Vacation Dream or Disaster? 10 Tips for a Great Family Escape

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hello everyone and welcome to today's webinar hosted by the American Academy of Pediatrics on 10 tips for a great family escape and now I'd like to introduce our host dr. Jennifer Shu dr. Shu is a practicing pediatrician and mother of two children a frequent guest on national and local television and a contributor to cnn.com WebMD Baby Center Parents magazine and more she's also the medical editor of healthy children org and the co-author of heading home with your newborn from birth to reality as well as food fights winning the nutritional challenges of parenthood armed with insights humor and a bottle of ketchup welcome dr. Shu thank you so much and welcome everybody through our webinar on travel safety we've got some great tips for you today and whether you're traveling with a baby toddler or young school-aged child these tips can help keep your dream vacation from turning into a disaster but now let's get started you have your baby what do you need to bring as a parents of two children I know that traveling with kids can be both a delight and a challenge I found that traveling with babies and young children always includes bringing a lot of stuff clothes toys and equipment sometimes I feel like I'm packing the whole house so even if you tend to be a light traveler which I am NOT there are some things that you are going to want to have when you're traveling with a baby and the first thing is diapers diapers and more diapers the reason for that is sometimes you're going to be in a place where you can't just borrow a diaper buy a diaper find a diaper especially wound up in your child's size so as my co-author and I say in our book heading home with your newborn it's Murphy's Law of newborns that if you don't have a diaper within arm's reach at all times babies are all but guaranteed to poop the first chance they get so when you're packing I recommend that you be sure to have diapers and wipes in your luggage in your carry-on bags or in the car in the diaper bag or backpack anywhere you want to put them so you always have a few within your reach when I travel by plane I actually like to put a travel a container of wipes and a single diaper right in that pocket in front of me just so I have easy access in case there's some kind of a blowouts if you want to travel lighter you can actually ship some diapers and other supplies ahead or find out if there's a store near your destination where you can be sure to buy more diapers if needed and the remember there's also quick online shopping services either from a local grocery store or for some place like Amazon Prime that might be able to to get you stuff on short notice if you'll be swimming on the trip be sure to pack plenty of swim diapers – for babies who aren't yet potty-trained and one tip is after the end of the summer you may want to stock up on extra swim diapers in case you travel somewhere in the offseason where you might need to find swim diapers that they might not be as readily available in the store make sure you bring changes of clothing not just for the baby but also for you bring an extra change of clothing definitely for newborns because blowouts leaks and spills can happen and will be much less stressful if you know you have extra clothes in your carry-on bag and then the obvious does carry a change of clothing and pajamas for every day that you're going to be on your trip and then add a few extra tops and bottoms in case those still spit up in other messes again not only does this apply to little ones but it also applies to their parents food is also something important to have just because newborns and kids don't really care when their last meal one is when they're traveling as soon as they leave your house then the whole feeding schedule kind of goes out the window so it's always good to be prepared with extra food even though you might not use it all if you're breastfeeding then that's great you'll have everything you need built right in otherwise for kids eating solids and toddler foods be sure you have bottles or cups with lids formula jar pouch food toddler spoons and forks snack or finger foods and definitely some wipes for cleaning up if you're traveling be sure to repack your diaper bag and backpack each night so you will be ready in stock for the next days vacation adventure baby carriers are great invention for keeping your hands-free they're comfortable for big often times they are front carriers but there are also backpacks that go behind you and slings that drape in front of you there are some important safety tips to keep in mind when you use a baby carrier the first thing is to make sure that your baby is in the right weight limit for the carrier and then also provide one that has good head and neck support especially for the littlest babies you're also going to want to carry one that's comfortable for you because if you're carrying your baby for a long time that might have wreak some havoc on your head and neck and back and finally keep in mind that for baby carriers although you're allowed to use them on a flight they're not allowed for use during takeoff and landing so make sure you don't have your baby in one of those during those times a stroller of course can be really helpful whether it's a simple umbrella folding stroller to the top of the line double jogger stroller if you have more than one child than having a stroller that has side-by-side speeds or a place where the older child can sit or stand in the next two or behind your baby can be really helpful you'll want to make sure you pick a stroller that has a wide base and don't and won't tip over and don't hang anything on the handles of your stroller because that can make the stroller tip back be sure you always use a seat belt and a harness if your stroller has them and put on the brakes if you if you have them and again if there's more than one break use them both and finally as you open and close your stroller make sure that your little wind fingers aren't nearby for fear of getting them caught you'll know better than anybody else what other additional supplies your child needs whether that extra pacifiers favorite blanket or stuffed animal my daughter is six and she has a favorite giraffe that she still insists on traveling with all the time she says I've never slept without my giraffe before and so should we bring it along even though she never lets me wash it so that's a you know a favorite thing that we can't leave home without moving on to safety and fun in the Sun if you're heading out of town for some fun in the Sun lucky you as awesome have a great time but don't let some burn get in your way and turn that fun into a disaster here are some safety tips for keeping in mind especially if you're traveling to an area where the Sun is stronger than what you're used to where you live your babies under six months try to keep them out of direct sunlight as much as possible use lightweight clothing that covers as much skin as you can as well as large brim floppy hats and even though labels may say for use six for babies age six months and up a small amount of sunscreen is okay for those areas of skin that you can't be cover such as the face or the back of the hand remember that it takes about 30 minutes for the sunscreen to become effective so plant your sunscreen application accordingly for older protection the same the same applies but see if you can try to get your baby to wear sunglasses with UV protection and for kids like toddlers who might not want to keep them on keep trying pick out sunglasses that they like and use a strap if needed again use sunscreen as well as lip balms that has some kind of sun protection remember that the sun rays are strongest between 10:00 and 4:00 p.m. 10 a.m. and 4 p.m. and that things like sand concrete and snow can reflect and make the Sun even stronger women shirts are a great way to protect the skin use something that has a UVA and UVB protection if at all possible and keep in mind that sunburn is still possible on cloudy days so don't skip the sunscreen even if it's a little bit overcast outside you're going to want to look for broad-spectrum sunscreen which protects against both UVA and UVB rays and you can use sunblock not just for the ears nose and cheeks but we do recommend products such as zinc oxide and titanium dioxide for the entire body so if you grew up in a time that I did many years ago you might remember lifeguards for example wearing six layers of white zinc oxide or maybe it was a pretty color especially on their noses well now that kind of zinc oxide rubs in a little bit more clearly and can be used on the entire body and is very protective choose a sunscreen that is at least SPF 15 or higher you know to max out at around 50 SPF because higher than 50 there really is not much added benefit reapply or apply apply your sunscreen early and often and reapply every two hours or even sooner especially if you're swimming mosquitoes biting flies and pick fights can make kids miserable and are another way your dream vacation might turn into a disaster while most kids only have mild reactions to insect bites some can become very sick and depending on where you're traveling kiss can become infected with very dangerous germs one way to protect your child from biting as insects is to use insect repellent so here's a chart of different insect repellents that may be available most of these products include a chemical called beep the amount of D founded insect repellents can vary from less than 10 percent to more than 30 percent the products with a higher amounts of bees protect people longer for example a product with 10% deep may work for about 2 hours while a product with 24 percent DEET can last for about 5 hours studies also show that products with amounts of greater than 30 percent don't offer any extra protection so you don't need to go overboard on that concentration keratin is another chemical repellent that works for about three to eight hours depending on the concentration you might also find repellents made from essential oils from eucalyptus and soybean and according to the CDC these may work as well as repellents with about 10% DEET however be sure to keep in mind that oil of lemon eucalyptus products should not be used on children under the age of 3 finally a chemical called permethrin can be used on clothing like hats shoes or on bed nets and camping gear but not directly on the skin you can find clothing already pre treated with permethrin at sporting goods stores for example but read the labels carefully to see how many times you can wash it before this treatment wears off the AAP recommends that repellents should contain no more than 30% gate when used on children insect repellents are also not recommended for children younger than 2 months of age and I recommend that my patients wash off the insect repellent after coming inside or at least before the child goes to bed preparing for illness and injury once your way to turn your dream vacation to a disaster is if anyone in the family gets sick or injured so here's a list of things to pack so you can be as prepared as possible and the things that you might keep in your first-aid kit includes bandages for minor cuts and scrapes allergy medicines any prescription medicines your kids may need or pain relief or a fever reducer medicines such as Tylenol or which is acetaminophen or ibuprofen which are advil and Mochan in addition to being able to treat fevers and pain they can also take away the sting from Oh sunburns which hopefully you are going to avoid most importantly make sure when you travel that you know in advance who you're going to call we're where to go in a case of emergency be sure to bring your health insurance information with you and consider getting travel insurance to cover any health problems that arise during your vacation emergency care is covered by most health insurance plans but check your plan for details such as whether you need prior approval from your pediatrician for an illness or injury that's not an actual emergency moving on to international travel if you're traveling abroad you'll want the experience to be fun safe and disease-free and here's what you need to know a good starting point is right in your pediatricians office and do this many weeks before your trip to make sure your child's immunizations are up to date depending on where you'll be traveling certain vaccines may be needed such as the meningococcal vaccine for meningitis especially if you're traveling to parts of Africa rabies vaccines for certain developing countries yellow fever vaccines for parts of South America and Africa typhoid vaccines is traveling to areas where the drinking water is not safe for example and a flu shot if needed you can also get up-to-date information about travel at the CDC's website CBC gov flash trap toll-free at 877 FYI trip there's been a lot of coverage in the news lately about Zika virus so it's understandable that many parents have questions here's what you need to know Zika is a virus that is mainly spread by mosquitoes and can cause rash fever pinkeye which is also nose conjunctivitis which basically means a swelling of the eye with redness and often discharged joint or muscle pain and headache symptoms usually clear up in less than a week so what's the fuss well while most people will actually have no lasting problems and sometimes no symptoms at all for Zika we now know that the virus is very dangerous for women who are pregnant or who are planning to become pregnant studies have confirmed that this virus affects the developing fetus in the womb and can cause microcephaly which is a condition in which babies are born with unusually small heads as well as other brain and physical problems this is why prevention is so critical the CDC provides these specific warnings for pregnant women first if you're pregnant in any trimester you should not travel to areas where Zika virus transmission is ongoing this currently includes certain parts of Latin America and the many popular vacation destinations in the Caribbean in the United States parts of Florida and Texas are seeing this part of Zika if you're pregnant talk to your doctor before traveling to these areas as well if you're pregnant and have already – if you're pregnant and have already traveled to any of the areas where the Zika virus is spreading you should be tested within 2 to 12 weeks of return even if you don't show any symptoms finally you can visit the CDC website at cdc.gov/scienceclips use insect repellents as we discussed before wear long sleeve shirts and long pants or look for clothing treated with permethrin stay in screened areas or air-conditioned rooms and or use a mosquito bed net and this is an interesting one wear insect repellent daily for three weeks after return the reason for this is if you're infected and maybe don't even know it if you get bitten by a mosquito in the United States after you return that mosquito can then infect other people in our country finally Zika can be spread through sexual contact to talk to your doctor about how long you might need to avoid sex or use condoms before trying to get pregnant and this does vary for men and for women moving on to kid friendly flying as it's just about every other aspect of parenting going with a small child will inevitably involve a lot more advanced planning than the trips you used to just take a lot two of the most common questions I get from parents are how young is too young to travel and what time of day is best to travel with a baby or fly with a baby well I've found from personal and professional experience that there isn't one right answer to the question of when it's ages and easier to travel you'll be assured to know that healthy term babies can probably fly just fine any time after the first week or two keep in mind however that premature babies whose lungs are fully developed may be more sensitive to the effects of high-altitude travel and that includes flying or any trip that involves a change in altitude such as going to the mountains so check with your pediatrician before planning a trip of the young infant also your pediatrician may recommend waiting until after getting the the first major set of shots at two months of age so that he or she will get a little bit more protection against viruses and bacteria the reality of flying with a small child is that kids do cry it's one of their ways of communicating with you so if your kid can't talk yet and it's crying check the usual suspects is she wet is she hungry too hot or too cold and then bring along a stash of books connects toys video games to keep her distracted some of these flights can be very long especially if there's a delay either on the ground or in the air a special consideration about headphones and noise control for children children can be very sensitive to the effects of too much noise and in order to prevent hearing loss it's a good idea to use headphones that are designated or designed for kids where you can have faith volume controls and limit the amount of noise your child hears regarding ear pain let me say that not all children or adults are bothered by airplane during airplane travel ear pain during airplane travel however some people are very sensitive to changes and pressures that occur during the flight and if I'm switching to pediatrician mode for a moment this is because the outer ear is separated from the middle ear by a thin piece of tissue called the tympanic membrane or the eardrum and changes in pressure across this membrane can cause temporary muffled hearing discomfort or even severe pain for adults chewing gum and yawning is often all we need to get our ears to pop and feel better but since chewing gum is not an option for babies and most young children still can't even yawn on command this is probably why some kids and young babies do complain about their ears during their flight so what can you do you can offer your baby breast milk or a bottle to suck on during takeoff and initial descent and the reason why I said initial descent not just landing is that the initial descent is when the pressure change is expected to be the greatest and the higher up you are at the earlier in flight that the descent usually starts so if you're not sure when that is ask your flight attendant or listen for the captain's announcement it's usually the time when they say that you need to turn off your electronic devices and stow your computers and your tray tables arm rests all that business sometimes however nothing works to help your child with the crying or the ear pain one thing to do is to try to stay calm if you've brought along some pain relievers you can give them talk about you can talk to your pediatrician about preventively giving some medicine in advance if you want and during flight you can try rubbing your child's ears or singing a soothing song you save one last snack or special Tori for for a initial descent and then try all your other distracting tricks like reading the in-flight magazine and doing some window shopping the good news is that landing and returning to normal air pressure should end the discomfort now remember that most babies who have some difficulty with your pain on airplanes do tend to outgrow it safety in the sky so it is true that there's no ticket currently required for kids under the age of two from a budgetary standpoint that is pretty appealing but the reality is that it's much safer for your child to have just their own seat when flying and be properly secured remember that the children follow the same rules of physics as suitcases and coffee pods both of which must be stowed during flights according to the FAA so the FAA recommends that all children under forty pounds use an FAA approved booster seat or car seat unfortunately booster seats are not allowed so if you need to use one at your destination you can either check it carry it off carry it on and throw it in the overhead bin or under the seat in front of you or rent or borrow one or when you arrive there is an FAA approved harness called Kear's which has been approved for use between 22 and 44 pounds and you can check the FAA website at FAA dot-gov for more details you may want to think about your seat placement for your child and for yourself windows might be good for distractions while aisles are better for easy access to the restroom or to just take a little walks for children in a car seat they must be placed in the window seat position so that they are not blocking anyone who needs to get out in case of an emergency bulkhead seats can be useful although they may not allow you to have a place to put your diaper bag in front of you so not be convenient in that regard that can give you extra space premium seating near the front of the airplane can be useful when try with children but they do come at a cost usually and remember that children may not be seated in exit rows children under the age of 15 may not be seated in exit rows even though they do afford you more legroom it's a post-911 world and security measures are now in place to protect everybody even though it means a little bit longer to take to make it to your gate be sure to give yourself plenty of time to get through security and be prepared for delays at any and all of the following checkpoint the first thing to be to expect is that you'll need to check in with IDs and boarding passes for everybody even infants in arms which are which is what you call the babies who don't have their own seat must have their own boarding passes so that they can be accounted for and that their names will be listed in their flight manifest keep these in easy-to-reach place because you may need to show them multiple times before you board the plane metal detectors are inconvenient because you'll need to lift your baby out of the car seat or carrier to go through security and you might even be asked to carry your baby at arm's length in front of you so that both of you can be go through the metal detector a little bit separately and make sure that you're not concealing any objects between your body while older children may not have to remove their students to go through security you may need to help them wait online and follow instructions from the TSA agents just like any carry-on baggage baby items like diaper bag strollers and car seats must go through the x-ray machine or be hand inspected by a security officer check the TSA website before traveling to see if there are any items that you need to put in your check luggage we'll just leave at home the good news about fluids is that although there is a limit for three at three point four ounces or less which is 100ml for carry-on fluids parents can now travel with baby related items like medications formula and food including breast milk and juice in reasonable amount beyond this 3.4 ounce limit be sure to let the tsa agent know that you have these items but still be prepared for them to be inspected and possibly even tested as you go through security many of us grew up taking car trips as our family vacations and for me these are great childhood memories but unfortunately often did not involve a car seat I'm using myself when I say that my friends and I sometimes that crowded in the backseat of a station wagon without any seat belts whatsoever today however we're much more aware of the importance of safety while in the car and have more equipment available to us so just as you would at home make sure your infants and toddlers are writing rear-facing at least until their two years of age and once they outgrow the height and weight limits of their rear-facing seat they may ride forward-facing in a car seat once your child outgrows the forward-facing car seat with the harnesses you can use a belt-positioning booster seat and these are usually used until a child is about four feet nine inches which is on average about ten or eleven years old although a large eight-year-old may reset that height indication a little bit sooner and these booster seats are good to help make sure the seat belts fit properly remember that all children under the age of 13 should ride in the backseat even if they're large for size a back seat is faces because children under 13 their heads and necks and back muscles aren't as well developed yet muscles and bones aren't as well as developed an adult so if in a crash in the front seat they can get antsy on long road trips but they can also get motion sick so a few tips for avoiding motion sickness pass to child if they're old enough stood in the front seat or at least look through the front window for example a child younger than age 13 could sit in the middle seat possibly look out the front so something as it might be to distract them with books or movies during long car travel it may be better to have them look outside and crack the window to get some fresh air it's excited to make sure your child has a light snack or meal prior to traveling if they get carsick easily but do keep a plastic bag a lot around for emergency you can talk to your pediatrician about giving a nausea relief medicine such as benadryl or Dramamine which may help is given about an hour before traveling there are also acupressure motion sickness wristbands that children can wear that have the pressure a ball that puts pressure on your wrist you just want to place at about half an inch from the wrist crease finally products such as ginger so ginger candies or ginger ale may help decrease nausea from motion sickness if you're Pete if your child has severe motion sickness or if any symptoms lasts over eight hours be sure to contact your pediatrician finally a word about hotel safety remember that the hotel has not had the same investment in shut up proofing the rooms as you have had for your house so make sure you get down on the floor and and ask out where your child may be going if you need to move some chairs and block outlets for example that can be useful or check with the hotel to see if they have any child proofing equipment that you can install yourself while you're there one really important thing is to plan where the children will sleep Co sleeping with an infant under an age under a year of age is not recommended and can be very dangerous babies who sleep in the same bed as their parents under age one are at risk of SIDS suffocation or strangulation not only can parents roll on to babies during their sleep babies can get tangled in the sheets or blankets so if you are going to share a bed with your baby I insist or highly recommend that you make that bed like a crib make sure that your baby cannot fall and that it is there and free of any pillows or blankets most hotels will have cribs that you can use and as of 2012 the cribs must comply with federal safety standards this means no drop sided cribs you can call ahead to make sure the hotel you're staying at pass cribs are a safe bassinet or play yard to sleep in to avoid the risk of getting it outdated or unsafe crib at a hotel or motel you may consider bringing your own portable crib inspect the hotel conditions and look out for exposed wiring chipping paint or any loose stairway or balcony railing and finally check the room for bedbugs well they don't spread diseases they can make you itchy and be very hard to get rid of the Environmental Protection Agency or EPA suggests these following tips look closely at mattresses and head boards using using a flashlight on your phone for example and look for any type of stain marks or actual bugs themselves and when you're unpacking your suitcase use a luggage rack or coffee table or desk instead of unpacking your clothes on the bed or floor and when you return home unpack your everything and load them all your clothes directly into the washing machine so finally let's review the tips that we went over today number one make sure you pack your must-have items number two stay safe in the Sun number three avoid bug bite number four be prepared for illness and injury number five consider implications for international travel number six be aware of special warnings about Zika number seven family-friendly flying number eight safety in the sky number nine airport security and number ten car travel thank you all for your attention today we will now have some time to answer any questions you may have if you haven't already done so please enter some questions into the chat window and we'll try to respond to as many as possible unfortunately we may not be able to answer all of them today so we got a question about preschoolers and toddlers fighting in the car that is a great question I think a lot of this has to do with behavior and maybe preparing your children in advance and letting them know that fighting is not tolerated because it is unsafe and can be distracting to the driver so one tip I like to recommend to all parents is have a special stack a stash of books or toys available for certain situations like car trips or going to the doctor's office or even potty training if you have something new that or different that your child doesn't see on a regular basis then they'll be more willing to play with toys where the novelty hasn't worn off do you can reward your children for playing quietly and playing well with each other by letting them use special toys that they love but they're only for use for things like road trips or or use on the potty um there was a question on toilet trips while flying I can be a tough one some people maybe not when flying but when going on road trips will bring a portable potty seat in the car with them so you can stop at a rest area or even on the side of the road somewhere safe to let their child continue the potty training process in general though even until my daughter was 5 I kind of had her use some kind of pull-up or something while flying just because not that I was so worried about her being able to make it to the bathroom but there are some restrictions as to when you can and can't get out of your seat and rather than risk an accident sometimes it's better just to to be extra safe and keep them covered Zika exposure for young children so the question is are children at risk and the answer is that yes everyone is at risk for certain infection symptoms if they get bitten by mosquito infected with Zika and we've talked about that a little bit earlier and that's fever the conjunctivitis headache joint pain and usually those lasts no more than a few days to about a week without any permanent problems or complications from that so yes it's not great for it for young children to get Zika bit not so damaging or potentially serious as if a pregnant woman were to get Zika so even though we do know that their brains and nervous systems are still developing there's not as far as I know and any evidence of that there can be long-lasting problems for them but do be sure to check out CDC gov going updates and more information about that as a reminder we will be archiving this presentation so those of you who have follow-up questions or want to relook at our presentations today we will be sending out that link to your email for everybody who did register for this talk so another question is you're going to a trip to Japan are there any vaccines to get you're just going to large city not to the jungle or anything like that that's a great question and I do recommend going to cdc.gov slash travel and you can choose the country where you are going to visit and Japan would be one of them you can be sure to ask your pediatrician about which vaccines your child may need before you travel to Japan as you can see on your screen we do have social media where you can follow us on Twitter Facebook and Pinterest and you're also invited to register on healthy children org to receive our twice monthly e-newsletter have a personalized homepage and get other special offers we hope you enjoy today's webinar please also keep an eye on your email for a quick survey and let us know what you thought of today's presentation and finally a special thank you to our sponsor the Centers for Disease Control and Prevention I hope you all have a great day thank you you


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