Traveling With Childhood Asthma

When my son was two years old he was diagnosed with asthma. The diagnosis threw me for a number of reasons: firstly, no-one in our immediate family suffered from asthma and so I had no experience dealing with it, and secondly my thoughts immediately jumped to how would this be managed in light of how much we travel?

We were living in South Africa at the time, a country with extremely good private health care to which we were fortunate enough to have access. But I knew that sometime in the future, we would be traveling to or even moving to live in a country where medications and medical advice may not be as accessible.

Our pediatrician assured us that our son’s form of asthma was mild and very manageable. and prescribed asthma pumps and air chambers with which we soon became familiar.

My first trip abroad post-diagnosis was a solo flight with both kids from South Africa to Athens via Istanbul. We were meeting up with my mum on a Greek island then spending a few days in Istanbul, a city I know well as we lived there for four years. I was however, terrified that something would go wrong and that my son would need medical attention. Luckily our holiday went off without a hitch. I was militant with his medication and pump, and that seemed to keep things on an even keel. I returned to South Africa sure I could competently manage my son’s asthma even whist traveling.

But asthma is not that predictable. I soon learned that an asthma attack can sneak up on you, that in the morning you can be fine, but by the afternoon you can be in the throws of a full on attack. Over the next year my son had a number of asthma attacks, each one reminding me that it was always there, lying in wait for the perfect storm of triggers, in his case germs, dust and dogs. It is the unpredictable nature of an asthma attack that really concerns me when we travel. Even though I take every precaution I can, sometimes we are caught out. My son has unfortunately had an asthma attack on the short flight from the UK to The Netherlands, in Spain during our summer holidays last year, and we ended up in the emergency room over Christmas in the UK. This is the reality of traveling with an asthmatic child.

But for every trip affected by his asthma, there are five that are not, and I have learned over the years that if the perfect storm is brewing there is not much I can do to stop it. And so we choose to continue to travel. We read up on our destination, we always know where the closest hospital is, and we stay on top of his medication. By continuing to travel we have had wonderful holidays in Cape Town, Greece, France, The Netherlands, Belgium, Italy and Germany, and have made incredible memories which would not have been the case had we opted to play it safe and stop traveling.

Tips for traveling with an asthmatic child

I’ve visited countless websites looking for answers, tips and tricks to avoid asthma attacks, especially when we travel. Most of them I find to be well meaning but useless against the unpredictability of my son’s asthma. There are just too many variables to control. I know now that I can only do what I can do, take every precaution I can to avoid him succumbing to an attack. If we’re lucky it remains under control.

1. Consult your child’s doctor or specialist before you go on holiday. They may want to tweak your child’s medication slightly. When we road-tripped through France and Spain last summer our doctor instructed us to double dose our son with his everyday preventative pump for three weeks before and three weeks after. He had no problems at all on that trip.
2. Always ensure you have your child’s medications with you and that they are easily accessible. It sounds obvious, but make sure you have enough to last your entire trip. Take extra pumps if any feel like they might be less than half full. On a trip to the UK last Christmas we used a whole entire pump in a few days as the doctors at the emergency room instructed us to use it as a nebuliser giving ten puffs at a time. Luckily I had brought extra with us.
3. Another obvious one but make sure you know ‘off by heart’ which medications to give when. My son has two pumps, an everyday pump and an emergency relief pump. But he also has prednisolon tablets and antihistamine syrup as well as other medication that opens his lungs if necessary. I need to know what to give when, and it can sometimes get complicated.
4. Try to avoid traveling when your child has a cold or respiratory infection. This is such a tricky one! You can’t put your kid in a bubble for a month before you go on holiday, and young kids are little walking petri dishes of germs. All you can do is make sure they wash their hands well, and try to keep them healthy as best you can. My son had had a cold on and off for weeks before our Christmas trip to the UK. I knew we were tempting an attack to travel with him, but I didn’t want to cancel the big family Christmas we had planned (my family lives all over the world and rarely all come together for Christmas). Yes, we ended up in the emergency room.
5. Know your child’s triggers and try to minimize exposure. Again, this is really hard to do! We always book smoke free, pet free accommodation, but realistically what does that mean? Cat and dog hair can linger in a room for up to six months, despite being vacuumed. So whilst a hotel or AirBnB apartment may say they are pet free, it’s still possible that there may still be triggers if an animal has ever been into the room. Besides, dust is EVERYWHERE, you can’t escape it.
6. Know what your plan of action is if you need to take your child to the emergency room. Where is it? Is it open 24 hours? How will you get there? Always have your insurance documents with you. Make sure your phone has international roaming, and take an iPad or some form of entertainment along for your child (and you), nights in the ER can be long!
7. Google what ‘asthma attack’ and ‘nebuliser’ are in the local language. Chances are the doctor will speak English, but you never know.
8. Whilst treatment is pretty standard across countries (nebuliser, oxygen), be prepared for differences in the system. In South Africa my son was seen immediately, no waiting, and his symptoms were taken very seriously. His oxygen level of 96% was seen as low, and he was admitted to hospital. In the UK over Christmas, we waited for four hours just to be seen, and his oxygen level of 96% was no big deal. A 10 minute nebuliser and we were sent on our way. Our son improved that night but was wheezing by morning again. My point is be prepared to fight for what you think your child needs.
9. Visit websites such as: The Asthma Mom; Kids Health and a simple Google search will provide you with many websites giving advice (but not much comfort).

Traveling with an asthmatic child is undeniably a challenge and it’s the unpredictability that really gets me. But we choose to continue to travel, taking what precautions we can and always being prepared.