Air Travel With Children

As I return from the West Coast after two cross-country flights with my family, I am reminded of all the challenges young children face while flying. We regularly travel with our children and have learned many lessons along the way – by doing research, by surviving en-route successes and disasters, and by observing other families’ inspired solutions. Parents frequently ask their pediatrician for advice before traveling; if you haven’t flown recently (or at all) with small children yourself, what can you tell them?

First, be sure that children are healthy and up to date on their immunizations before travel. Any needed shots should ideally be given at least 4-6 weeks before leaving to ensure time for an adequate immune response. If a family will be traveling out of the country, it is important to research the specific areas they will be visiting for any additional medical concerns or requirements that may exist (for example, malaria prophylaxis). The Centers for Disease Control and Prevention website is a wonderful and quite detailed resource for both providers and patients. I highly recommend consulting it before travel anywhere out of the country, even if the destination is somewhere a family has been before; recommendations can and do change.

It is also important to remind the family to carry on an adequate supply of any chronic and emergency medications they might need. Additionally, I encourage families to check the airline’s website for guidelines on traveling with a car seat, which I strongly recommend doing. Riding in cars without the proper child restraints isn’t any safer away than it is at home.

There are no set guidelines for how young an infant can be before flying – one of the most common questions I am asked – but I think it is quite reasonable to recommend waiting at least 1-2 weeks to ensure that a newborn is healthy and does not have as-yet-undetected cardiac (or other) anomalies. I typically also discuss the risks of infection with parents of very young infants – both the risk of acquiring illness during travel and the importance of identifying local medical facilities as a part of pretravel preparations. The younger a child is, the more stringent I encourage parents to be about frequent hand washing/sanitizing and limiting exposure to other travelers.

We found that keeping our baby in a cloth carrier on our chest was a very effective way of discouraging friendly strangers from touching them or coming close into their faces. It made lugging around all the supplies they needed a bit easier as well. I don’t think this is a reason to discourage travel at a young age, but parents should be aware of the risks and be cautious.

During air travel, motion sickness and eustachian tube dysfunction are the most common complaints, so it is helpful to be prepared for them.

Eating large amounts or unfamiliar and overly exciting food immediately before flying can put anyone at higher risk for stomach upset, so I recommend traveling with plenty of milk for younger infants, plus a stash of healthy snacks and baby food or a sandwich. Giving a child lots of junk food and candy to keep them happy in flight can definitely backfire and leave the parent grabbing for the airsick bag. Again, it is helpful to check the airline’s websites for guidelines on traveling with liquids for children. This is typically allowed for small children, within certain limitations.

For most children, eating small but more frequent and familiar meals is all they need to prevent motion sickness; however, some will still have trouble. Children older than age 2 years can take an antihistamine such as dimenhydrinate (Dramamine; 1-1.5 mg/kg per dose) or diphenhydramine (0.5-1 mg/kg per dose up to 25 mg) at 1 hour before travel and every 6 hours during the trip. Note, however, that these medications are not approved by the Food and Drug Administration for the treatment of motion sickness in children; additionally, some children have paradoxical reactions, so if a family plans to use these medications, they should give a trial dose sometime before travel.

For eustachian tube dysfunction, drinking from a bottle or straw during takeoff and landing, chewing gum (for older children), or using a pacifier (for young children) is helpful. Middle ear disease is not a contraindication to flying; however, it may make a child more prone to pain during ascent and descent.

Overall, the better prepared a family is to travel with their child, the more enjoyable the trip will be, and everyone will land ready to have a good vacation.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington. 

As I return from the West Coast after two cross-country flights with my family, I am reminded of all the challenges young children face while flying. We regularly travel with our children and have learned many lessons along the way – by doing research, by surviving en-route successes and disasters, and by observing other families’ inspired solutions. Parents frequently ask their pediatrician for advice before traveling; if you haven’t flown recently (or at all) with small children yourself, what can you tell them?

First, be sure that children are healthy and up to date on their immunizations before travel. Any needed shots should ideally be given at least 4-6 weeks before leaving to ensure time for an adequate immune response. If a family will be traveling out of the country, it is important to research the specific areas they will be visiting for any additional medical concerns or requirements that may exist (for example, malaria prophylaxis). The Centers for Disease Control and Prevention website is a wonderful and quite detailed resource for both providers and patients. I highly recommend consulting it before travel anywhere out of the country, even if the destination is somewhere a family has been before; recommendations can and do change.

It is also important to remind the family to carry on an adequate supply of any chronic and emergency medications they might need. Additionally, I encourage families to check the airline’s website for guidelines on traveling with a car seat, which I strongly recommend doing. Riding in cars without the proper child restraints isn’t any safer away than it is at home.

There are no set guidelines for how young an infant can be before flying – one of the most common questions I am asked – but I think it is quite reasonable to recommend waiting at least 1-2 weeks to ensure that a newborn is healthy and does not have as-yet-undetected cardiac (or other) anomalies. I typically also discuss the risks of infection with parents of very young infants – both the risk of acquiring illness during travel and the importance of identifying local medical facilities as a part of pretravel preparations. The younger a child is, the more stringent I encourage parents to be about frequent hand washing/sanitizing and limiting exposure to other travelers.

We found that keeping our baby in a cloth carrier on our chest was a very effective way of discouraging friendly strangers from touching them or coming close into their faces. It made lugging around all the supplies they needed a bit easier as well. I don’t think this is a reason to discourage travel at a young age, but parents should be aware of the risks and be cautious.

During air travel, motion sickness and eustachian tube dysfunction are the most common complaints, so it is helpful to be prepared for them.

Eating large amounts or unfamiliar and overly exciting food immediately before flying can put anyone at higher risk for stomach upset, so I recommend traveling with plenty of milk for younger infants, plus a stash of healthy snacks and baby food or a sandwich. Giving a child lots of junk food and candy to keep them happy in flight can definitely backfire and leave the parent grabbing for the airsick bag. Again, it is helpful to check the airline’s websites for guidelines on traveling with liquids for children. This is typically allowed for small children, within certain limitations.

For most children, eating small but more frequent and familiar meals is all they need to prevent motion sickness; however, some will still have trouble. Children older than age 2 years can take an antihistamine such as dimenhydrinate (Dramamine; 1-1.5 mg/kg per dose) or diphenhydramine (0.5-1 mg/kg per dose up to 25 mg) at 1 hour before travel and every 6 hours during the trip. Note, however, that these medications are not approved by the Food and Drug Administration for the treatment of motion sickness in children; additionally, some children have paradoxical reactions, so if a family plans to use these medications, they should give a trial dose sometime before travel.

For eustachian tube dysfunction, drinking from a bottle or straw during takeoff and landing, chewing gum (for older children), or using a pacifier (for young children) is helpful. Middle ear disease is not a contraindication to flying; however, it may make a child more prone to pain during ascent and descent.

Overall, the better prepared a family is to travel with their child, the more enjoyable the trip will be, and everyone will land ready to have a good vacation.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington. 

As I return from the West Coast after two cross-country flights with my family, I am reminded of all the challenges young children face while flying. We regularly travel with our children and have learned many lessons along the way – by doing research, by surviving en-route successes and disasters, and by observing other families’ inspired solutions. Parents frequently ask their pediatrician for advice before traveling; if you haven’t flown recently (or at all) with small children yourself, what can you tell them?

First, be sure that children are healthy and up to date on their immunizations before travel. Any needed shots should ideally be given at least 4-6 weeks before leaving to ensure time for an adequate immune response. If a family will be traveling out of the country, it is important to research the specific areas they will be visiting for any additional medical concerns or requirements that may exist (for example, malaria prophylaxis). The Centers for Disease Control and Prevention website is a wonderful and quite detailed resource for both providers and patients. I highly recommend consulting it before travel anywhere out of the country, even if the destination is somewhere a family has been before; recommendations can and do change.

It is also important to remind the family to carry on an adequate supply of any chronic and emergency medications they might need. Additionally, I encourage families to check the airline’s website for guidelines on traveling with a car seat, which I strongly recommend doing. Riding in cars without the proper child restraints isn’t any safer away than it is at home.

There are no set guidelines for how young an infant can be before flying – one of the most common questions I am asked – but I think it is quite reasonable to recommend waiting at least 1-2 weeks to ensure that a newborn is healthy and does not have as-yet-undetected cardiac (or other) anomalies. I typically also discuss the risks of infection with parents of very young infants – both the risk of acquiring illness during travel and the importance of identifying local medical facilities as a part of pretravel preparations. The younger a child is, the more stringent I encourage parents to be about frequent hand washing/sanitizing and limiting exposure to other travelers.

We found that keeping our baby in a cloth carrier on our chest was a very effective way of discouraging friendly strangers from touching them or coming close into their faces. It made lugging around all the supplies they needed a bit easier as well. I don’t think this is a reason to discourage travel at a young age, but parents should be aware of the risks and be cautious.

During air travel, motion sickness and eustachian tube dysfunction are the most common complaints, so it is helpful to be prepared for them.

Eating large amounts or unfamiliar and overly exciting food immediately before flying can put anyone at higher risk for stomach upset, so I recommend traveling with plenty of milk for younger infants, plus a stash of healthy snacks and baby food or a sandwich. Giving a child lots of junk food and candy to keep them happy in flight can definitely backfire and leave the parent grabbing for the airsick bag. Again, it is helpful to check the airline’s websites for guidelines on traveling with liquids for children. This is typically allowed for small children, within certain limitations.

For most children, eating small but more frequent and familiar meals is all they need to prevent motion sickness; however, some will still have trouble. Children older than age 2 years can take an antihistamine such as dimenhydrinate (Dramamine; 1-1.5 mg/kg per dose) or diphenhydramine (0.5-1 mg/kg per dose up to 25 mg) at 1 hour before travel and every 6 hours during the trip. Note, however, that these medications are not approved by the Food and Drug Administration for the treatment of motion sickness in children; additionally, some children have paradoxical reactions, so if a family plans to use these medications, they should give a trial dose sometime before travel.

For eustachian tube dysfunction, drinking from a bottle or straw during takeoff and landing, chewing gum (for older children), or using a pacifier (for young children) is helpful. Middle ear disease is not a contraindication to flying; however, it may make a child more prone to pain during ascent and descent.

Overall, the better prepared a family is to travel with their child, the more enjoyable the trip will be, and everyone will land ready to have a good vacation.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington.