Travelling with a sick child: fly, wait or see a doctor first

Travelling with a sick child is often fine for a mild cold. HealthHub says there's no need to worry if a child with a cold is active and eats and plays as usual. A baby under 3 months with a fever is different, and NUH calls that a medical emergency. If you're unsure, see your GP or polyclinic before you fly.

How to travel with a sick child, step by step

1. Check your child in the days before you fly. Any sign on KKH's emergency list, such as difficulty breathing, persistent vomiting, unusual drowsiness, or any fever or illness in a baby under 3 months, means a doctor comes before the flight.
2. See your GP or polyclinic if you're unsure, since KKH says a doctor can judge your child's fitness for travel. The AAP suggests asking first if your baby has cold or chest symptoms, or had an ear infection in the 2 weeks before.
3. Check your airline's medical clearance rule. Singapore Airlines needs clearance when fitness to travel is in doubt, and it and Scoot both want the Medical Information Form (MEDIF) at least 5 working days before the flight.
4. Ask the doctor for a letter, which KKH advises when your child has a medical condition or needs medicines abroad. Changi says liquid medicines over 100ml may be exempted at security with a bona fide doctor's letter.
5. Pack medicines in your cabin bag, as Singapore Airlines asks, with enough for the whole trip and extra for delays, as CDA advises. Scoot wants prescription medicines to carry a printed label from the clinic, pharmacy or maker.
6. Feed or offer a drink at take-off and landing. The AAP says sucking on the breast, a bottle or a pacifier can ease ear discomfort, and older children can drink through a straw.
7. Give small, frequent sips if your child is vomiting, as HealthHub advises. Mix oral rehydration salts exactly as the packet says, the CDC adds.
8. Save the numbers before you land: your travel policy's assistance line, the local emergency number on MFA's page for your destination, and MFA's 24-hour Duty Office on 6379 8800.
9. See a doctor for any fever once you're home, and say where you went. CDA asks you to tell your doctor about your trip for a fever within 12 months of visiting a malaria area.

Fly, check first or postpone: symptom by symptom

Use this table to frame the question you take to your doctor. It isn't a diagnosis. Each row names its source.

Not sure which row fits? Our fever checker walks through a fever by age, and common childhood illnesses in Singapore covers the usual bugs. HFMD has its own guide: HFMD in Singapore.

Why some illnesses and flights don't mix

Singapore Airlines says most medical conditions don't stop you flying, but cabin pressure can drop to what you'd feel at 5,000 to 7,000 feet. Most children cope with that. The CDC says children with long-term heart or lung problems may get too little oxygen in flight, so ask their doctor before you book.

Ears are the next reason. Take-off and landing change the pressure, and the CDC says swallowing or chewing evens it out in the middle ear. It also says antihistamines and decongestants haven't been shown to help. Our child ear infection guide covers the signs and home care.

Then there's spread. CDA calls chickenpox highly contagious. HealthHub says a child with HFMD should stay away from all public places until recovered. An airport and a plane count.

What the airlines, Changi and HSA ask for

Singapore Airlines asks you to keep medicines in your hand luggage, not your checked bag, with a letter from your doctor about the condition and the medicines. Changi's transit advice is the same: keep medication in your hand carry luggage.

If you need to cancel, Scoot's help page says it reviews refunds on medical grounds once you send supporting documents, and an eligible refund comes as Scoot travel vouchers. The medical certificate has to say the passenger is unfit for travel, or give the diagnosis. Your travel policy may also help: the General Insurance Association lists a trip cancelled for serious illness among the unforeseen events travel insurance guards against, so check your policy wording.

Bringing home medicines a doctor abroad prescribed? HSA says some ingredients need its approval before they come into Singapore. Each medicine should stay in its original packaging, labelled by the dispensing pharmacy. Check HSA's page before you fly back.

If your child gets sick while you're away

Pack a thermometer, fever medicine and oral rehydration salts for diarrhoea. All three are on KKH's travel kit list. Doses come from the label, a pharmacist or your doctor. Our guide to giving medicine to a baby covers the how, and the baby medicine and first aid kit checklist covers the packing.

Leave out anything meant to make your child sleep on the flight. The CDC says antihistamines shouldn't be given under 1 year old, and the AAP warns that diphenhydramine makes some children more alert. Our guide to baby sleep while travelling has other ways to help.

For a tummy bug, HealthHub's advice is small, frequent sips rather than a big drink at once, and the CDC says breastfed babies should keep breastfeeding. Our food poisoning guide sets out the dehydration signs.

To find a doctor, call your travel policy's assistance line first. Then open MFA's travel page for your destination, which lists local emergency numbers and the Singapore mission. In Malaysia, MFA says to call 999 for a medical emergency. A transfer to Singapore by ambulance is possible if the Malaysian hospital's doctor and the Singapore hospital both agree, and the cost falls on you or your insurer.

Carry what any doctor will ask for. KKH suggests bringing your child's medical conditions, allergies, a copy of the immunisation record and emergency contacts.

When to see a doctor

Get help the same day, before a flight or while you're away, if your child has any of these:

• A fever in a baby under 3 months: above 37.5 degrees C under the arm or 38.0 degrees C in the ear. NUH calls this a medical emergency and says to go to the nearest hospital.
• Difficulty breathing, wheezing, noisy breathing, or too breathless to talk, drink or play (KKH).
• Bluish lips or gasping for air. HealthHub says to go to the emergency department.
• Persistent vomiting and not keeping fluids down (KKH), or small sips not staying down for more than 6 hours (HealthHub).
• No wee or wet nappy for 8 to 12 hours, no tears when crying, or a dry mouth (HealthHub).
• Unusual drowsiness or confusion (KKH), or crying that won't settle (NUH).
• Small purple spots that look like bruises, or a fit (NUH).
• Blood in the poo or vomit, or green vomit (KKH).
• A fever, diarrhoea, vomiting, a rash or yellow skin after a trip (KKH's Children's Travel Clinic).

In Singapore, KKH says your GP or polyclinic can treat common illnesses in young children. For something urgent, go to KKH Children's Emergency or NUH Children's Emergency, which runs round the clock. Call 995 in an emergency, as KKH advises. Abroad, use the local emergency number on MFA's page, your policy's assistance line, and the Singapore mission or MFA's Duty Office. Back home, KKH's Children's Travel Clinic checks children who fall ill after a trip.

Frequently asked questions

Can I fly with a sick baby?

Often, if it's a mild cold and your baby is feeding well. The AAP suggests asking your doctor first when a baby has cold or chest symptoms. A baby under 3 months with a fever shouldn't fly, because NUH treats that as a medical emergency.

Is flying with a cold OK for my child?

Usually, yes. HealthHub says there's no need to worry while a child with a cold stays active and eats and plays as usual. Offer feeds or sips at take-off and landing, as the AAP suggests. HealthHub adds that saline nose drops or spray can clear a baby's nose.

Can my child fly with an ear infection?

Ask the doctor first. The AAP suggests checking before you fly within 2 weeks of an ear infection or ear surgery. The CDC says there's no evidence that flying makes an ear infection or its complications worse.

What should I do if my child is sick on holiday?

Keep fluids going and let your child rest. Watch for the signs in the list above. To find a doctor, call your travel policy's assistance line, and in an emergency use the local number on MFA's page, which is 999 in Malaysia. Keep every doctor's note and bill. GIA says insurers ask for documents to back a claim.

What should I do about a fever on holiday?

Start with your child's age. Under 3 months, NUH says any fever means the nearest hospital. From 3 months to 2 years, NUH suggests a doctor within 24 hours if the fever lasts more than 24 hours with no other symptoms, and sooner for any warning sign. Our baby fever guide goes through it step by step.

Should my child have a pre-travel health check?

KKH suggests seeing a doctor about 4 to 6 weeks before you leave. The doctor checks which vaccines your child needs and whether your child is fit to travel. Our travel vaccinations guide lists what to ask for.