By Dr. John Concannon (moondancezids.net)
Pediatrics & Adolescent Medicine
1145 Reservoir Avenue, Suite 124 Cranston, RI 02920-6000

Children under the age of 2 years travel free on most airlines, but this means that they may have to sit on your lap if the plane is full. When you make your reservations, try to avoid a full flight. If you can, schedule your flight to avoid the busiest times of day at airports (8 to 10 AM, 4 to 7 PM). If possible, reserve a bulkhead seat (just behind the bulkhead that separates coach and first class), since it has the most room. If you have to change planes, be sure to schedule enough time for the connection.

Car rental agencies generally have infant seats available with their cars. You need, however, to reserve the satety seat when you reserve the car. It is also wise to call ahead to the local agency where you will pick up the car to confirm that the car seat is available. The flight attendants can warm food and bottles for you. Be sure to also bring small snacks your baby can nibble on and play with: Cheerios, bagels chips, etc.

Check-in early so that you can get the baby settled before others board the plane. If you are traveling by yourself and won't be met at your destination, a portable stroller is a lifesaver. You can generally fold it up and take it on board with you.

Diapering can be a hassle on the plane. Try to double-diaper or use ultra-absorbent diapers just before you board the plane. If you do change diapers on the plane, you can use an airsickness bag to dispose of them.

For takeoff and landing, put the seat belt just around you and hold your baby on your lap or in a Snuggli (frontpack carrier). Don't place the seat belt around the baby. This, obviously, is for airplanes only, not for autos where the child must be placed in a proper car safety seat. Children over two will need to wear their own seatbelt on the airplane.

In the older child prone to airsickness, it is usually okay to give Dramamine or an antihistamine one half hour before flying. If your child has a mild cold prior to flying you might consider giving some decongestant medicine beforehand. Younger infants could get an oral dose of Sudafed or similar product up to every 4 hours. Toddlers could get a dose of Children's Neo-Synephrine nasal spray up to every 6 hours. Older kids and teens can get a full adult dose (two sprays into each nostril) of Afrin (oxymetazolidine) adult-strength nasal decongestant spray up to every 12 hours.

Airliner cabins maintain a constant atmospheric pressure above 8,000 feet altitude. Actually, there is no problem associated with taking off, climbing, flying as high as 45,000 feet, or descending to 8,000 feet. But, it's those last 8,000 feet to landing that creates problems for children's ears. Usually you can tell when your plane is passing below 8,000 feet because that is about the time when you'll see the stewardesses start to scurry around, making sure that everyone's seat belts are buckled, seatbacks are in their upright position, etc. That's your cue to start giving your child something liquid to drink. The swallowing will help to equalize the pressures in the ears while the plane is on final approach to landing. Older children above 8 years old can sometimes be taught to clear their ears on descent by having them close their mouths, pinch their nostrils, and swallow.

Given all the equipment you have to carry when you travel with a baby, it is easiest to let other passengers deplane before you. Use this time to clean up your seat area before you leave. If worse comes to worst, and your child needs medical attention, there are usually many walk-in medical care centers near-by airports. Or, if you have relatives at your destination, they may be of help in selecting urgent medical care for your child.

Bon voyage!

Comments should be directed to the author, Dr. John Concannon (moondancezids.net)