While we didn't start as early as 1, we did start sailing with both our boys at the early toddler stage, which given their mobility did add some concerns. We sailed with friends who brought their daughter down at probably that age and left for the trip literally the day after she had ear tubes inserted. In all cases it worked out fine. I think the key part was to always have someone dedicated to watching the child. You never know what they might find interesting. On one trip one child was fascinated by the winches and would sit by (an unused) winch and pretend it was the baggage carousel he had just seen at the airport.

Some issues while underway were trying to find food, replenishing diapers, and keeping soiled diapers around until we reached a garbage disposal location. (Still have memories of that 20+ years later!).

We brought life jackets down, and on later trips when they were older, appropriately sized snorkels and masks. We also brought kid sized harnesses, though we seldom had a need for them.

While I can't speak for post-Irma capabilities, over the years having VISAR around certainly made for a lot of piece of mind. When our older son was about 12, he was having a reaction to an anti-seizure medication he had been prescribed prior to our departure. Cutting him off cold turkey could have precipitated seizures so we contemplated shutting it all down and heading home. After conversations with VISAR about their ability to reach us from various locations, we decided to stay and were glad we did. We never had to utilize their services but were grateful for their availability.