Traveling with children鈥攚hether for a holiday or a permanent move鈥攃omes with unique health challenges. To better understand how families can prepare, we spoke with Dr. Natalie Prevatt, a Consultant Paediatrician and expert in travel and tropical medicine. Dr. Prevatt trained in London and at the Hospital for Tropical Diseases, and she has worked across Africa and the Pacific. She now runs NHS clinics in infections and immunity, and a remote travel clinic, ,聽focused on children and pregnant women. As Chair for Paediatrics at the International Society of Travel Medicine, she helps shape global travel health guidance. In this interview, she shares essential advice on vaccinations, illness prevention, and planning for both short trips and long-term relocations.
Could you please聽introduce yourself?聽Who is Dr Prevatt, and what interested you in traveling聽children's聽health?
I'm a Paediatrician with a passion for travel. I always wanted to travel the world and work overseas. After completing paediatric infection training in London, I trained in tropical and聽Travel Medicine at the Hospital for Tropical Diseases, where I achieved the first fellowship concentrating on the needs of travelling pregnant women and children.聽I travelled extensively and worked as a tropical paediatrician in Lesotho, Uganda, Kenya, Tanzania, and the Pacific Islands.聽Eventually, I returned to the UK, and I decided to focus on prevention, not only of tropical illnesses but also routine diseases and accidents that can happen overseas.聽
Currently, I hold the position of Chair for Paediatrics at the International Society of Travel Medicine. My contributions to the field include writing travel guidelines and authoring a book chapter on children's vaccinations.
Since 2017, I've been a Consultant Paediatrician, where I run NHS clinics in general child health, infections and immunity, and, of course, travel preparation. In addition, I now operate a remote telephone Travel clinic catering specifically to pregnant women, children, and young people.
From your experience, how well do families prepare for traveling with children?聽How far in advance should families schedule a travel health consultation for their children?
Adults are usually advised to attend a travel clinic 6 weeks before departure- for pregnancy, this length is fine too. For children, I advise a little earlier because children may refuse to take certain medicines, such as malaria tablets, which taste horrid, and need to change over to a new regime prior to the trip.聽
In my experience, parents sometimes have their child less protected than themselves because of concerns about licensing of medicines and vaccines. That should never happen, and I can help with that! I am trained to meet someone at their own risk level, and I don't ever tell parents what to do, but I will provide them information and reassurance to make essential choices.聽
What are the most common health concerns parents should look out for when to traveling internationally with young children?
Young children are often sick, no matter what you do, and so the most common issues are respiratory viruses. The most common infection is the flu, and it's often caught at the airport! Flu can be a nasty illness, and the flu vaccine is important, often more important, I would say, than vaccination against very rare location-specific diseases.聽
Are there age-specific considerations that parents often overlook? For example, how does traveling with an infant differ from traveling with a toddler?
There are loads! Traveling with a baby presents feeding challenges, such as storing and transporting familiar milk powders or frozen breast milk. Babies may not be allowed to have some vaccines, and also they may not need some vaccines that the rest of the family requires 鈥� for example, they'll be in your arms, so it's highly unlikely they'll be bitten by an animal. Toddlers are at risk because of their very nature- they toddle off! There are risks of being bitten or stung, of falling, drowning, and of getting lost. We need to prepare for all these scenarios and ensure we have the right travel insurance in place in case the worst happens.聽
Toddlers and older children can really suffer from motion sickness and jet lag; they are often treated as little adults, but they are not!
What are the聽major聽health challenges for families relocating abroad permanently or in the short term?
Many children will catch a lot of viruses, such as those causing 鈥榯raveller's diarrhoea', in the first year after they move abroad because they are naive to the local bugs. Children are more at risk than adults because they aren't as hygienic (they put fingers in their mouths and pick up suspicious-looking items!), and they get closer to their peers, for example, when mixing with children in local schools. As such, for example, they'll have a higher chance of catching TB or meningitis, and they need to be protected with vaccination.
Many families face specific challenges around their child's medical conditions, for example, allergies or medications that cannot be sourced overseas. Some medications, such as those for ADHD, aren't allowed into certain countries and need to be changed pre-trip.
Are there specific risks聽that come聽with frequent travel, such as for聽鈥渄igital nomad鈥澛爁amilies?聽
Keeping up to date with vaccines can be difficult! Where countries have different vaccine schedules, you may think your child doesn't need a vaccine as they've already had it, perhaps -but then the gap might be too long before the next dose in that country, so it's definitely something to consult an expert about.聽
Frequent relocation can cause children to feel like they are not from any specific culture, and this has been coined 鈥榯hird culture kids (TKDs). While these children have many favourable attributes, such as being malleable, they have trouble settling into adulthood. They've usually been separated from extended family for long periods and had repeated culture shock.
Whilst I certainly wouldn't say it must be avoided, it should be something parents understand before repeatedly working in different locations.
Travelling in childhood is not the same as travelling as an adult when you have a fully formed sense of who you are. Older children and teens are more likely to experience severe culture shock if not properly prepared and these can affect their schooling.聽
Other risks- sunburn and skin cancer spring to mind!
What can families expect when booking a consultation with you, virtually or in person?
It will be a fun and informative single consultation! I'm excited about where you're going, and it is my passion to help you do it in the best way possible. I prepare families not just for the weird and wonderful "you never heard of it until you caught it" diseases, but also the聽common things that can cause distress on a trip. This can range from preparation methods to stop ear pain in flight -> to how to recognise dehydration and sunstroke and how to prepare oral rehydration solution -> to how to make it taste good enough to drink -> right through to what to do if you get bitten by a monkey or lose your child in the airport! I will obviously advise you on all your vaccinations. I can prepare airport letters for medication and prescribe additional supplies in case your luggage is lost.聽
Do you offer ongoing support or health planning for expat families who are settling in new regions long-term? Do you collaborate with other pediatricians or health systems abroad for follow-up care?
We currently don't offer ongoing support; most of our consults are single 1-hour meetings where we cover everything. Of course, we have children who will come back for each trip! If children need ongoing medications, we prescribe those and spares, and we also try to find them a suitable local paediatrician.
What's聽one piece of advice you wish every parent would follow before boarding a plane and moving abroad with their child?
There are many options, but if I have to choose one, it would be to make sure you get a travel insurance policy suitable for them. If they have any conditions, these should be covered and not excluded! Also, be sure to check your insurance to see what will happen to your child if something happens to a parent overseas. Too many children are stuck overseas while a parent is hospitalised because the policy doesn't automatically bring them back to their home country if they're alone. Think about what you'd want to happen and plan for it.聽
