To Grandma’s House We Go (With Sneezing Kids in Tow)

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It’s the most wonderful time of the year . . .  said someone who obviously never boarded a crowded plane or merged into gridlock with a bunch of cranky kids along. If traveling with kids makes the phrase “family vacation” seem like an oxymoron, read on.

Dr. Gwen Wurm, pediatrician, and Dr. Simon Angeli, an otolaryngologist with the University of Miami Health System, have tips and tricks to make your journey healthier and happier.

Parents, prepare for departure

Adding more chores to your “to do” list isn’t easy, but a little extra effort pays off in keeping kids well. While Dr. Wurm says there’s no evidence to support the claims of over-the-counter immunity boosters, she believes in giving children a healthy edge. “How you nurture your family’s health matters. Children who eat healthy, get enough sleep and outdoor physical activity seem to recover faster from illness.”

Her other rule is to keep up with your child’s routine vaccines. If traveling overseas, review the CDC Travelers’ Health website to see if additional shots are needed. “A lot of people do adventure travel or visit family in tropical countries,” Dr. Wurm says. And whether you’re traveling to the tropics or just enjoying a Miami staycation, protect your child from dengue fever. Do your homework and you’ll be good to go.

To avoid nausea and vomiting – two of the most common ailments kids suffer from while flying, “Skip the airport junk food. Flights get delayed, so pack nutritious snacks. And don’t overstuff your kid.”

Tip: Tuck some ginger candies or ginger tea bags in your carry-on. This natural remedy soothes a troubled tummy.

If your child has a medical condition, carry a doctor’s note mentioning the diagnosis and a list of necessary medications. That note could help any medical professionals who might be on your flight, should your child experience a problem. Always keep medicines in your carry-on bag, in case your luggage is lost. You may also want to review these TSA rules on traveling with medicine.

The bottom line? “Talk to your doctor ahead of time if you have any concerns about traveling with your child,” Dr. Wurm says.

Did you know? Nausea and vomiting are the two most common in-flight ailments for children.
Hold the pizza and soda if you want your kids to avoid getting queasy.

Fly the child-friendly skies

You made it through the maze of security and past the pricey airport shops with only a minor meltdown. What could go wrong, now that you’re on the plane? A recent study highlighted a dozen “in-flight medical events” involving children. Don’t panic, just plan ahead when booking your flight. Ask yourself – could you hang onto your infant if the plane hits rough air? Consider purchasing a separate seat for your infant or small child and their car seat. (Review these guidelines from the American Academy of Pediatrics.) Some airlines discount ticket prices for babies traveling in an FAA-approved car seat. Others provide free bassinets on international flights for babies under six months of age.

Speaking of seat selection, always book the window seat for children. Some kids sitting in aisle seats have been injured when their hand, arm or leg came in contact with food carts moving along the narrow aisle. And as other passengers grab their luggage from overhead bins, kids can get bonked on the head. So, window seat it is.

Long haul flights instill zombie-like exhaustion, especially in parents of young children. If you hope to catch a few Zzzz’s while traveling with kids, seat your baby separately or, if you have a travel partner, ask them to take charge. This prevents you from rolling over on your baby while you sleep.

Managing airplane ear

Have you heard of the latest travel marketing trend? One international airline now uses an icon on its online seating chart to let customers know where children under age two are seated. (Talk about reverse ageism!) If you think sitting next to a wailing little one is painful, imagine how the child feels.

traveling with kidsIf a child cries during take-off and landing, the cause may originate in the ear, says Dr. Angeli. “Otic barotrauma or aerotitis media occurs when the Eustachian tube cannot equalize pressure between the middle and outer ear. The pressure is normally equalized via the Eustachian tube, a valve that connects the middle ear with the throat near the back of the nose. As the plane gains altitude, the pressure in the middle ear’s air chamber decreases. The eardrum pulls in and when the plane begins its descent, the air pressure increases, which stretches or pulls the eardrum out.” If the Eustachian tube doesn’t react quickly, the eardrum may stretch too much and even bruise, rupture or bleed.

“Under the age of four, the Eustachian tube is immature and slow to react to pressure changes,” Dr. Angeli says.

Patients with barotrauma usually have ear pain and muffled hearing that resolves after a few days. Without intervention, recurring barotrauma can lead to vertigo and permanent hearing loss.

Before you swear off air travel, Dr. Angeli says, try these tips.

  • Don’t travel when your child is sick. Allergies and congestion interfere with the Eustachian tube.
  • Avoid smaller planes. Stick to commercial jetliners. Smaller planes are not always sufficiently pressurized.
  • Use nasal decongestants. In babies, over-the-counter neo-synephrine nasal drops work better than decongestant syrups. Use the drops 30 minutes before takeoff and landing. If your older child struggles with chronic nasal congestion, ask your pediatrician about nasal steroid sprays. Dr. Angeli recommends you start using these steroid sprays at least one week before flying.
  • Encourage sucking or swallowing. Both actions move the jaw and throat muscles and activate the Eustachian tube valve. This helps equalize pressure on the eardrum. Breastfeed or bottle-feed your baby upon takeoff and initial descent. Encourage toddlers to drink from a sippy cup. Older children can eat a snack or chew gum. If your baby won’t take the bottle, try a pacifier. (That trick won’t ease ear pain unless the baby actually sucks on the pacifier.)
  • Keep babies upright while feeding. Your seatback isn’t the only thing that needs to return to its upright position. Sitting upright while taking the bottle or breast keeps milk from draining into the baby’s Eustachian tube.
  • Put a plug in it. Children five or older may benefit from EarPlanes, small earplugs that help prevent pressure from building up. This allows the Eustachian tube to adapt gradually to increased pressure.
  • Correct the problem. Frequent flyers of any age or children who struggle with chronic ear infections benefit from ventilation tubes placed in the eardrums. This brief outpatient procedure is common but requires general anesthesia in small children. Another procedure, endoscopic balloon dilation, also treats problems with the Eustachian tube but is only approved for adults.
  • Keep an eye on ear pain. Ear problems that arise during air travel should subside within two weeks, as long as your child isn’t flying again. Use decongestant drops for two days after flying and acetaminophen if your child is in pain. If pain persists or if there’s blood in the ear, see a doctor. “Your pediatrician can diagnose the problem. If necessary, an otolaryngologist can lance the eardrum to relieve pressure and pain.”

Rules of the road

Traveling by car simplifies family travel unless your child is prone to car sickness. In that case, try these suggestions:

  • Don’t give your child heavy, rich or spicy food before traveling.
  • Open a car window to let in fresh air.
  • Have your child look out the window instead of looking at books or devices.
  • Distract your child by talking, singing, listening to music or e-books.
  • Time drive time to coincide with naptime.
  • Give your child a small snack such as saltine crackers or ginger candy.
  • Before a long car trip, ask your doctor about over-the-counter medications for car sickness.
  • Pull over in a safe place and allow your child to walk around.

Just remember Dr. Wurm’s wise counsel. “Keep kids close to you at rest stops.”

Electronic-free memories

You’ve followed the doctors’ orders for healthy traveling with kids. Between bites of a healthy snack, your well-rested child is happily singing her 100th rendition of “Baby Shark”.

Before you count your blessings for the electronic babysitter, keep Dr. Wurm’s words in mind. “Kids were entertained on trips long before cell phones. Make the holidays as electronic-free as possible. Use travel as an opportunity to connect as a family.”

And planning aside, “Have your child adapt to you. Family memories are more important than strict adherence to a schedule.”

 


 Nancy Moreland is a regular contributor to UMiami Health News.  She has written for several major health care systems and the Centers for Disease Control and Prevention. Her writing also appears in the Chicago Tribune.


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