how safe to travel to s.e. asia with an infant?
 

hi all,

i'm american, my wife is lao. in april we had a beautiful baby girl. at some point want to take her to meet the lao side of her family. my wife grew up in laos, i've been there several times. we are thinking about the risks of taking the baby to laos when she is 1 year old - april 2011. our itinerary would be ny to bangkok, then to LP, and possibly a side trip to western laos. we're obviously concerned about her susceptibility to disease. we wonder if confining ourselves to LP (a quasi-developed environment) would appreciably limit the risk. can we take this trip and keep the baby safe? we'd love to get input from anyone who's had experience with or thought about this question. many thanks.

I would be concern with the air quality during the month of April as that is the height of the dry season and the slash and burn.

Hanuman's comment about air quality is important. And you might want to choose a cooler time of the year for your trip.

Do talk with your baby's physician about getting her immunizations complete by then. Childhood diseases that are nearly eradicated in the west are prevalent in SE Asia.

The other thing you will have to be very careful about is food and water precautions. But it is certainly possible to do this trip safely. Take a look at www.cdc.gov/travel

If you go once she turns 1, then she can get Hepatitis A vaccine which our travel clinic highly recommends. (Too young for Typhoid vaccine until age 2.) Visiting friends and relatives can be risky from a gastro-intestinal standpoint -- local relatives prepare special dishes in your honor (how can you refuse?) and your delicate westernized GI tract may not be up for it.

There is malaria risk everywhere except Vientiane, so your daughter will need malaria pills -- either daily Malarone or weekly Mefloquine; dose is weight based. Dont' try to talk yourself out of this. Also insect repellant againt Dengue Fever, mosquito netting on her bed, etc. If in rural agricultural areas, there is also risk of Japanese Encephalitis.

To be honest, at this age she is not going to remember ANYTHING about this trip. It would be lovely for your Lao relatives, but she won't appreciate it until she's several years older.

We traveled a lot when our daughters were small, but mostly to places in the US or Japan.

My take on traveling with young children is do it while they are still breastfeeding, and before they can crawl. No worries about what they eat and you can pretty much control what they touch!

At one year, most kids are very mobile and want to touch or taste everything. At two, they are even worse.

Your daughter may be different, but I'd wait till the last minute to buy tickets, just in case!

thanks all for this input. i should have said our reason to go to LP is for that side of the family to connect with the baby, and my wife to spend time with her family. lcuy - you raise a good point, and maybe raise the idea of taking her over when she's a bit younger. our pediatrician has said something about 9 months and 12 months being the best times to travel with an infant, b/c of the inoculation schedule.

If it is later in April, the air quality should be ok. I agree with HepA shots. Seriously, you will have no trouble; we live here, have an eighteen month old daughter and another on the way. Hundreds of other expats do as well.
Skibumette offers very poor and incorrect advice in my opinion, and in the opinion of doctors who work here. Firstly Malaria is mainly present in hill areas and not in really in LP or in Vientiane; cases of Malaria recorded here are nearly always from Hill Tribe residents. Giving malaria prophylactics to a chld is criminal in my opinion. Japanese encephalitis is not a problem at all unless you are staying on a pig farm.
There have been many cases of dengue fever over the last couple of months and it is far more important to cover your infant and to use a low strength deet repellent.
Reagrding food and water: water is fine, as long as you make sure you don't drink the tap water - nobody, Lao included do anyway. We have had no problems with food, but one thing you might want to consider - if she is on a formula, bring enough to see you through. Infant formulas are available here but they are not the same brand as in your country and you may find you bub does not like th change.
You will be fine, Lao love kids.

Oh, and I should point out, but you probably already know this - malaria prophylactics do not protect against dengue.

Can you go this winter? Go before she is crawling and just keep a mosquito net over her crib.
If she's still breastfeeding than that is ideal and super easy.

The immunizations are not such an issue because she will be at home with family. Have family keep clean hands around her.

Mostly, you have to watch the toys they give her to be sure they are not things that can break off if she chews on it.

It will be more comfy if you go while the weather is not overly hot.

Since Vietianeboy seems to think I don't know what I'm talking about, I include info on malaria from a highly regarded private resource used by medical professionals in the field. Prophylactics are criminal? Tell that to a mother whose child contracts falciparum malaria.

MALARIA


Malaria Information
Laos
General information: predominantly P. falciparum. Transmission occurs throughout the year.

Protective recommendations:
Chemoprophylaxis is recommended for all travelers throughout the country, including all cities and towns except Vientiane (Viangchan). No protective measures are necessary (no evidence of transmission exists) in the city of Vientiane (Viangchiang).

Malaria Prophylaxis
Laos
Protective measures: Evening and nighttime insect precautions are essential in areas with any level of transmission. Doxycycline and atovaquone/proguanil (Malarone) are protective in this country. Primaquine may be used in special circumstances (G6PD testing is required).


My note: they don't recommend weekly Mefloquine; there has been some Mefloquine resistance in border regions. Doxycycline can't be used under age 8 due to risk of staining teeth.

It's okay, VB thinks most of us don't know what we're talking about.

Not so filmwill. I do prefer to take my advice from professionals however and also those who live in the area and not from some who have either never been here or have been here on a short visit.
Note that Skibumette has distorted my op. I did NOT say prophylactics were criminal, however giving them to kids is. If you are going for an extnded jungle trek, then yes, there is something to said for taking them as an adult.

"highly regarded private resource used by medical professionals in the field" And this would be....? Do they live and work in Lao as do my medical sources.

ski, I've tangled with VB often over this issue. His belief is that living in Laos gives one special knowledge not available to the rest of the world. Personally, I'd rather rely on case reporting than anecdotal evidence.

Malarial mosquitoes are most likely to breed in the rice paddies. It's hard to imagine going to Laos and not being in rice paddy areas.

ski, I don't know where you live. I like the cdc traveler's med website, but I love the NHS malarial risk maps:

http://www.fitfortravel.nhs.uk/desti...laria-map.aspx

They are much clearer than the WHO maps.

all,

your comments are very helpful. they reflect i think the struggle to come to a decision in a situation with complex variables and limited information. thank you all for weighing in.

kathie - i think our posts crossed. thanks for this map.

Kathie: love the color maps!! Our subscription service has started making their maps MUCH more detailed; fortunately, they've also gone to using color and it makes a HUGE difference. But I love that anyone can access the fitfortravel maps -- thanks for the tip!

How odd! Some very tame and informative posts got deleted. Why? This is a bit unfair to the op.