Q. My wife is expecting our first child in the autumn. If this wasn't enough change for one year, her parents are also planning to move to Mauritius shortly afterwards.
Q. My wife is expecting our first child in the autumn. If this wasn't enough change for one year, her parents are also planning to move to Mauritius shortly afterwards. Naturally, we would like to visit them as soon as possible but realise that it may not be safe for a newborn baby. Can a baby travel safely without vaccination, or what is the minimum age that a child can be vaccinated for travel?
David Flintham, via e-mail
A. Immunisations are not the most important issue for a very young baby going to the tropics. The key health concerns are to do with protecting your child from infections that can get in via the mouth and from insect bites; ideally he or she should be exclusively breast-fed and must be protected from mosquitoes from dusk until dawn. The precautions you take to avoid night-time bites must be meticulous if you are in a rural area, since there is a risk of malaria.
With a baby, you can set up a safe mosquito-free area under a permethrin-impregnated cot-net; permethrin is a chemical compound that keeps mosquitoes at bay. Your in-laws in Mauritius might find it easier to buy one out there. You can also buy kits starting from about £3 from shops such as Nomad Travel (020-889 7014; www.nomadtravel.co.uk), which also has a mail-order service.
If he or she is out and about after dusk or is up around first light, cover all clothes and bare skin with a child-friendly insect repellent such as a natural mosquito guard. In addition, spray the bedroom with a knock-down insecticide then use pyrethroid vapour - pads of mosquito killer that are heated on an electric hot plate and repel flying insects for eight hours. These cost £8.50 and an additional £3.20 for 10 pads from outdoor suppliers such as Cotswold (0870 442 7755; www.cotswoldoutdoor.com).
Assuming that your new baby's doctors feel that he or she is in normal good health, there are no real medical reasons not to fly within days of birth. Personally, I'd wonder whether you as parents would be ready for an 11-hour flight so soon.
In their first weeks of life, babies do little but sleep, eat and fill nappies, and so are reasonably easy to manage on a long flight. Even so, there is still a lot to be said for getting a feeding routine established and making sure that all is well before you leave home. I'd suggest waiting to travel until the baby is a month or two old when routine immunisations (against diphtheria, tetanus, whooping cough/DPT, polio, hib and meningococcus) are available. Travel immunisations are not an issue at this age - except BCG and possibly hepatitis B if you were to be moving to the tropics yourselves - but these routine jabs are essential.
It would be wise for both mother and baby to have had their normal six-week check-ups before you travel - go early if you intend to fly sooner. And, especially if you decide to travel within two weeks of the birth, your wife should wear flight socks to reduce the chance of a blot clot.
Do set out on your first trip before your child gets mobile - this usually happens at eight or nine months. From this age, until bribery becomes possible at around three years old, exotic travel is challenging and can be very tiring.
Clearly you and your wife also need to ensure that you are fully immunised, so go to a travel clinic or see your practice nurse. If you are likely to be doing further tropical trips this is a good time for your wife to get fully immunised against hepatitis A, if she isn't already. If you are intending to stray out of town in Mauritius you should both take chloroquine antimalarials, which are safe to take while breast-feeding.
For more information about travelling abroad see www.fitfortravel.scot.nhs.uk.
The writer, Dr Jane Wilson-Howarth, is co-author of 'Your Child's Health Abroad', Bradt Travel Guides, £8.95
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