Mom, I think I am going to vomit. Motion sickness/Children/Prevention/Treatment

If no one in your family has ever been motion-sick, it’s only because they haven’t yet encountered the right (or is it the wrong?) ride. It may be a storm at sea, an “amusement” park roller coaster that spins in three dimensions simultaneously while riders are strapped in upside down, a ride atop a camel or elephant, or space travel. Motion sickness happens on camel and elephant rides because they sway from side to side as they walk. Astronauts experience it in spite of being screened, trained and medicated to deal with it. (A new source of motion sickness-like symptoms, virtual reality headsets, doesn’t even require motion,)

1. Children two to twelve years of age are especially susceptible. A test for motion sickness is to have children read or draw in the back seat of a moving car. If that does not make them sick, chances are they will tolerate rides in boats in moderate waves, airplane turbulence and merry-go-rounds.

2. Motion sickness is rare in infants. Most actually fall asleep with motion. However, consider motion sickness when infants are unusually fussy in moving cars, boats and planes. In cars it may be because infants face backwards for safety reasons, a position known to increase motion issues. When possible, in cars, wait until they are asleep before starting the car.

3. Recognize early symptoms. Children will lose interest in their activity and lie down or curl up in their seat. Next comes “queasiness” – dizziness, paleness, stomachache, sweating, headaches, yawning, and rapid breathing. Take immediate action to avoid the ultimate disaster, vomiting. Symptoms usually disappear promptly when motion stops.

4. Prevent vomiting. Distract kids with singing and word puzzles. Expose them to fresh air, well-ventilated areas, or air conditioning. Have older children breathe slowly and deeply. Tell them to close their eyes and keep their heads still. Avoid sights and odors of food. Separate them from people who are already sick, especially ones already vomiting.

5. Air travel. The larger the plane, the smoother the ride. Avoid propeller planes if possible. Opt for window seats; looking out at the horizon helps minimize symptoms. Sitting over the wings or over the middle of the plane (often suggested) is not particularly helpful. Recline seats, when possible, and aim an air vent at the child’s face.

6. Sea travel. Choose voyages with the least motion. Small boats in open waters are problematic. For cruises, choose large ships with stabilizers, smooth seas (inland waterways, for example), and calm seasons. Find cruises where ships pull up at docks rather than use smaller boats to bring you ashore. Choosing cabins at the center of ships is not helpful.

7. Carsickness. If possible, raise car seats so that children can see out of windows. Tell older children to focus on distant scenery. Stop frequently and expose children to fresh air. Also stop if children show early symptoms. Keep the car cool and well ventilated. Avoid strong odors. If possible, avoid winding roads and frequent traffic stops. Drive during children’s usual sleeping hours. Expert opinion is divided as to whether watching DVDs increases, decreases, or has no effect on the probability of motion sickness.

8. Amusement park rides. Generally, moderate roller coasters are better tolerated than merry-go-round-type rides. Outdoor rides are better than indoor ones. Rides simulating space travel are prone to cause illness; some supply motion sickness bags. Sit facing forward. Ask ride operators if many children become ill. (Generally, they prefer losing a fare than having to clean up the mess.)

9. Preventative medications are not generally recommended. Antihistamines – dimenhydrinate (Dramamine) and diphenhydramine (Benadryl), for example – may reduce the incidence and severity of motion sickness but can cause many side effects (agitation, for example). Read labels regarding lower age limits, dosage and frequency of administration. Medication by injection is available on cruise ships. Transderm Scop, the most frequently used medication for adults, is not approved for children.

10. Many other preventative treatments are available – with little evidence that they are effective. These include small, light carbohydrate snacks along with frequent sips of water, juice or soda before and during travel; doses of ginger; and applying acupuncture or acupressure just above the wrist.

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