Travelling with a Poorly Child or Grandchild

Every parent knows that kids do spend a lot of their time getting poorly! So whether you’re heading off on holiday with your children, grandchildren or extended family and friends, it’s important to be prepared.

On the plus side, I can vouch for how quickly kids often get better. I’ve lost count of the number of times my younger patients’ exhausted parents have arrived in my consulting room, up all night with a little one – while their youngster is bouncing around happily, fully recovered.

But they can also go downhill just as fast, and it’s a particular worry if they become ill when you’re far from your usual medical services.

Why Do Children Get Sick More Often?

Firstly, children haven’t been exposed to as many bugs as adults, so their immune systems (which help us fight off disease) haven’t built up the same level of protection.

What’s more, their immune systems are less mature and may not be as effective. This may be in part because as a species we’ve evolved to prioritise growth over immunity in childhood. Children’s bodies are growing fast, meaning they use up more energy and need food and drink more often. So they may absorb poisons more quickly than an adult would.

That’s before we get to their social habits! We all know kids spend a lot of time touching each other when they’re playing, or cuddling up close to adults. That means they’re more likely to come into contact with infectious diseases like coughs and colds. They’re also still learning about washing their hands and less fussy about what they put in their mouths, so are more prone to tummy bugs and the like.

Finally, because kids are smaller they have a bigger surface area (of skin) compared to their volume. This makes them more likely to get dehydrated if they’re very hot, have diarrhoea or vomiting or aren’t drinking much.

What Do Children Get Ill With Most Often?

According to a 2018 survey, the top five illnesses children get on holiday are tummy bugs, flu/cold/sore throat, chickenpox, food poisoning and ear infections. The most common injuries are cuts, insect bites, bruises, sprained wrists and bumps to the head.

Some of these – especially coughs, colds, ear infections and chicken pox – are common in the UK too. So it’s worth knowing the warning signs of possible serious illness anyway.

But when you’re abroad, it’s also essential to know how to contact a doctor or get emergency medical help. And since you may not be able to access over-the-counter medicines easily, it’s important to consider what you should take with you.

What Supplies Should I Take With Me?

There are a few first-aid essentials you may be very grateful for if your little one is poorly while you’re on holiday. Do remember that liquids over 100ml and scissors can’t be taken in your hand luggage (apart from certain prescribed medicines etc).

READ MORE: Travelling with Medication

• GHIC or EHIC. Your child, like you, is entitled to a Global Health Insurance Card (GHIC), which is replacing the European Health Insurance Card (EHIC). This offers urgent medical care at the same cost as local residents pay across the EU and in some other countries.
• Travel insurance certificates – even if you’re travelling in a country covered by a GHIC or EHIC, it’s still essential to take out travel insurance which covers any conditions your child or grandchild may have. The GHIC doesn’t cover all costs and not declaring any health conditions on private insurance cover could mean the insurance is invalid.

READ MORE: GHIC, EHIC & Travel Insurance

• Thermometer (healthcare professionals use in-ear versions as they’re most accurate)
• Tweezers for small splinters etc.
• Small scissors for cutting dressings.
• Liquid painkillers – paracetamol or ibuprofen. Take a good supply suitable for the different ages of any children travelling with you. Check the correct dose of both paracetamol (from 2 months) and ibuprofen (from 3 months).
• Oral syringes or medicine spoons.
• Antihistamines – for itchy insect bites and chicken pox.
• Antiseptic and antiseptic wipes.
• A selection of plasters, dressings and bandages.
• Travel sickness medicine for older children if they’re prone to travel sickness – speak to your pharmacist.
• Insect repellent.
• Hand sanitiser

READ MORE: 10 Essentials For Your Holiday Medical Kit

How Do I Look After a Poorly Child?

Like you, a child is likely to feel tired and need a lot of rest if they’re poorly. Keep the room at a comfortable temperature, and make sure it’s not too hot. A fan or tepid (never cold) sponging may be needed if they have a fever.

Offer them regular fluids, and do encourage them to drink (especially if they have a fever or diarrhoea and vomiting). Encourage them to rest, but let them lie on the sofa rather than in bed if they prefer.

If your child is mildly unwell, they don’t automatically need painkillers. However, if they’re uncomfortable because of a fever, you can give them paracetamol or ibuprofen. However, do make sure you give the correct dose for their age.

Never give ibuprofen to a child with chicken pox, or to a child with asthma unless you’ve checked with your doctor. Children under 16 should never have aspirin because of the risk of a very rare but serious complication called Reye’s syndrome.

If a child has diarrhoea or vomiting, don’t give fruit juice or fizzy drinks, as these could worsen diarrhoea. And use infant formula, if your baby is taking it, at normal strength rather than watered down.

Warning Signs of Serious Illness 

If your child becomes unwell, you know them better than anyone. If you’re a grandparent, you’d be amazed how quickly the memory of your children's childhood illnesses – and what you did about them – comes back.

Do trust your instincts. The list below gives many of the warning signs of a seriously unwell child – but if you think your child is seriously unwell, seek help regardless of their symptoms.

Fever

You should seek urgent medical help for:

• A temperature over 38 °C in a baby under 3 months old, or over 39 °C in a 3-6 months old.
• A fever that doesn’t come down with the age-appropriate dose of ibuprofen or paracetamol.
• A child with a high fever but cold hands and feet.
• Any fever with a blotchy rash that doesn’t fade when you press a glass against it.
• A very low temperature (below 36°C - check three times over ten minutes).
• A child who isn’t responding or showing interest, even if their temperature has come down.

You should also speak to a doctor if your child’s temperature stays above 37.5°C for 5 or more days, or if they’re also shivering or shaking all over.

Breathing and Cough

Get emergency help if a little one:

• Making grunting noises when they breathe.
• Breathing very fast (more than one breath a second in under 1 year-olds) or panting.
• Can’t say more than a few words at a time or can’t talk at all (if they usually can)
• Are having to work hard to breathe – a sign of this can be when they suck their stomach in, under their ribs when they breathe in.
• Has pauses when they’re not breathing.

You should speak to a doctor quickly if they have a cough that sounds like a seal barking, if their breathing is unusually noisy or if their nostrils flare with each breath.

Skin, Tongue, Lips

Get help straight away if your child has:

• A rash that doesn’t fade when you press a glass against it.
• Blue, very pale, blotchy or mottled skin, or bluish lips or tongue.
• Sunken eyes and/or crying without tears.
• Very cold hands and feet, even if their body is very hot.

If their mouth, lips or tongue look dry, their skin looks pale or they have a rash that does fade when you press a glass against it (unless it’s mild insect bites etc), get medical advice.

Eating, Drinking and Wet Nappies.

A baby under one month old who’s not feeding at all should always be checked out urgently. So should any baby who hasn’t had a wet nappy for at least 12 hours. In under ones, more than five watery poos over 24 hours, only one wet nappy over 8 hours, needs medical attention.

You should also get advice for any under one year-old with any persistent vomiting (more than twice in 24 hours) or diarrhoea, or who’s eating or drinking much less than usual.

For children of any age, ‘red flags’ that need immediate help include:

• Not being able to keep any fluids down, or vomiting persistently for more than 24 hours.
• Green or bloodstained vomit, or vomiting ‘coffee grounds’.
• Not drinking at all for over 8 hours when they’re awake.

Other Red Flags

In a baby or younger child, get urgent advice for:

• Bulging of the soft spot on top of the baby’s head.
• Not responding or being extremely irritable.
• A weak or high-pitched cry, or crying continuously (especially if it doesn’t sound like their usual cry).

At any age, seek urgent help if a child:

• Has a seizure.
• Is confused, doesn’t seem to recognise you, is hard to wake or can’t stay awake at all.
• Is floppy (except when they’re asleep).
• Has a stiff neck or doesn’t like the light.
• Isn’t using or putting any weight on a leg, foot, arm or hand, or a joint or limb is unusually swollen.

Caring for a poorly child can be a daunting experience, but being informed about the symptoms and warning signs of serious illness is crucial in ensuring their health and safety.

Always trust your instincts and monitor your child closely, providing comfort and care as needed. If in doubt, seek medical advice promptly to prevent potential complications.

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