January 15, 2012
Posted in Air Travel, Safe & Healthy Travel 
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Tags: airline baggage fees, airlines, annoying children on airplane, babies on airplane, baby discrimination, baby ghettos, baby segregation, bulkhead seats, business travelers, child-free aircraft, child-free flights, child-friendly flights, family air travel, family boarding, family flights, family seating, family travel, frequent flyers, infants on airplanes, major airlines, middle seat airplane, non-collapsible strollers
Fasten your seatbelts – family air travel is heading for turbulence. Children are becoming persona non grata in the supposedly friendly skies.
London’s Daily Mail reports that several major airlines are considering child-free sections on aircraft and child-free flights. The Wall Street Journal asks, “Will new airline seating proposals create “baby ghettos” in the back of planes?” Blogs talk about families being seated separately, sometimes leaving small children in middle seats among strangers, unless parents succeed in convincing passengers to swap seats – and middle seats are difficult to swap. Airline personnel may or may not assist in “seat swapping diplomacy.”
(Will infants have to stand up for their civil rights in Occupy Wall Street-type protests? Of course, literally, infants cannot stand up. But they can raise their heads and wail to make their wills known. Will hordes of infants crawl into airports, creep beneath the crowds, and lie down blocking ticket counters and security check points? Will police dare to interfere?)
Here is what is happening:
Airlines are flying low financially. Ever-increasing operating costs are shrinking profits. Some airlines are in bankruptcy. To increase revenue, they are scheduling fewer flights and eliminating scores of amenities, many of which affect families.- Getting your family seated together is becoming a hassle. Fewer flights mean fewer available empty seats, giving reservation agents (or computers) less flexibility to find seats together. Worse, confirmed reservations can become void when sparsely filled planes are cancelled, sometimes days before flights. Passengers are then placed on other flights, ones already partially filled, and sometimes with different seat configurations, leaving few blocks of seats for families.
- Family amenities are being curtailed. Amenities cost airlines money. Cost saving measures already instituted on domestic U.S. flights include: discontinuing checking heavy, non-collapsible strollers at the gate; removing microwave ovens (no longer needed since there is no hot food service) making bottle heating problematic; not storing milk; requiring parents to bring birth certificates to prove that a lap child is really younger than 2 years of age. And don’t count on pillows, blankets and snacks.
- Families may no longer board first. Several major airlines have discontinued this practice. One airline charges $10 a person to guarantee a spot in the first boarding group in coach. Family boarding now comes after first class and frequent fliers. The reasons given: parents and kids lugging car seats, diaper bags, videogames and other large toys clog the aisles and delay general boarding.
Baggage allowances have been reduced. Don’t count on airline personnel to look the other way when you lug children’s travel paraphernalia aboard. Most airlines allow one or two items considered hand baggage, strictly enforce the rules, and charge hefty fees if more are carried. - Choice seats are no longer available for families. Bulkhead seats at the front of coach cabins have space for airline cribs and for tending to infants. But many airlines now charge extra for such seats and reserve them for frequent flyers, people with disabilities and VIPs.
- Make family reservations early and check on them frequently. Call ahead and ask whether the amenities you expect are available. If not, plan accordingly. If you can afford it, pay extra for bulkhead seats. U.S. airlines are more child-friendly on their overseas flights than on domestic flights. This is to compete with foreign airlines which tend to be very child- friendly.
- Business travelers are behind the movement to segregate children. Surveys of such travelers show that about 75% believe that children on planes are “irritating.” Business travelers fly frequently, do their work in flight, and request (sometimes, demand) seats away from children. And they have clout with the airlines. “Flights through hell” is how some describe long flights sitting near screaming infants or in front of a toddler who continuously kicks or pulls on that seat. An Australian airline recently settled a lawsuit by a passenger who said a screaming child caused her to lose some of her hearing.
Parents are often unfairly blamed for unruly children. While some parents are oblivious to their misbehaving children, in fact, even well intentioned parents have limited means to soothe crying infants and calm rambunctious toddlers. Air travel subjects young children to disrupted eating and sleeping schedules, limited and uncomfortable space, unfamiliar surroundings, and perhaps ear or stomach discomfort. Parents should set rules for their children and enforce them as best as they can, and carry plenty of snacks and games. Sedating children is not recommended.
Will airlines implement child-free sections and child-free flights? One major Asian airline already bars children from first class, and perhaps other airlines will also do so. But, likely, segregation in economy class, where most families sit, won’t “fly,” and raises questions. If family sections are full and seats available elsewhere, would families be barred from that flight? Must families with well-behaved children sit in the family section? Will adults traveling alone accept seats near children? Will soundproof partitions and separate toilets have to be installed to contain/accommodate children?
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January 4, 2012
Posted in Air Travel, Prevention, Safe & Healthy Travel, Travel Comments Off
Tags: Air Travel, airport, antibiotic, asia, breast pumps, children medication, codeine, doxycycline, families, hyperactivity, ill children, kids, Medications, nebulizers, overseas, pseudoephedrine
This is Part 2 of a two part series. To read Part 1, please click here.
You need not be under suspicion of possessing narcotics to be hassled by security and customs inspectors at airports. Families have been hassled for merely carrying everyday, over-the-counter medications, have had the medications confiscated, missed their flights and, very rarely, been detained to explain their “crime.” Moreover, once overseas, obtaining medication for your family is often a maze of confusion. When your children are ill, your treatment may be more problematic than the disease you are treating.
- Carry all your family’s medication in one kit for air travel. This makes it simpler for security personnel to check your kids and yourself. If you carry nebulizers, breast pumps and such, have letters from your doctor and get to the airport early. Security personnel must examine each item and call supervisors to look at unusual ones, and are under orders not to rush inspections because your flight is leaving.
Pack more medications than you will need – but not much more. While you don’t want to run out, large supplies make security and customs inspectors edgy. Problems occur if you are staying abroad for prolonged periods and require a large supply. Keep medications in their original containers with intact labels and drug insert pamphlets. Inspectors are not fond of containers filled with a medley of pills and capsules.- The amount of radiation emitted by airport radiation devices is insufficient to damage medications, even if you fly frequently with the same substances. X-rays do not make medications radioactive. Generally, you may request hand inspection of your carry-on bags, including medications. Leave extra time for this.
- Airport security regulations change frequently, especially regarding liquid items, the medications children generally take. Presently, in the U.S. and in many other countries, you may carry multiple liquids in quantities up to 3 ounces (90 ml) placed in a quart-size (liter-size), clear plastic, sealable bag. Medications in volumes larger than 3 oz. are permissible if placed separately and declared verbally or in writing to security personnel. A doctor’s letter explaining the medical need for the substances helps but is not essential. “Reasonable” quantities expedite security checks.
Many countries ban specific substances. It is illegal to enter Japan with many over-the-counter items commonly used elsewhere: inhalers and allergy/sinus substances containing the stimulant pseudoephedrine (Actifed, Sudafed, and Vicks inhalers), for example. Codeine-containing substances and medications to treat hyperactivity are banned by many countries in Asia and travelers have been detained for carrying such items. Check medications with the embassies of countries you plan to visit. Most have websites with complete information.- Buying medications overseas is tricky. For example, the antibiotic doxycycline is known by 50 different names around the world, says Drugs.com. This database contains information on medications in 185 countries, listing 40,000 names. Also, many medications have very similar names, in spelling or pronunciation or both. Requesting such items is further complicated when dealing with people who speak other languages. Worse, there are cases where identical names are used for totally dissimilar substances in different countries.
- Familiar items may have different strengths overseas. Even if your medications have the same name and similar packaging as items back home, they may be quite different. A teaspoon of a substance may contain more or less of the active ingredient(s) than you are accustomed to, measuring devices such as droppers may be calibrated differently, and letters at the end of the name may be in a language or alphabet you do not understand. Such letters may stand for “extra strength” or “time released,” for example, and change potency significantly.
- Prescriptions may or may not be filled overseas. In most poor, developing countries prescriptions are generally not necessary for items that require ones at home. In developed countries, pharmacists may not fill foreign prescriptions, requiring that you see a local physician. Some countries (Germany, for example) prohibit the mailing or shipment of medications from overseas so you cannot legally have someone from home mail you what you need.
Medications and herbal substances in developing countries may be suspect. A third or more of the medications bought in local pharmacies in such countries are fake, diluted, outdated, incorrectly labeled, improperly stored, and may even contain toxic substances. Natural and herbal cures are generally not properly tested or standardized (one batch rarely equals another in active ingredients) and are often stored in large open bins accessible to insects and vermin. - Traveling or not, when children are ill, consider doing – nothing. Obviously, medications are essential for many illnesses. But not so for the vast majority of mild illnesses that children experience – colds and coughs, intestinal upsets, and low grade fevers, for example. Remedies for these generally do not shorten the duration of illness or prevent children from getting worse. When possible, speak to your health care professionals back home or reputable local professionals before treating.
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December 11, 2011
Posted in Prevention, Safe & Healthy Travel Comments Off
Tags: adverse effects of medication, antacids, blood test strips, children, children medications, children travel doctor, Dehydration, Diarrhea, dimenhydrinate, Dizziness, Dr. Karl Neumann, dramamine, exotic foods, insulin, Kids Travel Doc, kids travel doctor, medication, medication interactions, medications overseas, motion sickness, motion sickness-related nausea, over the counter medication for kids, Travel, travel-related, vitamins, Vomiting
Are you familiar with the harmful effects that may result from medications you give your children? That when you give more than one medication, the two may interact and cause adverse reactions not caused by one alone? That travel-related factors can cause additional interactions?
(This is Part 1, one of a two-part series. Watch for our next posting. Find out which over-the-counter medications may be confiscated by Customs in other countries and, albeit rarely, result in you being detained.)
- Reactions to medications are common. Each year, more than half a million U.S. children have medication-related adverse reactions, some serious. Among children, those younger than 5 years are most affected; they metabolize certain substances poorly, allowing undesirable concentrations to accumulate.
- Food, food supplements and vitamins can interact with medications. Travel often means new and exotic foods, or familiar foods with different ingredients. Some foods combine with medications, neutralizing them; hence the warnings that certain substances should be taken on empty stomachs. Read drug inserts. Vitamins, food supplements, herbal medications and items marked “natural” or “organic” are often erroneously considered to be benign. Not so. These too can affect medications.
Environmental factors affect medications. Expiration dates on medications are based on proper storage at room temperatures and away from excessive heat, cold, sun and humidity. Exposure to these factors “shortens” expiration dates, and sometimes, in a matter of days, can decompose them chemically into harmful substances. Certain antibiotics and antihistamines, for example, increase the effect of the sun, worsening sunburns.- Travel-related medications can interact with medications. Dramamine (Dimenhydrinate) is commonly used to prevent and treat motion sickness-related nausea, vomiting and dizziness. One website, Drugs.com, lists 414 items that this drug can interact with: 16 major interactions, 390 moderate, and 8 minor. Dimenhydrinate requires no prescription. Over-the-counter substances are almost as likely to cause adverse interactions as those requiring prescriptions.
Illness can affect the way medications perform. Intestinal upsets prevents certain medications from being properly absorbed. Dehydration (from excessive heat) increases the concentration of substances in the body, producing symptoms resembling overdoses. Taking an antacid decreases stomach acidity. This acidity is important to destroy diarrhea-causing microorganisms sometimes found in foods, especially in developing countries. Antacids allow microorganisms to multiply more rapidly, sometimes resulting in illness. - Heat may compromise the stability of capsules, tablets and powders. Prolonged temperatures over 86 degrees F (30 degrees C) can dry out capsules, causing them to become brittle from heat and affecting how well the substance is absorbed from the intestines. Heat can cause antibiotics to lose their potency or make cortisone creams useless. But damage is difficult to detect. Clues include changes in color or consistency, odors and items sticking together. Often decisions on spoilage must be made on the basis of how items were stored.
- Most items marked “refrigerate” will maintain potency in a cool room overnight. While traveling, flight attendants usually will store medications in refrigerators if there is room. Cruise ships store medications; some provide refrigerators for staterooms. Battery-operated cooling travel bags are available at travel supply stores. Check the web.
- Humidity adversely affects quickly-dissolving tablets. Many medications for children come in this form. Excess humidity may also have an adverse effect on capsules and give false readings on urine and blood test strips. (At home, humidity makes bathrooms poor choices for storing medications. Store elsewhere.)
Medications may lose their effectiveness if they freeze. This is true for liquids, especially suspensions (items that require shaking before use). Insulin degrades if frozen or kept for prolonged periods in a very hot environment. Unopened bottles of insulin are best kept in the refrigerator. Open bottles can be kept at room temperature. - Pharmacists tend to be your best sources for information. They can access websites which track most known drugs including their side effects, interactions and stability in different environments. And pharmacists can interpret the data for you. When possible, use the same pharmacy for all your family’s purchases enabling them to crosscheck your prescriptions on their computers. Tell them about your OTC purchases and your travel plans. Most large pharmacy chains have websites that you can check yourself. Or check specific medications on the web; most manufacturers have detailed information about their products. Make sure that you check recommendations for children.
Consider medications when children display unusual symptoms. Symptoms may appear immediately or days later. The most common symptoms include changes in behavior, skin manifestations and gastrointestinal upsets. Medications children take for hyperactivity and attention deficit conditions are prone to drug interactions. Consult your pediatrician regarding what to do if you must discontinue medications. Some should not be stopped abruptly.
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November 24, 2011
Posted in Safe & Healthy Travel Comments Off
Tags: Caribbean Island, child health care, children, co-pay, co-payment, copay, cruises, Destinations, domestic travel, family vacations, fever, healthy travel for kids, HMO, hospitalization, illness, in-network facility, insurance card, insurance coverage, kids health care, land excursions, medical bills, medical expenses, non-emergency visits, overseas, reimburse, scuba diving, skiing, Travel, travel plans, traveler's assistance insurance
There is an old saying that children always become ill at inopportune times. But are there opportune times?
Especially exasperating is when they choose family vacations for their illnesses. Worse, you then discover that your insurance policy does not reimburse you for medical expenses incurred away from home, provides no assistance in finding medical care, and does not cover the cost of changing your travel plans.
Here is what you have to know:
1. Young kids get sick often. With preschool children, count on having about half a dozen illnesses a year with roughly half requiring a visit to the doctor. So if you are away from home two or three weeks a year, there is a fairly good chance that illness and travel will one day coincide.
2. The good news. Studies show that travel is surprisingly safe and healthy for children. This is true for adventurous travel, going overseas, and even for infants. And when ill, the illnesses are usually minor and generally the same kind of illness they would have experienced had they stayed at home But, unfortunately, there are exceptions.
3. Children can become ill even before you leave home. Many family trips are planned – and paid for – long in advance. The more children, the greater the chances of one becoming ill, the more money down the drain if you must cancel. Increasingly, documentation of illness, doctor’s notes, for example, do not help in obtaining refunds from airlines, cruise lines, amusement parks, and ski resorts, for example. Check cancelation policies and consider cancellation insurance. (Ditto for non-medical reasons for cancellations; business-related, weather, or turmoil at your destination.)
4. Check your insurance coverage. An informal survey of dozens of parents planning major family trips showed that most did not know whether their children (or themselves) are covered for medical care while traveling. They had not read their policies – not even the large print.
5. Is your insurance accepted everywhere in the U.S.? Not necessarily. Your carrier or HMO may be a regional or statewide entity, one not automatically recognized in other parts of the country. Even large nationwide companies have limitation on coverage away from home. Disputes often arise over non-emergency visits, for ongoing chronic conditions, asthma, for example. Some companies require pre authorization for such visits. Check with your carrier.
6. What is an emergency? Within the U.S. in case of an emergency, insurance companies advise you to go to the nearest medical facility, whether or not it is in your network, and pay the bill if necessary. If it is out of network, your company will reimburse you later – usually weeks later and, sometimes, only if the company says it was an emergency. For example, reimbursement was denied for a late night emergency visit for an otherwise healthy 10 month old, cranky child with a fever of 101 degrees F (38.5 C). The bill came to several hundred dollars. (Medically, speaking, this case is a gray area.)
If hospitalization is recommended, companies strongly suggest you obtain pre-authorization in all cases other than dire emergencies.
7. Envision paying for medical bills. In-non-emergency situations look for urgent care clinics, emergency rooms or a doctor’s offices which accepts your insurance. If there is one, you will pay only your usual co-payment. (Carry your insurance card. Make copies, and have each adult carry one.) If no in-network facility is available, look for one that accepts your credit card. For major trips and long absences from home, assign a relative or friend who can help you in case health, financial or other problems arise. Keep receipts for all medical expenses to submit to your insurance for reimbursement later.
8. Does your primary insurance carrier automatically pay for expenses incurred outside the US? Until recently, the answer was, no. And for most policies that still is the answer. But, recently, some companies have added coverage for health issues occurring overseas, sometimes at no additional cost. Check with your company.
When you travel, whether domestic or international, also check if your policy covers all destinations, all family members and all activities. For example, check categories such as: remote Caribbean island; cousin and grandparent; skiing and scuba diving accidents, for example.
9. Consider buying travelers’ assistance insurance. Such companies provide: world-wide, 24-hour telephone “hotlines” manned by “assistance coordinators” who direct you to approved English-speaking physicians and hospitals, guarantee payments, and if necessary, arrange transportation to a facility that can provide the necessary treatment. Some companies offer such services within the U.S., if you live more than a certain distance from your home, usually a few hundred miles. However, the company decides whether, where, and what kind of hospital care is indicated. You may not be covered for pre-existing conditions. The companies may also reimburse you for changing non-refundable airline tickets, for example. Numerous companies advertise on the web.
10. Travel assistance insurance is expensive. But you may be eligible for reduced or even free insurance. Some companies insure children free when parents buy policies. Many corporations, universities, and other organizations cover their employees overseas. Your credit card company provides such insurance, allegedly at reduced cost. Most cruise and package tour operators insist clients buy travel assistance insurance, and include it in the price of the trip. However, on cruises, for example, you may be covered only for ship-related incidences, not for air travel or land excursions you take on your own.
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October 23, 2011
Posted in Air Travel Comments Off
Are infants likely to catch colds and other infectious diseases during air travel?
I have been asked that question hundreds of times, more than any other involving children and travel. And even though I’ve had decades in pediatrics and travel medicine to think about it, read all I could find on the subject, and talked to dozens of experts in related fields, I have no definitive answer. (What I tell parents is at the end of the article.)
Here is what we know – and mostly, what we don’t know:
1. There is nothing in the medical literature on the subject. Much of the advice in the media is simply hearsay or extrapolated from information on adults (who do become infected, but, rarely) and infants’ susceptibility to various diseases on the ground.
2. No infants were involved in known in-flight disease outbreaks. There are about a dozen documented cases where numerous passengers contracted an infectious disease (in one case, tuberculosis) from a fellow passenger. About a billion flights are taken each year worldwide and estimates are that one million are by infants less than one year of age (about one percent of passengers). With so few known outbreaks and relatively few infants traveling by air, it is very possible that, by chance, no infant was exposed.
3. Likely, many disease outbreaks are never recorded. Most infectious diseases have incubation periods of days or weeks; symptoms can’t occur during flight from illnesses caught on that flight. And, after landing, passengers scatter. Unless there are a very large number of passengers involved or it is a serious illness, an in-flight outbreak remains unknown.
The illnesses that parents claim that their children contracted in-flight were, in fact, caught days earlier, or the children are reacting to fatigue and other discomforts associated with air travel. (Disease outbreaks are frequently reported on cruise ships. The reason: passengers spend days or weeks together and see the physician aboard ship. Outbreaks on ships calling at American ports must be immediately reported to the U.S. Public Health Service.)
4. Attempts to ban individuals who are ill from traveling by air are rarely effective. Airline personnel can refuse to board an ill-appearing passenger – but rarely do so. Coordinated attempts to identify ill passengers during known epidemics, Severe Acute Respiratory Syndrome (SARS) and H1NI in recent years, were only partially successful, for several reasons. Infected individuals spread disease-causing organisms several days before symptoms surface. Some passengers travel knowing they are ill. Symptoms are fairly easy to disguise and changing travel plans at the last minute is cumbersome and, sometimes, expensive.
5. Air travel favors the spread of infectious diseases. Infected individuals exhale, cough up and sneeze out disease-causing organisms. Nearby passengers inhale the organisms. The longer the exposure, the more organisms inhaled, and the greater the risk of infection.
6. Very long flights further increase the risk of infection. Such flights further increase exposure time and, often, are to and from Asia or the Southern Hemisphere, areas where different disease causing organisms exist. SARS and HINI influenza originated in Asia. Influenza viruses in the two hemispheres differ sufficiently that there are separate vaccines for the two. People living in one hemisphere have little immunity to the influenza viruses found in the other. Young children are especially susceptible to influenza.
7. However, sophisticated ventilation systems minimize organisms in the cabin air. Air is continuously pumped into the cabin during flight. Outside air at cruising altitude is sterile and, in most aircraft, the air passes through the hot engines, killing all organisms. In the cabin, half the air passengers breathe comes from the outside and half is recirculated through hospital-grade filters, removing almost all organisms. Cabin air is exchanged numerous times per minute, more often than in most public buildings. And air circulation goes vertically, from ceiling to floor, not horizontally throughout the cabin. If an individual is traveling with a contagious disease, only passengers sitting within a row or two are exposed.
8. Risk of infection may be greatest when aircraft are on the ground. Often passengers sit in aircraft for prolonged periods before takeoff, and sometimes after landing. During such times ventilation systems may be inoperative, increasing the risk of illness. New regulations limit the time that passengers can be kept in an aircraft on the ground.
9. Airlines are required to keep seating plans after flights. If an individual is diagnosed with a serious contagious disease soon after air travel (tuberculosis or meningitis, for example), passengers who sat in nearby seats are notified of their exposure. They may need preventative medication. However, the notification system has shortcomings: sick individuala are not always reported to the proper authorities, passengers change seats during flights, and difficulty locating exposed passengers.
10. What can you, the parents, do to protect your children? Not much. Using nasal sprays may help. Cabin air is dry. Dryness prevents the hairs in the nose from killing organisms inhaled. Also, wiping down seats and trays and frequently wash children’s hands; some organisms survive for days on inanimate objects.
Products available at airports to “boost” the immune system – Echinacea, and large doses of Vitamin C and Zinc, for example – are inappropriate for young children (and probably ineffective at any age).
My opinion: Air travel is a low risk activity for healthy young children when there are no reported epidemics. The chances of contracting illness are remote, far less than at daycare, early childhood classes, and birthday parties.
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October 3, 2011
Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Travel Comments Off
Thank you for making our website, KidsTravelDoc and our newsletter, TenTips the sources for keeping kids healthy and safe for travel and outdoor recreational activities. TenTips has almost 7,000 subscribers in about 55 countries. Our articles frequently make the top five references on Google.
In fact, we have many more readers than subscribers. Many of you forward TenTips to friends. And many physician readers (35% of subscribers) print TenTips to distribute in their offices or post on their websites.
Readers ask if they can add friends to our mailing list. Yes. Click here to do so. If you have more than one name to add, please send the list to travhealth@aol.com . (We never share or sell addresses.)
All our newsletters are indexed and updated on our website, KidsTravelDoc. Below are seven topics which may be of interest. Click on topics you want to read.
Airport/Children/ Navigating security: Avoiding hassles. (Each year several infants are accidentally placed on conveyer belts at security and pass through the machines…)
Outdoors/Sick children/Old wives’ tales/Bed rest/Fresh air: Caring for sick children is never child’s play. But outdated advice – keeping them quiet, for example, only make them more irritable – and more irritating.
Air Travel/Long flights/Children/To sedate or not sedate?: This is an oft-raised question. Is it truly nobler to spurn sedatives, risk an unruly child, and bravely suffer the heartaches of stares and scorn of outraged fellow passengers? Or is it more virtuous to sedate infants, perchance they’ll sleep, and endure the thousand humiliations that parental guilt is capable of self-inflicting?
Infants/Car safety seats/New recommendations: Just when you thought that you knew all you had to know about children’s car safety seats, the experts come up with a slew of new recommendations, forcing you to rethink what you were sure that you already knew.
Children/Animal encounters: Children may become ill from visiting petting zoos. But they also become ill in well-managed daycare centers and get hurt in modern playgrounds. You need to judge the risk/benefit ratio for any activity your child engages in.
School/Vacation/Priorities: You want to take your family to Disneyworld. You are as eager to go as they are; you’re feeling guilty. Lately you’ve spent too little time with them: work schedules and such. You find an ideal and affordable package. But they will miss three days of school. It’s a case of family bonding versus teaching kids priorities. Do you go?
Traveling/Living overseas: Children make great travelers. They are inquisitive, fun and, when motivated, adaptable and inexhaustible. Time spent overseas, whether a week in Paris or a year in a developing country, helps enrich their education, builds self-confidence, promotes family cohesiveness, and creates memories for tomorrow.
Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Travel Comments Off
September 17, 2011
Posted in Air Travel, Safe & Healthy Travel Comments Off
Tags: Air Travel, airport screening children, airport screening kids, airport screening rules for kids, airport security checks for kids, does my child have to remove shoes at airport, effect of metal detectors on children, full body images, kid medication, metal detectors, pat-down, rules about children at airport screening, security checks kids, tsa children
Children/Airport Security/ New Rules
Good news for parents traveling by air with their children. The U.S. Transportation Security Administration (TSA) has announced that it is easing airport security screening procedures for children under the age of 12 years, and is also easing the rules for carrying liquid medications. But expect occasional exceptions to the new rules.
Here are the reasons for the new rules and the effects they will have on you and your children.
1. Children will no longer have to remove their shoes. Removing shoes during checkpoint screening was begun in 2001 when an operative tried to set off a bomb built into his shoe on a flight in December 2001. But few countries around the world adopted this requirement; countries in the European Union have never required travelers to remove their shoes. Apparently there are other methods to prevent such acts.
2. There will be fewer pat-downs of children. Screening procedures can be upsetting for young children; they are taught at an early age not to allow strangers to touch them. Screening is especially troubling for children with serious psychological and other behavioral issues.
3. Rules have been simplified for carrying liquids through security. This includes medications. You are now permitted to carry multiple liquids in quantities up to 3 oz. (100 ml) when placed in a quart (liter)-size, clear plastic, sealable bag. Medications in volumes larger than 3 oz. are permissible if placed separately and declared verbally or in writing to security personnel. A doctor’s letter explaining the medical need of the item is helpful but not essential. “Reasonable” quantities expedite checks.
4. New rules will not compromise safety. To reduce the number of pat-downs screeners will send children through metal detectors or the walk-through imaging machines multiple times to capture a clear picture, and use more explosive trace detection tools such as hand swabs.
5. New security devices are safe. There is no evidence that children will be harmed by metal detectors, even if they pass through the devices numerous times, or from hand swabs used to detect explosives.
6. Does full body screening violate children’s rights? Yes, say some child advocacy groups in the US and in Great Britain. These groups believe that screening devices that show full body images of naked children violate anti-pornography laws. Adults can refuse such screenings and accept pat-downs. Adults can make the same choice for their children.
7. Security checks of children will continue. According to counterterror experts, the psychological profile of terrorists does not rule out them using children – their own and others’ – in deadly missions, that children as young as ten years have been recruited to carry out missions, and that there is evidence that terrorists have planned to plant explosives in teddy bears and other children’s toys.
8. There will be exceptions to screening rules. And you will not be able to object if your child is asked to take off his or her shoes and is patted down, says the TSA. “There will always be some unpredictability built into the system, and there will always be random checks even for groups that we are looking at differently, such as children.” This is to help keep terrorists guessing.
Posted in Air Travel, Safe & Healthy Travel Comments Off
August 24, 2011
Posted in Destinations, Prevention, Safe & Healthy Travel Comments Off
Tags: bathroom accidents, bathroom hazards, bathroom safety children, children safety, Dr. Karl Neumann, hot water, hotel bathrom safety, hotel bathroom, hotel bathroom accidents, hotel bathtubs, slip-proof, toilet drowning, water pressure
Warning: hotel bathrooms are hazardous for your children – even more hazardous than the bathrooms in your home.
1. Upscale hotel plumbing is all about sleek appearance. Even adults have difficulty deciphering the numerous knobs on tubs and showers, for example. One never knows where the water is going to come out, and at what temperature. Most knobs have no ONs or OFFs, HOTs or COLDs, shower or tub, symbols or arrows. Overseas, different letters represent “hot” and “cold.” Call housekeeping for interpretations, if necessary.
2. All bathrooms are hazardous for children. U.S. emergency rooms annually see 43,000 bathroom-linked injuries in children 18 years or younger. (Many more injuries are treated elsewhere.) More than half of the injuries occur in children less than four years of age. More than eighty percent are due to falls and 4% are hot water-related.
3. Check hotel bathrooms on arriving. Are there locks on the inside of the door? Young children tend to be better at locking than un-locking. Many hotels in developing countries have reachable candles and matches on sinks in case of electricity outages. Remove accessible hair dryers, razors, and such. When visiting friends and relatives, check medicine chests, cabinets under the sink and wastepaper baskets for potentially harmful products.
4. Children who can shower and bathe alone at home may need supervision away from home. Young children generally assume that if situations/conditions closely resemble ones that they have previously encountered, they are identical. They fail to recognize subtle differences and do not make the necessary mental adjustments. Hence the high injury rates in children in places like bathrooms. Poor coordination and lack of strength also play roles.
5. Bathtubs are the site of 79% of bathroom injuries. Many hotel bathtubs are large, deep, and have wide sides to straddle. Tubs themselves have slippery surfaces. (Slip-proof tub surfaces and adhesive strips are often not used because they are difficult to maintain and appear “dirty,” which takes away from appearance.) Grab bars, which help adults get in and out of tubs, usually are not reachable by young children. Instead, children reach for towel racks which are not intended for weight bearing; the racks can be pulled off the wall. Bath mats without rubber backing are not slip-proof and are worse than no mat. Don’t use towels for bathmats. Insist that children sit for baths, not walk in the tub.
6. Keep floors dry. Easier said than done; children like to splash and most hotel bathroom floors are slippery, even when dry. Falls in bathrooms are more likely to result in injury than falls elsewhere. Bathrooms are generally small so falling often results in striking tubs, toilets or sinks, causing head trauma, lacerations and broken bones. Mop up constantly. Ask for extra towels. Make sure that shower curtains and doors keep water in.
7. Test the water temperature before children get in. A survey of major U.S. hotel chains found that many occasionally had water at scalding temperatures, probably due to malfunctioning anti-scald valves. Hot water temperature should not exceed 130° F (54° C). Especially monitor water temperatures in inns, guest houses and in hotels in developing countries which are more likely to have faulty temperature control mechanisms. Don’t add hot water to baths while children are sitting in the tub. Bathtubs are not swimming pools. Use the shallowest amount of water possible when bathing young children.
8. Tubs are generally safer than showers. Shower water temperature is harder to control, as water temperature can change suddenly and cause burns. Tripping is likely to occur when children (and adults) attempt to rapidly escape sudden bursts of hot or cold water, especially when showers are in bathtubs.
9. Instruct children on “don’ts” around toilets. Injuries have occurred when lids break from children jumping on them. Seats may be delicately balanced and fall on children’s hands and, in boys, on their penises. Children fall while standing on toilets and stretching to reach sinks to wash up; sinks may be further from the toilet than at home. Consider traveling with an appropriate stepstool. Some children-friendly hotels have them. Keep toilet lids down when not in use. In a recent five-year period in the U.S., 16 toddlers drowned by falling headfirst into toilets.
10. Miscellaneous safety tips. Luggage, clothing and towels on the floor of hotel rooms and bathrooms are common causes of falls. Keep a small light on at night. Spa-type tubs are inappropriate for small children due to strong sprays, water currents, and excessive heat. Infant bath seats are not safety aides. Recently the government upgraded mandatory standards for seats to prevent seats from tipping over. Such seats are involved in an average of 7 deaths a year in the U.S. Keep infants within an arm’s reach at all times.
======================================================
Shower instructions at a five-star hotel in St. Andrews, Scotland:
Water Pressure. Turn the upper control anti-clockwise to activate water at the standard pressure. To increase the water pressure, press the end of the override switch on the side of the control and continue turning.
Water Temperature. Turn the lower control to change the water temperature, up to 40 degrees Centigrade. To increase the temperature further, press the end of the override switch on the side of the control and continue turning.
Posted in Destinations, Prevention, Safe & Healthy Travel Comments Off
August 7, 2011
Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Sun Comments Off
Tags: acclimatization, air conditioning, air temperature, baby carriers, children, Dehydration, drinking water, fluids, healthy, heat index, heat-related illness, HI, hot weather, Infants, national weather service, obesity, perspiration, Prevention, relative humidity
Common sense, air conditioning and readily available drinking water have greatly reduced the incidence of heat-related illness in infants and children. But don’t let your vigil down. Cases do still occur, generally due to lack of forethought, and sometimes with horrific results.
Here is what you must know:
1. The younger the child, the more susceptible to heat-related problems. Young children produce more heat per body weight and their ability to perspire is less efficient. Perspiration is the main mechanism for the body to rid itself of excessive heat.
2. Pay attention to the heat index (HI). During heat spells the HI is well publicized by the National Weather Service and the media. The index combines air temperature and relative humidity. The higher the humidity, the less efficient perspiration becomes and the more heat remains in the body. (Conversely, dry air removes perspiration from the skin, and removes heat from the body.) In short: high HI = rethink outdoor activities. Consider staying indoors.
3. Fluids. Fluids. Fluids. Drinking appropriate types and amounts of fluids helps prevent dehydration, one of the roots of heat-related issues. In hot weather the body needs fluids to produce perspiration to keep cool and to keep the brain and other vital organs functioning optimally.
For infants and young children, the type of fluids taken is not particularly important. Offer them additional breast milk, formula or water. Encourage them to drink, but never force them. Older children participating in strenuous activities may benefit from sports drinks to replace sodium, chloride and other elements lost with perspiration. Encourage older children to drink even when they are not thirsty.
4. Forget old wives’ tales. You do not become ill from air conditioning blowing on you (though many adults find this annoying) or from going in and out of air conditioning. In very hot environments, fans merely blow hot air around with virtually no cooling effect. Cold drinks do not cause illness, though some children (and adults) experience mild, fleeting stomach discomfort from such drinks. Nor do cold drinks appreciably cool the body – unless you consume many liters. At best, cold drinks give some people a psychological boost. Eating spicy foods does not increase perspiration and has no cooling properties.
5. Dress children in lightweight, light-colored, loose-fitting cotton garments. Loosely fitting shirts allow wind currents to remove heat from the skin and absorb perspiration. This helps cool the body and helps prevent heat-related rashes. Leave diapers loose, when possible. Avoid sunburns. Click here to see our TenTips on preventing and treating sunburn.
6. Recognize early warning signs. In hot weather, think “heat” when children display nausea, vomiting, headache, dizziness, changes in mental status, profuse perspiration, paleness, muscle cramps, tiredness, or weakness. If symptoms occur, seek professional help. For children in organized programs, make sure that the staff understands heat-related issues. And consider “heat” when preverbal children become inexplicably irritable. First get them to a cool place (air conditioned cars are often handy), offer them fluids – and then check for other possible causes.
7. Children require several days to acclimatize. Their bodies take longer to adjust to heat than adults. Summer football workouts and travel to hot, humid climates are common sources of heat-related problems. Gradually increase the length of time and intensity of exertion. Athletes may take up to a week to acclimatize completely.
8. Be aware of risk factors. Being overweight decreases heat loss; layers of fat under the skin are good insulators, keeping heat in the body. High school football players suffer heat-related problems ten times more commonly than athletes in other high school sports; 47% are obese (Centers for Disease Control statistic), they wear heavy equipment, and practice begins in summer with little time for acclimatization. Other risk factors are illness, rarely exercising, previous episodes and the use of certain medications.
9. Other considerations. Choose baby carriers made from lightweight nylon. Heavy fabrics, your body heat and the snugness of the carrier produce heat. Limit use of car safety seats outdoors on hot days, at picnics, for example; the seat partially surrounds the infant with heavy fabric.
Diet plays little role in staying cool. In hot weather, older children and adults generally gravitate away from meats and hot foods, which add some heat to the body, and towards fruits and vegetables, which are marginally beneficial because these foods have high liquid content.
10. Never leave children unattended in or near cars, especially in hot weather. This may seem like needless advice. Not so. In 2010, in the U.S., 49 young children died and many more were injured, some permanently. Most were left intentionally with parent planning to return immediately, but becoming distracted, meeting a friend, or receiving a cell phone call, for example. Other children were forgotten, usually having fallen asleep. A few children climbed into unattended cars, locked themselves in and were unable to exit. In hot weather, the temperature in a closed car can increase from 80 to 120° F (27 to 49° C) in 15 minutes.
Posted in Outdoor Recreation, Prevention, Safe & Healthy Travel, Sun Comments Off
July 17, 2011
Posted in Safe & Healthy Travel, Travel Comments Off
Tags: australia, Brazil, canada, China, Driving, family travel, India, jetlag, local transportation, Mexico, Morocco, motor vehicle related accidents, motor vehicle safety, motor vehicles, Nigeria, Norway, overseas, overseas motor vehicle, road hazards, Russia, traffic circles, traffic signals, traffic signs, UK, US, Vietnam
Motor vehicle-related accidents – not illnesses – are the biggest threat for families traveling overseas. While illnesses occur far more frequently – and children are especially susceptible – most illnesses are minor. On the other hand, injuries, whether to car occupants or pedestrians, are the leading cause of death of Americans overseas and of British children overseas.
1. The poorer a country, the more ominous the statistics.
Representative risks of motor vehicle-related deaths per 10,000 vehicles per year
| Nigeria |
193 |
|
Brazil |
4 |
| Morocco |
34 |
|
US |
2 |
| China |
26 |
|
UK |
2 |
| India |
26 |
|
Canada |
2 |
| Russia |
15 |
|
Australia |
2 |
| Vietnam |
14 |
|
Norway |
1 |
| Mexico |
4 |
|
|
|
(These figures are for local populations. The risk for visitors is likely less; they generally use safer transportation. These figures offer country to country comparisons. Americans driving in Mexico are involved in more accidents than when driving at home, for example.)
2. Consider leaving the driving to others. Reputable local drivers can better deal with language issues, driving customs, and road conditions. Rules regarding passing, signaling and headlight use vary from country to country. Make clear to drivers that you are in no hurry. Request safe routes rather than the fastest or most scenic ones. Check vehicles for safety features for young children. Take bus tours with reputable travel agencies.
3. Don’t drive immediately after long flights through many time zones. Jetlag, fatigue and lack of sleep interfere with cognitive thinking and reaction times – essential for driving on unfamiliar roads. Cranky, jetlagged children worsen the mix.
4. Familiarize yourself with road conditions. In poor countries, most roads are badly designed, not properly maintained or patrolled, and have few traffic signs. Many drivers lack basic driving skills. Law enforcement is lax. Emergency medical services are inferior or nonexistent. Rapid development in many countries worsens the situation by placing ever more cars on roads without improving the roads. Driving at night is especially hazardous. Drivers turn off headlights to save fuel.
5. Don’t underestimate the hazards of driving on the “wrong” (opposite) side of the road. Problems arise when you enter a street/highway, make turns or pass other vehicles. Traffic circles (“roundabouts”), common in Britain, can be disorienting. Generally roundabouts have no signal lights, traffic moves counter clockwise, and you exit the traffic circle on the left side of the road. Avoiding errors takes total concentration. Misbehaving children are a serious distraction.
6. Familiarize yourself with regulations regarding children. In many European countries having a reflective vest for each child (and, sometimes, for adults) is mandatory. The vests must be worn in emergencies (if children have to stand at the side of the road, for example). Also, strict laws regulate seatbelt use and where children must sit. In some countries, children under the age of twelve, regardless of size, must sit in a rear seat.
7. Rent cars from well-known international companies before leaving home. Such agencies are more likely to have well maintained cars. Check if they have appropriate children’s restraints available or if you must bring your own. Generally, larger cars are safer but are difficult to maneuver on narrow roads.
8. Think twice before using quaint local transportation. Riding three-wheel taxis, small open vans, and other inexpensive and colorful local vehicles make for memorable family photos but such vehicles are unsafe. You must hold small children on your lap – which is dangerous if the vehicle tips over (not a rare occurrence) or is involved in a collision.
Think twice before allowing teenagers to use motorized bicycles, scooters and mopeds; these take practice to operate, especially on overcrowded roads. Helmets may not be available. In Bermuda, where motorized bikes are popular, visitors sustain higher rates of injuries than locals. Mishaps occur even at low speeds. Check lower age limits for teenagers to ride such vehicles.
9. Children who cross streets safely at home may need help overseas. Crossing streets that may have no crosswalks, traffic moving on the opposite side of the road, motorbikes to dodge, and drivers who may disobey traffic signals requires consciously rethinking well ingrained (“kneejerk”) reactions.
10. Sources of current safety information:
U.S. State Department: http://travel.state.gov/travel/tips/tips_1232.html
United Kingdom: http://www.fco.gov.uk/en/travel-and-living-abroad
International Road Travel (ASIRT): http://www.asirt.org/
Make Roads Safe: http://www.makeroadssafe.org/Pages/home.aspx
Posted in Safe & Healthy Travel, Travel Comments Off
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