10 Tips For Staying Healthy At Sea

A vacation at sea offers families the best of all worlds: seeing foreign countries without the hassle of constant packing; supervised age-appropriate activities, lots of other children and, should you need it, "in-house" medical facilities.

Here's what you have to know:

1. Bring your children's medications:

A leading reason for passengers visiting ships' infirmaries is to obtain medications inadvertently left at home or ones you did not anticipate needing. Some common over-the-counter medications and motion sickness preparations are available free from the ship's nurse. Many prescription and non-prescription items are stocked but may be expensive, not covered by drug plans and not identical to the ones you use at home, possible causing confusion.

2. Take along a medical kit.

Most illnesses children experience when traveling would have occurred had you remained at home (upset stomachs, colds, and such). Pack mediations your children have taken recently. Include the telephone numbers of all their health care providers. Call them first if a problem arises. (See section: "Medical Kit".)

If not, buy travelers' assistance insurance. These plans cover such expenses, including evacuation to a medical facility if none is available locally. Policies have exclusions - pre-travel conditions and hazardous activities, parasailing and diving, for example, sports popular at some ports. Evacuation from ships is rare but costs tens of thousands of dollars. Assistance insurance policies are available through your credit card company.

4. Update your children's immunizations.

Influenza vaccination is recommended for cruises for children six months and older and for adults. Outbreaks have occurred aboard ships. For visits to exotic destinations check with a travel medicine professional. For shore excursions, even ones lasting a few hours, you may need additional vaccines and preventative medications.

5. Medical facilities.

Medical care aboard ship is designed to treat routine illnesses, provide emergency care, and stabilize serious medical problems. Most cruise physicians are trained in emergency medicine, and all speak English. You are responsible for fees. Consultations can cost up to $100 for the initial visit. Injections, x-rays, lab work and "house" calls to cabins are extra. Fees may be waived for minor ship-related injuries.

If a family member has an ongoing medical problem or mobility issues, consult the cruise line's medical department several weeks before sailing. In most cases they will accommodate you.

6. Sun.

Sunburns are common on cruises. Children burn easily. In the tropics, the sun is directly above, daylight is long, there is almost no haze to filter out rays at sea, and rays reflect off water, increasing exposure. In temperate climates, don't let cool weather and breezes lull you into complacency; neither reduces radiation. Taking ibuprofen immediately after excessive exposure and before burn symptoms occur may alleviate discomfort, but does not reduce long-term skin damage. Use sunscreen at SPF 15 or above, and reapply frequently.

7. Most shipboard accidents are preventable.

Leading causes are embarking and disembarking, the rolling of the ship, and for adults, alcohol. Inform your children about steep stairs, wet decks, door sills, and falling over items in the cabin. Baby-proof cabins. Leave a small light burning at night. In many ports, ships do not pull up to dockside. Getting on and off launches, particularly in heavy seas, and while holding young children is potentially dangerous. Wear slip-proof, low-heeled shoes and allow crewmembers to assist you.

Many serious accidents occur ashore. Riding motorbikes and parasailing are hazardous activities. In many ports there are no age restrictions. Tropical beaches have undertows and poisonous and hazardous sea life. Few beaches have lifeguards. In developing countries, watch for broken sidewalks, exposed roots, and unexpected steps. Many ports of call have only rudimentary medical services.

8. Gastrointestinal (GI) illness.

Occasional outbreaks of vomiting and diarrhea continue to occur in spite of expensive and elaborate campaigns to eliminate the problem. Most cases are caused by the norovirus. However, such problems also occur frequently in daycare and preschool settings with little publicity; million of Americans have the virus each year without leaving home.

Virtually all cases of norovirus are mild and self-limiting, and require no treatment. Frequent hand washing and keeping hands away from one's mouth, eyes and nose helps reduce risk infection. Keeping children in your cabin when they are ill helps prevent spread.

9. Seasickness.

Most modern ships are large and have stabilizers, and captains rely on sophisticated weather forecasts, making seasickness uncommon. Rough seas are predictable by geography and time of the year.

Taking a cabin in the center of the ship is not particularly helpful. When children feel "queasy", stay on deck and tell them to focus their eyes on the horizon. Or stay in a cool, air-conditioned or well-ventilated area, recline, and tell them to keep their eyes closed and heads still. Avoid large meals and odor of food. Sip fruit juices.

Transderm-Scop, a patch placed behind the ear, is effective but not approved for children less than 14 years of age. It requires a prescription and there are side effects. Oral medications include Bonine, Marazine, Phenergan, and Dramamine. Injections of these are available on many ships. (See section: "Motion Sickness" for complete details.)

10. Ship rules regarding children.

These vary among cruise lines. Some do not accept infants less than six months of age (or women after the 24th week of pregnancy). Some bar children not toilet trained from swimming pools and do not allow counselors in babysitting facilities to change diapers. But they will supply you with a beeper to summon you. Parents are urged not to send sick children to recreational programs. On some ships, ill-appearing children must be seen by the ship's physician or nurse before joining the program. There's no charge if your child is well and is allowed to join the activities.