Kids trekking and the risks – (AMS) Acute Mountain Sickness

Travelling with children is never without risk, and as our list of overseas visits lengthens, it was only a matter of time before we experienced some new situation regarding our child’s health.

It happened while trekking Nepal’s Annapurna Circuit: acute mountain sickness. We were tackling a gentle route out of Pokhara up the western side of the Annapurna Mountains between Beni and Kagbeni, an ancient village that peers into the restricted lands of Upper Mustang.

Switchbacking between the hiking trail and the easier 4WD track that parallels it, we moved slowly up the Kali Gandaki valley, walking hand-in-hand with our child who could easily tackle the gentle gradient, and making plenty of stops to enjoy the scenery.

We stood beneath thundering waterfalls and skipped through muddy puddles, dared each other across rickety suspension bridges, and spent sunny afternoons with our boots off sipping pots of milky masala tea.

After nine slow days we reached Kagbeni at 2840m, having made acclimatising day trips at both Marpha and Jomsom along the way. To reach the sacred site of Muktinath at the end of our pilgrimage, we were then forced to tackle a much bigger ascent to the town of Ranipauwa at 3710m in a single day.

Aware that we were embarking on a higher than recommended ascent, we took our time throughout the day, stopping for plenty of rests and tea breaks, and at day’s end our daughter was happy, hungry, giggly and slept well through the night.

The Himalaya
The Himalaya, beautiful but can be dangerous if not treated with respect

All seemed good and the anxiety I had been feeling all day slowly retreated to the background. We had booked into our guesthouse at Ranipauwa for two nights to aid acclimatisation, but on the second day, a short walk uphill to explore Muktinath temple, less than 100m above our hotel, proved too much for our 4.5 year-old daughter Maya. After being chirpy all morning, she suddenly became tired, teary and sick around lunchtime.

After being chirpy all morning, she suddenly became tired, teary and sick around lunchtime.

Immediately recognising that she was exhibiting symptoms of acute mountain sickness (AMS), we wasted no time in returning to the guesthouse (where Maya vomited), packed our backpacks in mere minutes, and made a swift descent down the hill. Just 15 minutes after dropping around 100m in altitude, Maya was totally revived, giggling and cracking jokes.

Despite being fairly experienced at altitude, David and I had allowed our confidence in our child’s fitness and acclimatisation and the slow success of our trek, to cloud our adherence to the rules about mountain sickness. These advise ascending no more than 300m in altitude a day, once you are trekking above 3000m.

On the flipside, that same experience meant we knew exactly what needed to be done and reacted quickly, knowing that Maya’s acclimatisation ‘level’ must have been fairly close to where we were overnighting. We were right, and her recovery from being sleepy and sick to jumping around a pony in a paddock, was swift and stunning.

Despite her recovery just beneath the town where we were staying, we kept descending all the way back to Kagbeni to an altitude that we knew she had been completely well at, and arrived in a matter of hours (where she proceeded to spend the afternoon jumping on the beds while David and I tried to hide our exhaustion!).

Hindsight being what it is, it’s clear now that the altitude hike we tackled between Kagbeni and Ranipauwa was simply too much. Instead, we should have stopped halfway between the two destinations at the dirty, overpriced teahouse that we had intended on staying at, and should not have let the disinterested bloke in charge and his filthy rooms put us off our plan.

A conservative approach to acclimatisation is vital, but knowing what to do when symptoms present themselves and reacting quickly when they do is equally important.

One piece of advice that has stuck with me over the years is this: if your child shows any symptoms of acute mountain sickness (AMS) – tiredness, tears, loss of appetite, difficulty sleeping, headaches (that’s assuming they can decipher their pain and describe it to you) or more of a concern, vomiting, always assume that it is the result of acute mountain sickness (AMS) first and react accordingly.

If you descend quickly and it turns out to be a tummy ache or genuine tiredness, you can always turn back around after a good rest and recovery, and continue on your trek.

Essentials: for more information about altitude, acute mountain sickness (AMS) and trekking with children, visit this very helpful website:

You can always turn back and return another day

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