Traveling with Kids? Plan Ahead to Stay Well

If you feel like your house has been full of runny noses, congestion and coughs since the cooler weather began, you’re not alone.

“Child viral illnesses are really concentrated during the cooler weather from October through March,” says UNC Health pediatrician Priyanka Rao, MD. “When children experience back-to-back sickness, parents sometimes wonder if something is wrong with their immune systems. However, for most people, it is just a normal part of life this time of year.”

Traveling during the virus-filled winter season can bring more exposure to new germs. But potential illness doesn’t have to keep your family from enjoying time with loved ones during the holidays.

Dr. Rao and UNC Health pediatrician Anita Skariah, DO, offer advice on which illnesses to watch out for and how to deal with them if they strike during holiday travel.

Common Illnesses Children Get in the Fall and Winter

Upper respiratory viruses spread easily during the colder months. They include:

  • Flu: Influenza viruses can infect the nose, throat and sometimes the lungs. Early symptoms of the flu include high fever, significant fatigue and body aches. Children with flu then typically experience coldlike symptoms, including congestion and cough, or gastrointestinal symptoms, such as vomiting and diarrhea. By getting an annual flu shot, available to everyone age 6 months and older, you reduce your risk of flu. If you do get the flu after a shot, the course of illness is likely to be milder.
  • COVID-19: Unfortunately, COVID-19 is still with us, and it shows up in many different ways. Symptoms can include fever, runny nose, congestion, sore throat, mild body aches, fatigue, nausea, vomiting and upset stomach. You can get COVID-19 any time of year. Protect your family by getting the COVID-19 vaccine and keeping up to date on boosters. Children age 6 months and older can get the vaccine; children 5 years and older are eligible for the bivalent booster targeted to the omicron strain.
  • RSV: Respiratory syncytial virus presents like a cold in most children and adults. Symptoms are primarily runny nose and coughing, but they can also include fever, decreased appetite, headache and sore throat. RSV can be more dangerous in young babies, older adults, and people with chronic respiratory conditions such as asthma or lung disease because it can make it much harder for them to breathe.
  • Common cold: Like COVID-19, you can get the common cold at any time of the year. Symptoms include fever, runny nose, congestion, sore throat, mild body aches and fatigue.

The symptoms of these viruses are similar, so if your child shows signs of illness, it’s best to contact your healthcare provider—especially if you’re planning to travel or gather with others.

If you suspect COVID-19, you can use an at-home antigen test, but be aware that people can sometimes test negative for days despite being infected. You may need to retest after a day or two; read the instructions. PCR tests at a doctor’s office or an urgent care clinic are the most reliable.

When to Contact Your Doctor While Traveling

Your primary care providers want to help you, even if you are traveling. Don’t hesitate to reach out to them or your clinic’s on-call nurse if your child seems off or is showing symptoms of illness. You might even be able to schedule a virtual visit from afar.

Go to an urgent care clinic for any of the following symptoms:

  • Fever that doesn’t respond to fever-reducing medicine
  • Inability to eat without vomiting
  • Not urinating at least once every six hours
  • Low energy levels
  • Not drinking water or other liquids

Go to the emergency department if your child:

  • Has a fever that lasts more than five days or that doesn’t respond to fever reducers
  • Has trouble breathing, particularly if you notice they are using their ribs and upper abdominal muscles to take in enough air
  • Suffers an injury (such as a broken bone) or trauma (such as a car accident)

Plan Ahead for a Healthy Holiday Season

While it’s not possible to plan for every situation, there are some things you can do to prepare your family for smoother travels.

  • Stay current on vaccinations.

“There are many children right now who are behind on vaccines because of the pandemic,” Dr. Skariah says. “That leaves the potential for exposure to measles and other diseases that were previously controlled.”

Check with your pediatrician if you’re uncertain about your child’s vaccination status. If your baby is younger than 60 days old, you’ll want to minimize their travel, because they are too young for some vaccines that prevent childhood diseases.

  • Maintain a healthy daily routine before the trip and stick to it while traveling.

Prioritize healthy eating, hydration and sleep habits in your child’s daily life. This will help boost their immune system, Dr. Skariah says.

“Children thrive on routines, so the more you can stick to their schedule for meals and naps on the trip, the better it is for everyone,” she says.

You might be wondering if loading up on products that claim to boost your immunity, such as elderberry syrup, drink powders and vitamins, is a good idea before a trip. Dr. Rao says these are not well studied in children, meaning there is little evidence to show that they work. Talk to your child’s doctor if you have any questions.

“There is no substitute for what we know helps boost your immune system: vaccines, consistent hydration, rest and a healthy diet,” Dr. Rao says.

  • Practice good hand hygiene.

Make sure your children wash their hands after going to the bathroom and before and after eating. You should wash your hands every time you change a diaper or help a child use the bathroom. This is the best way to prevent the transmission of germs, Dr. Rao says.

  • Spend as much time outside as possible.

Eat, play and visit with loved ones outdoors as much as you can. It’s harder for viral transmission to take place outside. Wear a mask if you’ll be spending time indoors with anyone who is at high risk for severe illness, Dr. Rao says.

  • Be flexible.

If your child suddenly becomes sick while visiting family or friends, think through who they might encounter for the rest of the trip. Try to keep them away from anyone who is at risk of severe illness. (In fact, if you’re visiting a high-risk person, consider making that the first stop of your trip, before any illness strikes.) If your child tests positive for COVID-19, flu or RSV, you’ll want to try to quarantine them as best as you can, Dr. Rao says.

  • Think through the environment where you’ll be and plan accordingly.

Snowy vacation? Make sure you bring warm clothes and items to help alleviate the sniffles. Long road trip? Be prepared to help your kids through motion sickness. Air travel? Bring all your most-used wellness items (such as thermometers and fever reducers for kids) in your carry-on and not in your checked luggage.

Every family has different needs, but the following packing list is a good place to start:

  • Sanitizing wipes and hand sanitizer
  • Nutritious, portable snacks
  • Tissues, bandages and antibiotic ointment
  • Change of clothes for each child while in the car or on the plane
  • Small trash bags, if your children are prone to motion sickness
  • Over-the-counter medicine for pain relief, gas, and allergies and allergic reactions (with a syringe or cup for dosing)
  • Over-the-counter cough and cold medicine for children 6 and older
  • Snot-sucker tool or nasal saline for congestion relief
  • Humidifier
  • Hydrocortisone cream, if your children are prone to itchy skin
  • Thermometer
  • At-home COVID-19 tests, especially if visiting grandparents or someone who is immunocompromised
  • Insurance card
  • Pediatrician contact information

If you have questions about your child’s health, talk to your pediatrician. Need a pediatrician? Find one near you.