As your child recovers from the blood and marrow transplant (BMT), they are slowly building the natural defenses in their immune system. This means your child is still vulnerable to infection.
When to wear the mask
Some viruses and bacteria that may not be in your home environment may be in the hospital. To minimize infection, your child needs to cover their mouth with a mask whenever they come to the hospital for check-ups.
Your child does not need to wear the mask when going outside for a walk or going for a ride in the family car.
For younger children and infants, a rain cover can also be used instead of a mask.
Avoiding crowds
To protect your child from getting an infection, it is important that they do not come into contact with people whose health status they do not know. This is why your child should avoid crowds. For example, your child should avoid attending stores, markets, church, laundry mats, movie theatres, and parties.
This period may be frustrating for your child, particularly for adolescents. Most children are anxious to return to their normal social lives. Remind your child that this is temporary. They need to take this precaution so that they can feel better in the long run and avoid re-hospitalisation. With the ease of online communication and visits from friends (who are not ill), your child does not need to feel completely isolated.
Your child’s health care team will advise you how long your child needs to avoid crowds.
Visiting
Family and friends can visit your child at home, as long as they are not ill. Be sure to carefully screen all children that visit your child, especially younger children who are in school. Because of the school environment, younger children have a greater risk of catching a contagious disease. Illnesses that are of particular concern include chicken pox, measles, mumps and cold sores (herpes simplex virus). Tell your child’s doctor or nurse, if your child has been exposed to any of these illnesses.
For children with immune deficiencies
If your child has an immune deficiency, it will take longer for their immune system to recover from the transplant. Because of the risk of infection, it is best that your child only comes into contact with immediate family. Remember that this is temporary. As your child's immune system becomes stronger, then they can come into contact with others. Your child's doctor will discuss this with you during each clinic visit.
Vaccines
While your child is recovering from the transplant, they cannot receive any vaccines. Your child’s transplant physician may decide to start giving your child some vaccines, one year after the transplant.
Also, siblings should not receive any live vaccines. This includes vaccines for chicken pox and MMR. Talk to your child’s transplant physician to check which vaccines siblings can take, after your child’s transplant.
If your child has an immune deficiency, the doctor will run blood tests to check how well your child's immune system is recovering. Based on these results, your child's doctor will discuss when your child is ready to receive vaccines. This is done during clinic visits.
Participating in activities
Your child can get involved in outdoor activities. Participating in some form of sports will be a good for your child’s physical health. Possible activities can include skating in the winter. Swimming in the family pool or free-flowing lake in the summer may be possible. However, remember to change your child’s central line dressing immediately after leaving the water.
If your child has an immune deficiency, talk to your doctor about whether swimming is a safe option.
For more information, please see the page on Central Venous Lines (CVL).
Pets in the home
If you have pets, it is best to remove them for the first several months after your child’s BMT. Try to arrange care for your pets well in advance, before your child returns home from the hospital. It may be upsetting for your child to not be around the family pet. Remember to talk to your child before coming home, so that they are prepared. Remind them that it is only temporary.
If you are unable to arrange care for your pet outside of the home, make sure your child does not:
- play too roughly with the pet
- sleep with the pet
- come into contact with the cat litter box (if you have a cat)