunization programs. Many are children, the main culprits when it comes to spreading these diseases. They visit amusement parks, fly on domestic airlines, and visit friends and families — sometimes in your neighborhood.
3. There is no practical way to check travelers for contagious diseases. (Except the way the Venetians did.) Infected people start spreading their diseases before they show any signs of being ill. Moreover, because canceling trips at the last minute can be cumbersome and expensive, some parents travel knowing that their children are ill.
4. Air travel helps spread contagious diseases. Fortunately, that spread is limited. Most of the microorganisms that cause these diseases are airborne, that is, the organisms are exhaled, sneezed out or coughed up by infected individuals and then inhaled by susceptible (non-vaccinated) ones. Close, continuous exposure over many hours, as exists on airplanes, increases the risk of becoming infected. However, modern aircrafts have efficient air filtration systems that change cabin air every few minutes. And airflow is from ceiling to floor, not through the entire cabin, limiting the air you breathe to that from passengers in nearby seats.
5. An increasing number of children in this country are not fully vaccinated. Ironically, one reason is the success of vaccination programs. Because most parents have never seen cases of the illnesses that these vaccines prevent, some parents erroneously conclude that vaccination is no longer necessary and that, possibly, the vaccines are more risky than the disease. Not so. Other parents refuse vaccinations on ethical or religious grounds.
6. Many parents ask to have vaccinations “spread out”. They believe it is “too much” to give more than a dozen different vaccines — with some requiring multiple doses — in the first eighteen months of life. However, experience from giving billions of doses and seeing the diseases virtually disappear shows that vaccine scheduling is safe and effective. Moreover, the younger that children are vaccinated, the earlier in life they are protected, often from diseases that are especially troublesome early in life.
7. If routine vaccination programs were discontinued these diseases would quickly return. The causative organisms continue to circulate in many parts of the world, including some in this country. Until all children worldwide are properly immunized, vaccination programs must continue. The more people not vaccinated in this country, the greater the risk that diseases from abroad will establish beachheads here, and then continue to spread.
8. Is your child fully vaccinated? The length of time vaccines are effective varies by vaccine and in some cases the time of effectiveness is proving to be shorter than anticipated. This requires giving multiple booster doses. Moreover, new and improved vaccines appear every few years, many for teenagers. Check with your health care providers. Keep your own records.
9. Travelers going overseas may require additional vaccines. Inform your healthcare providers of your travel plans and do so as soon as your plans are finalized. Most overseas destinations require no additional vaccines for fully vaccinated people.
10. Review periodically the vaccination status of every household member. (Do so even if you don’t travel.) This is especially important if there are infants in your home. Check with your health care providers and have nannies, housekeepers and frequent visitors (grandparents, for example) check with their providers. Flu vaccine must be given yearly. (Safety officials suggest that you check fire alarms and smoke detectors when you adjust your clocks in the spring and fall. Add “check vaccination status” to that list.)
“I carry a light-weight blanket when I travel with my breast-fed infant. If someone seems bothered by my nursing – even though I do it discreetly – I offer them the blanket so they can cover their eyes.” (From a website on breast-feeding.)
1. No reason to curtail your travel plans because you breast-feed. Stories that travel-related stress significantly interferes with milk flow are hearsay. In fact, the alternative, bottle-feeding, is a bigger hassle, requiring you to carry formula, bottles and paraphernalia for sterilization, for example. (However, most experts say that sterilizing bottles and nipples is necessary only where sanitation is very poor.) Until infants are six months of age, exclusive breast-feeding is recommended, negating the use of solid food – which also can be problematic where sanitation is poor.
2. Restriction on breast-feeding in public, once common in the US, is now legal in 47 states and the District of Columbia. Two of the three remaining states, South Dakota and Virginia, exempt breast-feeding women from indecency and nudity laws, making breast-feeding legal. Idaho is the only state that has no laws regarding breast-feeding in public. Outside the U.S., attitudes for breast-feeding in public are far more relaxed with few, if any, restrictions. No airline restricts breast-feeding.
3. Many mothers are wrongly advised to discontinue breast-feeding for travel-related issues. Limitations on breast-feeding generally come from people, including health care professionals, who are overly cautious and not familiar with the latest findings, says the American Academy of Pediatrics. Check with lactation and travel medicine practitioners. For information on medications and breast-feeding, go to LactMed.
4. Check with your health care providers back home if you become ill while traveling. Routine illnesses virtually never require discontinuing nursing. However, being away from home, especially being overseas, tends to make illnesses seem worse than they are. Your own health care providers usually can advise you if you need to take medication or to seek medical care – or do nothing, which increasingly is the suggested cure for most minor illnesses. Carry your providers’ telephone numbers. Virtually all over-the-counter medications are safe while nursing.
5. Be fully vaccinated. Both mother and infant. Most vaccines given to mothers do not protect their infants; infants need their own age-appropriate vaccines. Only one vaccine, for preventing yellow fever, is contraindicated while nursing. This disease is limited to mostly rural areas of tropical Africa and South America. The vaccine can cause serious problems for young infants. Neither mother nor infant should receive this vaccine if the infant is less than nine months of age. Consult a travel medicine professional.
6. Overseas travel may also require changes is preventative medications. Malaria, for example, exists in large areas of tropical Central and South America, Africa, and Southeast Asia. Malaria can affect infants beginning at birth. Anti-malarial medications given to mothers do not pass through breast milk. Infants need their own medication, which may be different from that given to adults. Consult a professional.
7. Air travel. At US airports, inform security agents if you are carrying expressed breast milk in excess of the allowable 3.4 ounces (100 millimeters) for liquids. If yes, the milk will be X-rayed – which does not harm the milk. If you prefer that the expressed milk not be X-rayed, agents will pour a small amount into a container to be examined for prohibited substances. Ice packs and breast pumps are allowed in carry-on luggage. Rules governing security issues may change and vary overseas. The latest US information is available at www.tsa.gov/traveling-formula-breast-milk-and-juice.
8. Never breast-feed infants in moving cars. Infants should be securely restrained at all times – as should adults, making safe nursing virtually impossible. For example: An unrestrained mother is nursing her infant in a car going about 40 miles (63 kilometers) per an hour. The car hits another car. In a millisecond, the infant becomes the equivalent of a missile weighing hundreds of pounds and flies forward at about 40 miles per hour.
9. Travel with an infant-carrying sling. Slings help maintain breast-feeding by allowing opportunities for unrestricted nursing, help protect infants from surrounding hazards, ease the burden of carrying the infant and, because slings free the hands, simplify many travel-related tasks (boarding an airplane, for example).
10. Miscellaneous. The use of sunscreens and insect repellents by mothers has no adverse effects on the infant. However check the web regarding the use of these substances on the infant. No need for mothers to drink extra fluid during air travel. Dehydration during air travel is a myth. And no need for nursing mothers to offer infants extra fluids in hot weather. Breast-feeding suffices.
All children should learn to swim at an early age. However, there is no consensus as to the optimum age to start; guidelines vary from six months, and sometimes even younger, to four years. In addition, there are health issues to consider regarding placing infants in public pools.
♦ The number of young children taking swimming lessons is steadily increasing. At the same time, the drowning rate for this age group (and for most other age groups) has decreased by about 50% in the past twenty years. However, the two may not be related. The decrease is credited to more adults being better informed about water-related hazards.
♦ Teaching young children to swim doesn’t “drown-proof” them. Infants who swim generally do so only when an adult hovers over them, rarely when they fall into the water unseen. Moreover, their ability to swim may give some parents a false sense of security, making parents less vigilant around water, perhaps increasing the risk of drowning. An adult caretaker should be within an arm’s reach at all times.
♦ Lessons for infants younger than one year of age are controversial. Some swimming courses have websites with films showing infants performing amazing aquatic stunts with no adult in sight. Some instructors claim that the younger the infants, the greater their affinity for water, a throwback to their existence in the womb. “What your child will learn depends on their developmental readiness, but in all cases, at minimum, they will learn to roll onto their backs, float, rest, breathe, and maintain this position until help arrives.” Perhaps some infants will do this, but certainly not all.
♦ Starting swimming lessons should not be determined by age alone. The American Academy of Pediatrics has lowered their recommended minimum age from four years to one year of age. This is based on a small study that suggests that an infant’s ability to swim may help survival rates, but only slightly. The American Red Cross (ARC) recommends that lessons start at two years of age. Both the ARC and the YMCA have programs for infants age six months and older to “teach infants and parents basic aquatic safety and help infants and parents grow closer together”.
♦ One year-olds do not learn to swim in less time than three or four year-olds. Nor do they necessarily become more proficient later on. Early swimming lessons do not increase intelligence, concentration or alertness, as some programs claim. Early lessons should emphasize water safety for parents and water-related fun for both parents and infants/toddlers. (Parents rarely make good instructors for their own children.)
♦ Flotation devices save lives, when used correctly. Numerous types are available. Check the web. Many are designed to keep young children’s heads above the water. Devices should fit properly and comfortably; some are weight-specific. Toddlers should wear floatation devices when they play near the water, not only when they are in the water or on boats. Many young children who drown or near-drown were not supposed to be in the water. Note that many air-filled swimming aids and air mattresses are toys, not flotation devices These toys may deflate suddenly, or the child may slip off them.
♦ Infants should go swimming even if they do not swim. Blame the English language for the confusion. “Swimming” is synonymous with “bathing in a body of water.” Do place infants in water to acquaint them with it, helping them to overcome fears and preparing them for lessons. Start with sprinklers. Choose lukewarm pools. Let them splash with their hands. Don’t rush progress. Stay within arm’s reach. Infants can go under in split seconds, without making a sound.
♦ Skip swimming when your child is ill. And hope other parents do the same. Even in optimally maintained pools, children who place their heads in the water become ill more often than children who do not. They swallow water. The more crowded and the smaller the pool, the more likely illness will occur. Some swimming facilities insist that infants wear special swim diapers, designed to keep stool from leaking out. However, at best, swim diapers slow leakage.
♦ Miscellaneous. Strong chlorine odors are not signs of well-chlorinated pools. On the contrary, it may mean chlorination or ventilation systems are malfunctioning. Infants can drown or near drown in six inches of water, in bathtubs, fishponds, ditches, fountains, rain barrels, watering cans and bucket used to wash cars. Empty containers of water when not in use.
Safety alert! When traveling, many parents put their infants to bed in unsafe positions or locations, increasing the risk of SIDS (sudden infant death syndrome) and other injuries.
1. Safe sleeping arrangements are often difficult to duplicate away from home. Until infants are one year of age they should be put to bed on their backs on a fairly hard surface with no nearby toys or bumpers, says the American Academy of Pediatrics (AAP).
2. No exceptions to these rules. Not for one night. Not for short naps. Not if the child wakes up at night – which may occur more often away from home. When infants wake up at night, parents tend to make practical rather than sound decisions as to how to get the infant back to sleep, says the AAP. Advise baby sitters to follow the rules. One in five infants who experiences SIDS was in the care of someone other than a parent.
3. Never “co-sleep.” Infants sleeping in bed with adults have been injured when an adult rolled onto them or the infant fell off the bed – no matter how ingeniously adults tried to prevent problems. Breathing issues may occur when infants bury their heads into pillows, comforters and loose bed linen. Also, co-sleeping when traveling may make it difficult to get infants to sleep alone upon returning home.
4. Car seats are not for overnight sleeping. Infants sleep well in car seats but should never be left unattended in them. Problems that have occurred include compromised airways when the infant’s head flops onto its chest, entanglement in straps wrongly applied, and falling out of seats. Many car seats are unstable unless properly strapped into cars. (Also, infants should not sleep unattended on sofas, recliners, bouncy chairs or swings.)
Check cribs for safety in hotels and when visiting friends and relatives. Cribs should look new and have firm, tight-fitting mattresses (two fingers should not fit between the edge of the mattress and the side of the crib; a 12-ounce soda can should not fit between slats). Cribs should not have protruding parts, screws, bolts or cutouts in the head or footboard, which can trap an infant’s head or limb. Cribs with sides that slide up and down are no longer considered safe. If possible, check whether cribs have been recalled by the manufacturer for being unsafe. Recalls occur almost yearly.
6. “Heirloom” cribs and cradles may not meet current safety specifications. Stringent upgrades in crib design went into effect in 1970 and again in 2000. Very old cribs may have been painted with lead-containing paints. Cradles are popular overseas. While they are quaint, infants in cradles can roll so far to one side that the cradle topples over. Most cradles have pins to prevent this but the pins may be broken or missing.
7. Place cribs in safe locations. For older infants, avoid areas near window blinds, shades and drapes to prevent strangulation, and away from furniture that can make it easier for the infant to climb out. Place cribs either flush against the wall or several feet from the wall so that if infants do climb out they will not become wedged between the wall and the crib. Place pillows on the floor around the crib, just in case. Secure wheels.
8. On flights, try not to fall asleep with an infant on your lap. Infants have slipped off laps, landing on the floor and, very rarely, suffocated when a parent’s sleeping body rested over the child’s face. Safety officials recommend using an airline-approved safety seat. Some car seats serve this purpose but few parents use them. The seats are clumsy to carry and may require paying an extra fare.
9. Buy a portable travel crib.They’re very handy for car trips, can be used outdoors, are lightweight, fold easily and compactly, are easy to clean, and have not been used by others. Some are specific for infants of certain heights and weights and constructed so that older infants cannot easily climb out. Learn how to assemble and disassemble it. Have infants sleep in a portable crib for a week before leaving home.
10. Miscellaneous. Don’t medicate. Some sedating medications (antihistamines, for example) may make infants sleep less, as well as having other side effects. Take along your infants’ blankets, sheets and pajamas. Familiar textures and odors seem to make infants more comfortable. Don’t overdress them. Keep rooms on the cool side. Air conditioning does not cause illness. Ask hosts not to smoke. While travel necessitates change, try to follow home feeding/napping/going outdoors/bathing schedules. Avoid keeping infants awake for evening get-togethers and such. Products that claim to reduce the risk of SIDS (wedges, positioners, special mattresses, and specialized sleep surfaces) are not effective.
When traveling with children safety is no accident, especially when you’re overseas. At home, you intuitively sense hazardous situations. Away from home, you must retrain your brain to be on the lookout for hazards in new surroundings and during unfamiliar activities.
1. When checking into a hotel room, crawl around on your hands and knees. (You read correctly.) See the room from a child’s perspective. Are there reachable unprotected electric plugs, lamps that can be pulled down, or coffee tables with sharp edges, for example? Check the bathroom. Can children who bathe and shower by themselves at home operate the plumbing without scalding themselves? Can they lock themselves into the bathroom? Check the balcony. Can infants fit under the railing or between the supports that hold the railing? Do the same checking when staying with friends and family
2. Stop at visitors’ centers in rural parks. Information is available on safe activities, areas to avoid, hazards to look out for, weather forecasts, and emergency telephone numbers. In such parks, children are injured by falls, cooking fires, and getting too close to wild animals. Many children have their own cameras. Don’t let them open car windows and lean out to take pictures when large animals are nearby. Camera-related accidents also occur from going too close to thermal pools or cliffs to get better views.
3. Check the safety features of new activities. Snowmobiling, scuba diving, and parasailing, for example, require training, proper equipment, and age or size limits. Get safety information before you go. Virtually all sport activities have national associations with websites. Many accident-prone activities take place in areas with no medical services.
4. You are the safety inspector at amusement parks. There are almost no mandatory federal safety standards for the rides and state and local government oversight is often murky. Don’t let kids “please, please, please” you into letting them go on rides not intended for them – even though you’re there to please them. Be especially cautious of rides at small, seasonal parks, even more so if the rides are part of a traveling carnival. Observe rides before allowing children on them.
5. Appoint a designated “toddler watcher” at family gatherings. Especially at outdoor ones. Everyone wants to play with infants and toddlers. But when “everyone” watches them, no one is in charge, and toddlers can wander or crawl away. When not overseeing your child yourself, make sure that someone responsible is, and that they personally return the child to you.
6. Be wary of pets. No dog is totally predictable, especially ones not accustomed to children. Two-thirds of dogs that bite have no history of aggressive behavior. Toddlers may innocently incite dogs by suddenly running towards them, arms flailing and making happy noises – behavior dogs may interpret as threatening. Pets are edgy during large gatherings: owners spend less time with them, many unfamiliar people are present, and there is much activity and noise.
7. Teach young children to “Hug a Tree.” If children lose sight of you outdoors, they usually panic, look all around, and then run as fast as they can in whatever direction they happen to be facing, greatly increasing the chances of hurting themselves and complicating locating them. Teach them to stay put and that you will be right back. Avoid using the word “lost” (it seems to scare them.)
8. Have children wear life vests when playing near the water. Most children who drown or near-drown were not supposed to get wet. They wandered away from family picnics, were walking along a canal, or slipped crossing streams, for example. At pools and beaches, check if lifeguards are present (don’t rely on signs) and whether the guards are attentive. Also check the depth of the water before diving. Stated depth may not extend far from signs. Partially filled pools reduce depths.
9. Think safety at waterfront facilities. Are older children roughhousing? Are waves too high? Drowning and falling while climbing on slippery rocks are the leading causes of death and serious injuries in many national parks. Toddlers who have learned how to swim with an adult standing next to them generally panic when they fall into the water and no adult is there.
10. Stop driving when children become distractions. Crying infants and unruly children are as distracting as texting and using cell phones. For drivers this compounds the fatigue of long hours on the road, driving after long flights, and driving on unfamiliar roads. The more children in the car, the greater the likelihood of problems occurring. Take a break if children need your attention.