Is air travel safe for infants/young children? Answers to your questions

(Folklore says that infants traveled by air centuries ago and the flights were healthier than those today. Storks “delivered” infants. Storks had the wisdom to skim rooftops, eliminating concerns of high altitude and the accompanying ear issues, dehydration, and excessive stomach air. Each newborn was a sole passenger enjoying fresh rather than recirculated air, with no worry of acquiring illnesses from disease-causing organisms coughed up and sneezed out by other passengers.)

1. Can healthy newborns travel by air? Yes. And the duration of the flight does not matter. However, it’s important to be aware that there are two groups of infants who require medical evaluation prior to flying: those born significantly premature and those having heart and lung issues at or soon after birth. Such infants should be evaluated by pediatric health care professionals until they reach their first birthday, even if they show no symptoms. Rarely, such infants may have difficulty compensating for lower oxygen levels at cruising altitudes.

2. Do airlines have lower age limits for infants to fly? Most major airlines no longer have such restrictions. Check your airline’s webpage (see “Infants”) or call the airline’s reservation number. A few airlines still ask for letters from a physician stating that infants less than two weeks of age are fit to fly.

3. Are aircraft equipped to handle infant-related in-flight health issues? Flight attendants are trained in first aid and aircraft carry kits with some basic life saving equipment and medications. Some of the equipment and medications can be used only by licensed physicians, if one happens to be aboard and volunteers to do so. Crews can contact specialists on the ground, and if necessary, land at the nearest airport. However, the training of crews and the equipment and the medications aboard are ill suited for infants. And most physicians are not trained in emergency medicine, let alone treating infants in flight. Fortunately, problems occur rarely.

4. What kind of accidents occur during flight? Accidents outnumber illnesses. Many are preventable: infants rolling off adults’ laps; adults holding infants tripping walking in aisles; burns due to hot beverage spills; luggage falling from overhead bins, for example. See preventing accidents.

5. What kind of illnesses occur in flight? Most are routine, ones that infants and young children experience at home. Carry medications to treat them. For children with cardiac and pulmonary conditions, asthma, diabetes and other on-going conditions, consult the treating health care provider before air travel.

6. Are infants likely to contact infectious diseases? Very unlikely. Infants are partially protected by immunity obtained from their mothers. Most contagious diseases that affect infants spread through the air. Cabin air is replaced every few minutes with mostly sterile air. And air circulates from ceiling to floor, not through the entire aircraft, making passengers susceptible only to illnesses from those sitting nearby. Infants should be up-to-date with their immunizations.

7. Do infants need extra drinks to prevent dehydration? No. In-flight dehydration is a myth. Feed infants no more in flight than at home. Adults erroneously interpret in-flight parched mouths and throats as dehydration. This dry feeling results from air conditioning removing most of the moisture from the cabin air.

8. Why are extra feeding in flight not advisable? At cruising altitudes the air in the stomach and intestine is already expanded by 20%, the result of lower atmospheric pressure. (This gives adult bloated feelings.) For infants, excessive liquids and solids and the act of sucking adds unnecessary bulk and air to the stomach and intestine and may cause fussiness.

9. Is it OK to sedate infants for long flights?Not a good idea. Some infants will cry whether they are medicated or not. In fact, surprisingly few infants cry considering that air travel disrupts their sleep and feeding schedules, they rest in unfamiliar and sometimes uncomfortable positions and, if they are on an adult’s lap, are disturbed every time the adult moves. No studies show which medications are effective and how much and when to give them. Some sedating medications (antihistamines, for example) make some infants more active.

10. Should infants with upper respiratory infections, nasal congestion, and ear issues travel by air? Discomfort may occur, perhaps somewhat more often than if these symptoms did not exist. However, according to experts, serious or permanent damage to ears from flying with these symptoms does not seem to occur. [See: Young children, air travel, ear problems. ] Decongestants and nose drops/sprays do not help infants. Air pressure regulating earplugs do not reduce ear discomfort in children. Carry acetaminophen and ibuprofen to treat pain.