Visiting Mexico City: 7,550 feet. Viewing the Grand Canyon: 8,000 feet. Skiing in Colorado: 8,000 feet (with some slopes going higher.) Driving up Pike’s Peak: 14,000 feet. At these elevations most children run circles around their huffing and puffing parents. But some children will show symptoms of acute mountain sickness (AMS), and a rare child will experience symptoms requiring prompt medical treatment.
Here is what you should know:
1. AMS is not due to less oxygen in the air.
The percentage of oxygen remains the same: 20%, whether atop Mt. Everest (29,000 feet) or at sea level. But as you go higher atmospheric pressure decreases. There is less force to propel the oxygen from the air into the lungs and blood stream, resulting in less oxygen reaching vital body organs such as the heart and the brain.
2. Know the altitude of your destination.
You need not be atop a mountain to be at high altitude – for example, the Grand Canyon and Mexico City are both at high altitude. Altitude is especially an issue at night because breathing is much less efficient during sleep. For mountainous activities, “climb high, sleep low.”
3. Choose destinations where medical treatment is available.
Many high altitude locations are remote and lack medical facilities, and weather conditions can prevent descent.
4. Ascend slowly.
About 30% of infants and young children show symptoms of AMS after rapid ascents of 5,000 feet or more, about the same incidence as in adults. The percentage increases the higher the altitude reached. Ideally, stay overnight at an intermediary elevation when going from near sea level to 8,000 feet or higher. Driving to high altitude destinations is better than flying; it takes longer thus facilitating acclimatization
5. Recognize symptoms of Acute Mountain Sickness.
Signs include headache, fatigue, loss of appetite, nausea, vomiting, irritability, excessive shortness of breath with exercise, and inability to sleep. Symptoms generally begin between 18 and 72 hours. Identifying symptoms in preverbal children can be difficult. Similar symptoms occur with upper respiratory and intestinal infections. If you are not sure, think AMS and act accordingly.
6. Give children time to adjust to altitude.
Have them avoid strenuous activities the first day. Never ascend further when AMS-like symptoms are present. If symptoms are mild, remain at the altitude you are at. Resume ascent after a symptom-free 24 hours. Staying dry and warm helps prevent AMS, hypothermia, and frostbite. Consider these as potential causes of unexplained crying in infants.
7. Give children frequent snacks and drinks.
More calories and liquids are required to compensate for cold and exertion. Dehydration increases the risk of AMS, hypothermia and frostbite. Don’t wait for thirst; it is not a good indicator of need. Drinking replaces fluids lost to dry air by heavier breathing and by perspiration under heavy clothing.
8. Have children breathe through facemasks and scarves in cold weather.
Sore throats and coughs are common at higher elevations, probably the result of deeper respirations. This causes mouth breathing, allowing more cold, dry air to bypass the warming and humidifying effects of breathing through the nose. Exertion and cold weather further increase the depth of breathing. Indoors, humidifiers and steam inhalation may be beneficial.
9. Be familiar with treatments.
Descents of 1000 feet generally relieve symptoms. Seek medical help when decent is not feasible or symptoms worsen. Oxygen and medications may be necessary. Headaches generally respond to aspirin (only for older children), ibuprofen and acetaminophen. Increased fluid intake also helps relieve headaches; dehydration can be a factor. Headaches that do not respond promptly may be early signs of more serious altitude-related problems.
10. Children with significant heath issues need clearance before going to altitude.
Severe anemia and heart and lung problems, for example, increase the risk of AMS. Generally, children who can play and run about at home without shortness of breath tolerate altitudes up to 12,000 feet. Simple tests help predict safe elevations.
Children with poorly controlled seizure disorders or those who had seizures in the past but are no longer on medication may be at increased risk of seizures.
Children with asthma do well in mountains, often better than at home, probably because of the clean air. Nevertheless, they should continue their medications.
For additional information: click www.high-altitude-medicine.com.
