Kids on planes

May 1, 2016

With a few tips, parents and adults flying with kids can diminish some of the angst that can set in at the thought of trying to subdue a crying baby in flight or concerns with potential risks posed to children, such as dehydration and gastrointestinal discomfort, by sending them up in the air.

Reviewed by Karl Neumann, MD.

 

“In America there are two classes of travel-first class, and with children.”

-Robert Benchley, American humorist

As summer nears and vacation plans begin to take shape, on the mind of many a parent is not only choosing the right resort and the best time to go, but inevitably bracing for what, for many, will be the fastest way to get there-air travel. As the quotation by the American humorist Robert Benchley suggests, air travel with kids is not the roomy “I’ll have a martini”-and-fall-asleep-and-wake-up-when-I-get-there” experience of first class. No, flying with children can deter even the hardiest of travelers.

With a few tips, however, parents and adults flying with kids can diminish some of the angst that can set in at the thought of trying to subdue a crying baby in flight or concerns with potential risks posed to children, such as dehydration and gastrointestinal discomfort, by sending them up in the air.

Karl Neumann, MD, a pediatrician, travel medicine practitioner, clinical associate professor of pediatrics at Weill Cornell Medical College, Cornell University, and clinical associate attending pediatrician at New York-Presbyterian Hospital/Cornell Medical Center, New York, provides guidance on flying with children on the website KidsTravelDoc.1 Billed as “a pediatrician’s guide to travel and outdoor recreational activities,” the website provides pediatricians with easy and accessible articles to help answer many common questions about traveling with children.

This article pulls together information from a number of articles written by Neumann on common concerns and questions regarding air travel with infants and children. It is hoped that pediatricians can use it as an easy guide when talking to parents and other adults when travelling with children. As such, most of the information is presented in table form, with each table highlighting tips for managing a specific issue or concern.

Excessive crying: The mother of all worries

Among the most worrisome of worries when flying with children is an infant or child who cries excessively while in flight, not only raising worries of the child’s physical discomfort but also of the parent’s discomfort at disrupting other passengers’ comfort. If that sounds like a syllogism, it is in the sense that better managing a child’s physical discomfort while in the air will go a long way to alleviate excessive crying and the subsequent discomfort of both parents and other passengers contending with an inconsolable child.

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Neumann is more to the point. “Forget lousy food, airport delays, and turbulence. One of air travelers’ biggest nightmare is sitting near a cute, cuddly little baby that suddenly morphs into a nonstop noise machine emitting high-decibel, ear-piercing, headache-producing, sleep-preventing terror,” he says in his updated article on Infants, air travel, and excessive crying.2 “An even worse nightmare: It’s your child.”

Neumann is quick to point out that surveys show that most infants do not cry during flight but tend to sleep well and even better than they do while at home. When they do cry, however, surveys indicate it as one of the most objectionable features of travel.

Although no hard facts exist on why infants cry excessively in flight, when they do many factors can converge and contribute to overall “general discomfort” that may result in crying.

“Infants are creatures of habit. Air travel upsets their routines, disrupting eating and sleeping schedules,” says Neumann. “It places them in new surroundings, away from their own cribs, in new and often uncomfortable sleeping positions, and among strange noises and unfamiliar faces.”

Surveys also suggest, he says, that infants who cry excessively in flight often cry excessively at home and at about the same time.

NEXT: Stopping excessive crying

 

Do’s and don’t’s to prevent or stop excessive crying

What can parents do to ease the excessive crying of an infant in flight? In answering this question, Neumann emphasizes 2 main things parents commonly do that they should not do: sedate an infant or child with antihistamines or other sedating substances, or overfeeding while in flight to prevent or reduce dehydration (Table 1).2,3,4

What parents can do is try to simulate the home sleeping environment, use items that can calm the infant or child, address possible ear pain associated particularly when ascending and descending, and, importantly, stay calm themselves (Table 2).2,5

“Stay calm, if possible. Infants feel an adult’s stress and cry in response, say some psychologists,” Neumann advises. “Attempt to make peace with your neighbors before they make an enemy of you. Apologize for the disturbance. Tell them that you are doing everything possible to quiet your baby.”2

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Parents also can try what pediatrician Robert Hamilton, MD, calls “the Hold” to stop their infant from screaming (for the demonstration, log on to bit.ly/HOLD-video).

NEXT: Safety issues

 

Safety issues

For healthy newborns, flying is considered safe. Infants with a history of serious medical issues (eg, significant premature birth, or heart and lung problems around the time of birth), however, should receive medical clearance for their first year of life before they fly, says Neumann.6

Because individual airlines may have age restrictions on travel for very young infants, Neumann recommends that parents go to the websites of individual airlines to review policies on travelling with infants and children. Generally, travel may be restricted only within the first 2 weeks of life and often airlines will not mandate the restriction.

Among the safety issues to keep in mind when flying with children are the use of safety seats in flight 7 and flying with respiratory illness or ear infection.6

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REFERENCES

1. Neumann K. Kids Travel Doc website. Available at: http://kidstraveldoc.com/about/. Accessed April 18. 2016.

2. Neumann K. Infants/air travel/excessive crying: an update. Kids Travel Doc website. Available at: http://kidstraveldoc.com/infantsair-travelexcessive-crying-an-update/. Published December 13, 2015. Accessed April 18, 2016.

3. Neumann K. Air travel/sedating infants/right or wrong? Kids Travel Doc website. Available at: http://kidstraveldoc.com/10-tips-air-travelsedating-infantsright-or-wrong/. Published November 16, 2008. Accessed April 18, 2016.

4. Neumann K. Infants/air travel/feedings/dehydration. Kids Travel Doc website. Available at: http://kidstraveldoc.com/infantsair-travelfeedingsdehydration/. Published October 15, 2008. Accessed April 18, 2016.

5. Neumann K. Children/air travel/ear infections/prevention/treatment. Kids Travel Doc website. Available at: http://kidstraveldoc.com/dr-neumanns-kidstraveldoc-ten-tips-childrenair-travelear-infectionspreventiontreatment/. Published April 12, 2014. Accessed April 18, 2016.

6. Neumann K. Air travel/infants/health: frequently asked questions. An update. Kids Travel Doc website. Available at: http://kidstraveldoc.com/air-travelinfantshealth-frequently-asked-questions-an-update/. Published February 28, 2015. Accessed April 18, 2016.

7. Neumann K. Do infants’ safety seats on airplanes save lives? Kids Travel Doc website. Available at: http://kidstraveldoc.com/do-infants-safety-seats-on-airplanes-save-lives/. Published January 16, 2016. Accessed April 18, 2016.

Ms Nierengarten, a medical writer in Minneapolis, Minnesota, has over 25 years of medical writing experience, authoring articles for a number of online and print publications, including various Lancet supplements, and Medscape. She has nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.