“Mom – I think I’m gonna throw up!”

Motion sickness/ Children/ Prevention/ Treatment – An Update

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?) situation. It may be a storm at sea, an “amusement” park roller coaster that spins in three dimensions simultaneously while you are strapped in upside down, a ride atop a camel or elephant, or space travel. Motion sickness happens on camels and elephants 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 is to have children read, draw or play video games 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, “merry”-go-rounds, and roller coasters. In children, once motion sick, always motion sick. It’s rarely outgrown but may become milder with age. Children are more likely to be susceptible when a parent has it.

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 often face backwards for safety reasons, a position known to increase motion issues. When possible, wait until they are asleep before starting the car.

3. Recognize early symptoms. Children will lose interest in their activities 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. Separate them from people who are already sick. Avoid sights and odors of food.

A mid-1800 British medical journal states that diets are an unpredictable feature. ‘Cold pork and chutney (a spicy Indian sauce) or corned beef and pickles will sometimes stay down when the daintiest substances the pantry can prepare are promptly rejected.”

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 in the middle of the plane (as is often suggested) is not particularly helpful. Recline seats, when possible, and aim air vents, when available, at the child’s face. A cold cloth to the forehead may help.

6. Sea travel. Take cruises on large ships with stabilizers, opt for itineraries and seasons when seas tend to be calm, and choose ships that pull up to docks at ports of call. At some ports, ships anchor outside the harbor and use small boats likely to cause motion sickness to ferry you ashore. Choosing cabins at the center of ships is not very 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. Expert opinion is divided as to whether watching DVDs increases, decreases, or has no effect.

Several thousand years ago, the Chinese observed that children were particularly susceptible to motion sickness. They called it cart-sickness – for obvious reasons.

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 causing 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 a mess.)

9. Preventative medications are generally not recommended for children. Antihistamines – dimenhydrinate (Dramamine) and diphenhydramine (Benadryl), for example – may reduce the incidence and severity of motion sickness but may cause side effects (agitation, drowsiness, and dry mouth 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 under the age of 12 years.

10. Other preventative treatments are available – with little scientific evidence of effectiveness. 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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