The freestyle cruising restaurant concept worked fine for young children, even my picky eater, because you can get "kid food" at any restaurant, no matter the cuisine. The trade off was that we didn't build a relationship with the waitstaff, which can be very special for kids and adults.
In another nod to the kids on board, the main buffet restaurant (the Garden) has an area with low tables, cushioned benches, and stools designed for kids. That area also has a small food line, with kid-friendly breakfast and lunch. Given the large crowds in this dining room, though, lots of adult groups used it too, so we couldn't count on sitting there too often.
The kids camp facilities, staff, and activities were terrific. The staff really engage the kids in group activities; they don't simply act as babysitters watching the children play. Because we didn't have swimming weather on our trip (we were in Alaska after all!), an excellent kids program was a bonus for all of us! We didn't have a chance to use the children's swimming area, but it looked really cute, and I was pleased to see that it is walled off from the main pool, so you can feel safe that your little ones can't walk away.
The list of excursions had lots of good choices for young travellers. We especially liked the dog sled musher's camp, which gave us a chance to ride on a dog sled pulled by 16 huskies and play with the puppies. The "family adventure gold rush" trip in Skagway was a bit hokie and didn't capture my children's interest. In Ketchikan, we had a great tour on the duck vehicles. The tour guide was able to engage the adults and the children too, and bravely gave the kids their duck whistles at the start of the trip!
Unfortunately, we had a chance to visit the doctor on board, but I'm pleased to report that they stock pediatric medicines, including decongestant and amoxicyllin.
The ship's game room had several sets of Chutes and Ladders, but so many pieces were missing that there was really only one set. It's such a nice idea to stock board games for children (I didn't expect it), but the ship really needs to take an inventory! Also, the library had no books for children, so be sure to bring your own.
Also, in a nice change from other ships we've been on, the arcade was near the kids camp facilities, and not attached to the smoky casino! Of course, this location made it hard to avoid, so be prepared for lots of pleas for quarters.
Overall, we had a terrific adventure and really enjoyed the Pearl.