Traveling has always come with complications. Our By The Way Concierge column will take your travel dilemmas to the experts to help you navigate the unexpected. Want to see your question answered? Submit it here.
At the end of the summer, my husband and I will be welcoming our first baby. In between the nesting, doctor visits and parenting books, an urgent message pings from the travel journalist part of my brain: We have to make the most out of this maternity leave!
My dream is to take our baby girl on a month-long trip to Thailand, where I spent about a year living during my 20s. Assuming we’re all in good health, we would aim to go when she’s 4 or 5 months old; we will both be on paid family leave, and the climate in the kingdom is at its best. (Particularly tempting as D.C.’s will be at its darkest and coldest.)
Is it safe to take a baby abroad so young? She should have many of the essential vaccines by then but not all of them. Do we need to rethink the destination?
I reached out to six medical experts to get their opinions on our family’s travel ambitions. Here’s what they said we should consider.
Have a talk at your 2-month visit
Barry Solomon, the director of general pediatrics at Johns Hopkins Children’s Center, told me international travel can be a great experience for families but said it’s important to talk to your pediatrician before you go — preferably at your baby’s 2-month visit.
Then “ideally, your baby can receive their second set of routine immunizations at their four-month visit, a few weeks prior to travel,” Solomon said in an email. The vaccines include: DTaP (the second dose of five), Haemophilus influenzae type b or Hib (the second dose of three or four), polio (the second dose of four), pneumococcal or PCV (the second dose of four), rotavirus (two doses of four), hepatitis B (two doses of three) and RSV (the second dose of two or three).
In addition to the standard shots, “there may be travel-related vaccines you and your baby should receive based on disease prevalence and the length of time you will be visiting,” Solomon said.
6 months and older is preferable
Taylor A. Heald-Sargent, a Chicago-based pediatrician and professor at Northwestern University Feinberg School of Medicine, loves to travel but had concerns about our timeline. Her main worry is measles, which is endemic in Thailand.
“We know that babies are at particular risk for some of the nastier complications of measles,” Heald-Sargent said, including long-term health issues. That could include death years later from rare measles-related complications.
The Centers for Disease Control and Prevention recommends children get the first of their two-dose measles, mumps and rubella (MMR) or MMRV vaccine around 12 months. Heald-Sargent’s advice is to wait a year before taking a baby to Thailand to allow for that proper first dose, plus additional doses of routine vaccines per the CDC schedule. At the very least, Heald-Sargent says it would be better to wait at least six months for the trip to get an early dose of MMR, although its protection will be less effective.
Tina Tan, a pediatrician at Lurie Children’s Hospital, had a similar take.
“We normally recommend that parents wait until the infant is at least 6 months of age before traveling abroad so that they have received their primary immunization series and are able to get a dose of MMR vaccine given the endemic amount of measles in Thailand,” she said in an email.
Check the CDC for country-specific guidance
Of course, Thailand isn’t the only country dealing with measles. Nor is it the only disease to consider when traveling.
“We have measles in the United States at levels we haven’t seen in quite some time,” said Ashley Darcy-Mahoney, a neonatal nurse practitioner and professor at the George Washington University School of Nursing. “So when we talk about this sort of travel, that’s not to suggest that we’re perfectly safe here, either.”
No matter where you consider going, Darcy-Mahoney recommends looking at the CDC’s full travel guidance to find out what infectious diseases might be circulating at your destination and whether it suggests additional vaccines.
“By 4 months, most babies have received protection against serious illness, like whooping cough and pneumococcal, but still haven’t completed that primary series,” Darcy-Mahoney said.
Families also should look into what medical access they’ll have available abroad. In our case, “Thailand has excellent medical facilities in major cities, so that should be somewhat reassuring,” Darcy-Mahoney said.
Protect for bug bites
Kewalee Wongplucksin, a pediatric specialist at Bangkok Hospital Samui and a member of Air Doctor’s global network of local physicians for travelers seeking care abroad, said in an email that “travel to Thailand is generally reasonable and medically acceptable.”
“Most healthy infants can travel safely,” she continued. “However, 4-month-old infants remain more vulnerable than older children.”
Wongplucksin said one of her most important precautions for visitors would be to remain mindful of heat exposure and dehydration, and practice “rigorous mosquito-bite prevention.”
The CDC also recommends travelers to Thailand “take measures to protect themselves from mosquito bites to prevent chikungunya, dengue, and Zika,” as well as malaria.
Solomon pointed me to the American Academy of Pediatrics guidelines on children’s insect repellent use. (For example, they recommend using DEET “sparingly when needed” in kids under 2, and say not to use “products containing oil of lemon eucalyptus or para-menthane-diol [PMD]” on kids under 3.) For further protection, “You will want to prevent insect bites by wearing clothes that cover as much skin as possible,” Solomon said.
‘One of the best things you can do for kids’
Measles concerns may force us to change the destination for our family leave but not drop a plan to travel entirely. The conversations I had with doctors actually reinforced my desire to travel with our baby.
In fact, “4 months is actually a perfect time to travel,” said Leah Rappaport, a pediatrician at Boston Children’s Hospital. “They don’t crawl yet. They are like beautiful potted plants that smile and have fun.”
For her family, the benefits of travel usually outweigh the risks. She recently took her kids (4 and 7) to India.
“I really think that traveling is one of the best things you can do for kids who are developing in this global world … as long as you’re thoughtful about where you’re going and what you’re exposing them to,” Rappaport said.
Darcy-Mahoney is also a mother of two who used some of her maternity leaves to travel domestic and internationally.
Even though her kids might not remember those earliest trips, she said she and her husband will always cherish them as capturing “this really exciting time in our life where we were able to still be who we are as people,” she said. “That was something important for us.”
The takeaway: Don’t be daunted by the prospect of traveling with a baby, but choose a trip that matches your risk tolerance. And at any age, make sure they are up-to-date on the vaccines needed for your destination.
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The post We asked: Can we take our infant abroad? appeared first on Washington Post.
