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Old 22-11-2009, 03:31   #1
iwi
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Infant Advice - Cruising Vanuatu and Papua New Guinea

We plan - to take our 2 1/2 month old daughter with us cruising to Vanuatu, Solomons, Bougainville, and Papua New Guinea over a two year period. At departure time she will be 9 months old. We live aboard in New Zealand and have had our boat offshore once to Tonga. I am mainly concerned about methods of coping with tropical diseases(I believe vaccination is not recommended for babies under 1 year old). If anyone could share there experiences on this or any other safety issues relating to infants in a tropical environment it would be greatly appreciated.

Thanks,
Corey
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Old 22-11-2009, 03:55   #2
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Old 22-11-2009, 05:45   #3
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Greetings and welcome aboard the CF, Corey.

Vaccination may be one of those questions best answered by your family physician, or local public health department.
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Old 22-11-2009, 06:57   #4
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Hi,

I can't advise medically but there are a few things I feel competent on.

I'd imagine that you are concerned mainly with two things, enteric tropical disease like typhoid and cholera and mosquito borne diseases.

Lets start with the water and food borne problems

BASIC FOOD HYGIENE is the way for you all to stay healthy. - Your daughters health depends on you both staying healthy. That means you should be very careful about what YOU eat both on the boat and ashore. Don't eat left overs unless you are very sure they have been kept sufficiently cool. Don't eat anything ashore that isn't REALLY hot, preferably cooked in front of you. Sterilize fruit in a solution of bleach, 1 tablespoon in a pint of water, wash off with boiled water. Don't eat fruit from shore side vendor until you can wash it. The same of course goes for salad vegetables.

Make sure your water supply is safe and if you are unsure, only drink what you have boiled and allowed to cool. Never have ice in drinks away from the boat. Without a child to worry about, I'd perhaps take a chance in a posh bar but....

For your daughter, breast is still best but otherwise, ensure that you make up a bottle for each feed when you need it, unless you have refrigeration what can maintain a temperature under 5 degrees Centigrade, (check this before you leave). With solids, cooked food, prepared not more than an hour before, again, unless you have very reliable refrigeration. OR, like most parents, lay in a supply of baby food in jars. Don't keep any left overs, these are particularly likely to be contaminated with staph and strep type bacteria from the spoon (contaminated in the mouth), these bugs can grow at an alarming rate in tropical conditions.

No swimming in rivers or lakes - the likelihood of faecal contamination is high and there is a possibility of nematode infestation.

Only eat shellfish that you have cooked yourself, avoid fresh water fish which may have liver fluke metacercarial cysts.

Of course, all food should be kept covered and away from flies.

Moving on mosquito problems - I'm sure that I don't have to remind you about the importance of a mosquito net. I think that on balance an impregnated net is best but you may want to talk to another tropical disease specialist about this. Most mosquitoes tend not to fly out any great distance from the shore so you may want to consider anchoring out most of the time, a minimum of 300 metres avoids most mosquitoes. In a marina, avoid dusk and dawn exposure as much as possible and perhaps consider always having the baby in a crib covered with a net at those times. I personally would use a pyrethroid insectacide spray below decks in the early evening and then keep all ports and access ways covered with insect screens.

Talk to your travel advice nurse or physician about vaccinations and anti-malarial prophylaxis.

Hope this is of some help

Paige
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Old 22-11-2009, 12:34   #5
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Thanks Paige,

This is the type of pratical advice that is useful. Anyone that may have done similar trips with children of the same age, I would love to hear how you went about things and coped with problems that came up.
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Old 22-11-2009, 13:18   #6
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I forgot to mention, I'm not conversant with trade names in New Zealand but you may want to make sure you have some paediatric strength paracetamol (acetaminophen) elixir or ibuprofen elixir on board and some adult strength as well. Children should never be given aspirin *. The further you get away from home, the less resistant you'll all be to the local cold viruses.

* for anyone who wonders about this see: Reye's Syndrome: Why You Should Never Give Aspirin to Kids

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Old 24-11-2009, 06:08   #7
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Immunize ASAP

Quote:
Originally Posted by iwi View Post
We plan - to take our 2 1/2 month old daughter with us cruising to Vanuatu, Solomons, Bougainville, and Papua New Guinea over a two year period. At departure time she will be 9 months old. <snipped> I am mainly concerned about methods of coping with tropical diseases(I believe vaccination is not recommended for babies under 1 year old). <snipped> Thanks,
Corey
Having practiced medicine in the outer islands of Vanuatu under the auspices of Project MARC for almost a decade I am quite concerned about your daughter's immunization status. Contrary to your belief, the preferred immunization schedule for Vanuatu (as recommended by the World Health Organization with minor modifications by the Vanuatum Ministry of health) tries to have children fully immunized before their first birthday..... In fact, the first two shots (to protect against tuberculosis and hepatitis B) are preferably administered within the first days of life.

To see the full schedule, just download the Vanuatu Health Workers Manual (in PDF format) from the Project MARC website and go to page 60.

There are many other serious health considerations as well when visiting a remote tropical paradise like Vanuatu, unless perhaps you only plan to stay in the relative safety of Port Vila harbor. Many of these concerns are discussed on the Project MARC website in the form of health advice and instructions for our volunteers.

Assuming you have taken care of the various immunizations for yourself and your daughter before your departure from New Zealand, the best approach to obtaining local medical advice would be to visit with one of the medical practitioners in the major port of each archipelago you are planning to visit.

Wishing you a safe and exciting cruising adventure,

Flying Dutchman
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Old 24-11-2009, 12:44   #8
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thanks to Paige for her practical advice, and to Flying Dutchman for his proffessional advice, and supporting references.
Great stuff!!!
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Old 25-11-2009, 12:57   #9
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I think all the places you named are relatively high malaria risk. Make sure whatever refers to malaria prevention / treatment is OK to your kid and to you guys.

b.
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