Trekking with children can be fun and rewarding, but some health issues need thinking about when you travel with children in remote regions — mainly the effects of altitude.
Altitude sickness in children
Acute mountain sickness (AMS) can be hard to recognize in children. The most common complaints are headache, nausea, tiredness, loss of appetite and disturbed sleep — but these can just as easily come from travel itself. Very young children can't even tell you they have a headache or feel sick. The available data suggest altitude sickness occurs in children about as often as in adults.
The first step is for parents to accept that AMS can affect their children, learn to recognize it, and plan prevention — above all a gradual ascent.
Recognizing AMS in children means watching for small changes in behavior: excessive sleepiness, fussiness or sleeplessness, poor appetite, a cranky or clingy child — as well as more obvious signs like vomiting and drowsiness. If you're worried that your child has AMS, descend promptly, just as you would for an adult. Descent relieves AMS very effectively, and it also helps tell you whether AMS was the problem.
The second step is that parents must be ready to act on symptoms that concern them, however easy it is to explain them away as something innocent.
Medicines for AMS in children
The effective dose of acetazolamide (Diamox) for preventing or treating AMS in children is 2.5 mg/kg per dose, twice daily, up to a maximum of 125 mg per dose. Diamox isn't needed if the ascent is slow and care is taken to acclimatize fully.
Which trek, and how high?
Avoid flying to the start of your trek. Plenty of beautiful treks begin with a short bus ride from Kathmandu or Pokhara, and one of these is ideal.
Your altitude ceiling is yours to decide, not ours. But going high means going where it's cold and remote, and where your child — and you — are more likely to get AMS. You can have a very fulfilling trek while staying below 3,000 m. You don't need to go to Everest Base Camp; its significance will be lost on most children under eight.
Other things to consider
Hypothermia. The higher you go, the colder it gets, and children are especially prone to hypothermia. They're smaller and lose heat faster. Children who are carried aren't generating heat by walking, and they may get separated from their parents if the porter walks fast — yet they rely on their parents to wrap and unwrap them along the way. Children often don't say they're cold, and struggling parents can forget the needs of a child being carried.
Accidents. Children around 3 years old are in constant danger of accidental injury: their curiosity leads them to pet the dog, wander toward the drop-off at the edge of the path, or put unfamiliar plants and debris in their mouths, noses or ears. With more than one young child you'll need a constant vigil — often just when you're exhausted, ill or both. Nepali porters can be wonderful with young children, but they have many jobs on trek, and ultimately the children are your responsibility.
Avoid a tight schedule. Getting to Nepal usually means a long flight. Most young children cope well; some don't. Children with blocked ears may have pain on descent — decongestants and sucking sweets can help. Allow a few days' rest on arrival to adjust to the time difference; children get jet lag too.
Diarrhea is common in Nepal, and children can dehydrate quickly. Bring plenty of oral rehydration salts, preferably a pleasant-tasting kind.
Points to remember
- Children get acute mountain sickness as often as adults.
- Don't take a sick child to altitude.
- AMS is difficult to diagnose in children.
- A slow ascent and a flexible itinerary are essential for proper acclimatization.
- Parents must be prepared to act if their child shows symptoms or signs of AMS.
- Descent relieves the symptoms of AMS — and may be lifesaving.
- Accidents, hypothermia and diarrhea are other common issues when trekking with children.
Some trekking companies specialize in treks with children — ask your trekking agent. If you have any questions, please contact us.