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Lessons from on high: Staying safe and sane while flying with kids

05/18/2015

Seasoned travelers with few fears of flying can go catatonic at the idea of having to spend time cooped up with kids in an aircraft cabin. You’ve seen the look as they suddenly realize they’re seated next to a mother with child. “I’ve certainly experienced my fair share of stink eye,” says Corinne McDermott, mother of two, frequent flyer and founder of the popular blog HaveBabyWillTravel.com. For some flyers “the very idea of sharing airspace with children” sparks quiet hostility. On go the noise-canceling headsets, down come the eyeshades.

Looking for strategies to defuse the situation, to set the tone for the flight so that frequent flyers and families alike have a better shot at comfortable co-existence? Read on.

The Power of Sleep
When traveling with daughter Megan and son Riley, McDermott tries to make sure departure time coincides with nap or bedtime, the better to fall asleep when onboard. This is a natural for families traveling from the U.S. East Coast to Europe, where departures dovetail nicely with bedtime.

If you can’t manage the clock the way you’d like, try getting the kids some vigorous pre-board exercise. Ditch the dead zone of the gate hold area. Have them stow the video game, unplug their headphones and take them on a brisk trek down the length of one those never-ending concourses. A treat at the end of the trek helps, perhaps a cup of sleep-inducing hot chocolate. It’s a sensational soporific.

Increasingly airports around the world are fitted with in-concourse playgrounds, places where kids can burn off energy before boarding or between connections. Take advantage of them.

At airports such as Dallas/Fort Worth International, American Airlines’ prime hub, some playgrounds mimic actual airports, complete with terminal, air traffic control tower and aircraft. It’s the sort of setting that gives free rein to kid’s imaginations, and tires them out at the same time.

This sort of natural approach works best. Medication well may not. “Most pediatric medicine specialists do not recommend sedatives for traveling children,” say Doctors Philip R. Fischer and M. Rizwan Sohail of the world-renowned Mayo Clinic. Their comments come from the June 2011 edition of Minnesota Medicine in the paper Children and Airplanes: Are We Having Fun Yet?

They say that while commonly used over-the-counter diphenhydramine (Benadryl) “is usually safe…parents should be warned that some infants…may become hyperactive or agitated after receiving a dose.” Fischer and Sohail suggest if you do intend to sedate your child they fly the best approach is “to try a test dose at home” just to make sure they aren’t prone to a bad reaction.

It all boils down to parental philosophy. If you do give a mild sedative to a wee one when traveling across multiple time zones make sure “at least one adult care provider…remains unsedated in order to be available to the children traveling with them.” It’s okay if you zone out while traveling alone. Flying with a child for whom you’re responsible is another matter entirely.

HaveBabyWillTravel.com’s McDermott says, “Gravol and Benadryl can make some kids drowsy.” But when she gave it to her children for the prescribed reason “it made them hyper.” She now flatly states: “Drugging my kids for a flight is not an option.”

Natural sleep is the best sort of sleep. The flight passes faster and the side effects are fewer.

Oh My Aching Ear
Ear pain is no joke, especially among small children. We hesitate to call it an ache, because the pain can prove excruciating. It usually comes on during descent, that long slow approach to the airport. That’s when first whimpers break out, whimpers that can quickly turn to screams among the very small. Doctors Fischer and Sohail write, “There is no known medication that can help.” While adults may benefit a bit by taking pseudoephedrine nasal decongestant half an hour before takeoff, kids who take the medication appear neither better nor worse for having taken it.

Both the good doctors, as well as Corinne McDermott, recommend packing finger food and drinks for the flight. A sippy cup half full of a child’s favorite juice helps somewhat in taking off that sharp edge associated with descent. That’s because kids have to swallow. “Children (especially young infants) can suck and swallow in ways that manipulate the Eustachian tubes and facilitate pressure equalization,” concludes Children and Airplanes: Are We Having Fun Yet?

This author’s first-born son had exceptionally narrow Eustachian tubes when born, and our family flew a lot. On a flight ‘twixt Birmingham, Alabama and Dallas/Fort Worth a Delta Air Lines flight attendant demonstrated a trick that seemed to work. She got a paper towel, soaked it in warm water, wrung out the excess water and then stuffed the towel in the far end of a plastic cup. She then said we should hold the cup to our son’s ear for a short time. After a few moments, he stopped crying. A cautionary note: be sure the temperature of the water is merely warm, not hot, and that any excess moisture doesn’t trickle into the ear. Some doctors don’t support this “cure,” counseling parents to avoid it altogether because it could lead to infection.

Don’t assume just because they’re flying that the yowls emanating from your child are pegged to pressure on the ear. “Children have a difficult time expressing when [and, more importantly, where] they hurt,” says Sara Nelson, international president of the Association of Flight Attendants (AFA). “Many times children are crying because they’re actually teething,” says the lady who heads the union representing some 50,000 flight attendants.

She says there are devices to be had that, when filled with ice, kids can suck on. They numb the gums, and can lower the cabin stress level considerably.

Let Me Entertain You
Keeping children placid on airplanes involves a bit of practice, and a decent degree of trial and error. Lots of parents opt to roll out a pack of in-flight entertainment: toys, books, videos. HaveBabyWillTravel.com founder McDermott is a true believer in the inspiration the iPad affords kids. Instead of toting along books, crayons and games simply consolidate the diversions virtually, via a tablet computer. As for the really wee ones the chore is much easier. “They’re easily distracted by the in-flight safety card, an airsickness bag, your cell phone or your watch.”

Older children, of course, demand a lot more. You can plug them into the IFE (in-flight entertainment system) and let them be or you can take the opportunity to interact with them, and render each flight a real journey of discovery.

Never underestimate the entertainment value that awaits just outside the window. Do a bit of reading up in AirlineRatings.com’s Did You Know? section and discover how wings work. How slats and flaps work to sculpt the air, producing the miracle that is lift; how ailerons operate bank and to turn the airplane. Each flight, indeed each phase of flight, can be a fascinating learning experience. All your kid has to do is look out the window.

Then there are clouds, in all their majestic shapes and hues. Before you travel, purchase a book on clouds suitable for young readers. Make it a contest to see which child can spot what kind. Kids love to compete.

Take along a map, either embedded in your digital device or folded out on your tray table. Work with your child as they trace the route across country. Many airlines have flight tracking software linked to seatback video monitors. Ask your child to match virtual cities, rivers and mountains with the real, live thing down below. It’s a great lesson in geography.

The point is you don’t have to “set and forget” your kid as they lose themselves in the world of pulse-pounding video games or music videos. Consider flight attendant Sara Nelson’s sometime solution. She’s gone so far on an overnight flight as to cradle a babe in her arms and sing to them against a backdrop of a darkened cabin and sleeping passengers. Such airborne lullabies, of course, aren’t always possible, “because there’s typically more workload than flight attendants can handle.”

But, before you can work any of this in-flight magic, you’ve first got to determine if it’s right for your child to fly. Most of the time it’s fine; sometimes it’s not.

Is It Okay for My Child to Fly?
Otherwise healthy (and that’s the key here) newborns aren’t too young to travel by air. Fischer and Sohail say once conventional wisdom was that infant alveoli (air sacs within the lungs where the exchange of oxygen and carbon dioxide takes place) took six weeks of post-pregnancy development before they could handle the low air pressure in an aircraft cabin. Not so. “No evidence supports this hypothesis,” they say. “Age is not in any way a predictor of one’s ability to tolerate low-pressure environments.”

More myth-busting revelations about cabin air and infants: the concern is that relative hypoxia in a commercial airliner (the equivalent of breathing air with 15 percent oxygen vs. the normal 21 percent at sea level) might be risky for babies. The conclusion: they had neither significantly longer instances of hypoxia (reduced oxygen) nor apnea (pauses in breathing or shallow or infrequent breathing during sleep). Moreover, say Fischer and Sohail, “There is little evidence that high altitude is associated with increased risk of sudden infant death syndrome,” or SIDS.

That said, parents should proper precautions when they do decide to fly. Among Fischer and Sohail’s recommendations:

– If your baby was born prematurely and had neonatal lung disease avoid taking the child on an aircraft for first year of life.

– If your child has been diagnosed with a peanut allergy always have an epinephrine pen on hand. That means when you’re flying too.

Seat of the Pants
Where your child sits matters. Ensure that it’s not on the aisle. Children sitting on the aisle not only have an unimpeded straight shot to the rest of the airplane should they become restive, they also run the risk of trauma from falling objects and burns from the meal and beverage carts. This is especially true for infants. A yet-to-be-published report by MedAire’s Dr. Paulo Alves finds lap infants much more likely to suffer in-flight injury from turbulence, material falling from overhead bins and amputation of fingers from food trolley carts.

Then there’s the issue of reserving a separate airline seat for your child and using an approved child restraint system to strap into that seat. Not everyone can afford to do that. As for holding a child in your lap or attaching them to you with a belly belt, rules vary from country to country. The International Civil Aviation Organization (ICAO) and International Air Transport Association (IATA) are working together to harmonize regulations.

There’s no doubt kids are safer in an approved child restraint system, one secured to their own seat. But, contends AFA’s Nelson, such seats “help soothe and calm” kids. It’s a matter of flying amidst familiar immediate surroundings, “because they travel all the time in the car, usually in that very seat.”

How to Pack that Carry-on
Corinne McDermott believes in being over-prepared before setting out to the airport. When children Meagan and Riley were very young she packed one diaper for every hour of her journey, not just the time spent aloft. “If you’re trapped in an airport, purchasing baby items is not the easiest thing to do,” she says. Another essential is wipes. They’re good not just for baby’s bottom but for sanitizing seat tray tables, armrests, even laminated safety cards.

Perhaps topping the must-have list is the child’s ‘Wobbie,’ thats special blanket or toy. She admonishes readers to “Guard this with your life!” If at all possible carry a back up. Otherwise, should the one, ‘irreplaceable’ comfort item be lost you’re doomed. To see McDermott’s phenomenally complete carry-on packing list go to http://www.havebabywilltravel.com.

To counter the evil eye some passengers inflict on infant flyers, their families, and their Wobbies, some of McDermott’s readers go so far as to bring peace offerings on board to hand out amongst nearby fellow travelers, things such as drink coupons. Personally, she doesn’t go for the idea. She contends it distracts from the task at hand: taking care your child with every fiber in you. “If you are 100 percent focused on your child, in keeping them engaged, comfortable and safe” one side effect is a pleasant plane ride for all.

Getting buy-in by older children is part of the prescription for a pleasant flight. AFA International President Sara Nelson finds siblings “can be very helpful,” in helping parents cope. “If you have two or three children and one’s a bit older, giving that older child the job of trying to keep the younger child quiet,” can work both to entertain the younger while occupying the older.

Neslon has been flying with her five-and-a-half-year-old son since he was two months. Before they board, Nelson “has a little discussion about airline etiquette,” about not kicking the seat in front of him, continually opening and closing the tray table, things like that. She’s a real advocate in “enrolling” children as part of the travel process, of “helping them understand that they’re part of the larger community.”

Among lessons learned aloft, this might be the most important, and the most lasting.

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