Traveling with Newborns

by Mary Gallagher, RN, MSN, CCRN

Jan 1, 2017
Health

IN JANUARY 1943 my mother traveled by train with my 6-week-old brother to visit my father, a U.S. Navy officer stationed in Oklahoma teaching flight using blimps. Many passengers asked to hold the baby, but she only allowed another woman to take him while she used the ladies’ room. She feared the baby would contract an illness from a stranger or someone would take him.

Today air travel is suitable for most infants. Before you travel with your baby, consult your pediatrician. Age usually does not affect an infant’s ability to tolerate travel; however, your doctor may discourage air travel for a newborn. Newborns have developing immune systems, and air travel may increase their risk of catching an infectious disease.

Vaccinating children for travel requires careful evaluation. Whenever possible, children should complete routine immunizations on a normal schedule. However, travel at an earlier age may require accelerated schedules. Not all travel-related vaccines are effective in infants, and some are specifically contraindicated.

Children should receive routine vaccinations for hepatitis A; hepatitis B; diphtheria, tetanus, pertussis; haemophilus influenzae type b; human papillomavirus; influenza; MMR; neisseria meningitis; polio; rotavirus; streptococcus pneumoniae; and varicella. In order to complete vaccine series before travel, doses can be administered at the minimum intervals.

Infants and children who have not received all recommended doses might not be fully protected. Rotavirus vaccine is unique among the routine vaccines given to U.S. infants because it has maximum ages for the first and last doses; specific consideration should be given to the timing of an infant’s travel so the infant will still receive the vaccine series.

Changing cabin pressure during a flight can cause temporary changes in middle ear pressure, which can cause ear pain. To help equalize the pressure in your baby’s ears, encourage your baby to breast feed, suck on a bottle or pacifier before and during takeoff and during descent and landing. If your baby is ill, ask your pediatrician if you should postpone the flight.

Air pressure in an aircraft cabin is lower than on land. This temporary change in oxygenation does not seem to pose problems for healthy babies. Your doctor may recommend supplemental oxygen if your baby has an underlying respiratory condition. If your baby was born prematurely and has a history of lung disease, you may need to postpone air travel until age 1 year or later.

Most infant car seats are certified for air travel. Although airlines allow infants to ride on a caregiver’s lap, the Federal Aviation Administration recommends infants ride in properly secured safety seats. When making reservations, let the airline know you are traveling with an infant and a car seat. Many flights are full, so finding an open seat or two seats together is almost impossible. Ask the agent for seats with extra room if possible. Evidence suggests “lap children” are among those most likely to suffer injury or death in the event of an accident or severe turbulence. Keep your infant/child strapped in on takeoff and landing and as much as possible during the flight.

Do not give your baby over-the-counter medication such as Benadryl to encourage sleep during flight. The practice is not recommended, and the medication can have the opposite effect. If you think medication might be the best option, discuss it with your baby’s doctor first.

Consider how you will keep your baby occupied during the flight. Bring a teething ring, pacifier, special blanket or stuffed animal and age-appropriate toys and books. If your baby is fussy, take occasional breaks to walk up and down the aisle with approval of the crew.

Be prepared to feed your baby during the flight. Baby formula, baby food, expressed breast milk and juice are allowed on board in reasonable quantities, according to the Transportation Security Administration. You can take your baby out of the seat for nursing whenever the crew approves moving throughout the cabin.

For the most part, many young babies travel well in flight; the key is preparation. It helps if your partner can travel with you and the baby to lend a hand.

TRAVEL TIPS

◆ Look for infant-/child-friendly airlines and airports

◆ Use curbside check-in for luggage

◆ Bring the baby’s birth certificate for check-in

◆ Bring the baby’s vaccination documentation

◆ Leave plenty of time to get through security

◆ Do not let breast milk containers/bottles go through X-ray

◆ Have a partner who can board early with bags and baby seat while you wait to board with the baby closer to takeoff

◆ Protect baby’s head and back as you board and exit

◆ Secure the pacifier to the car seat

◆ Be polite and considerate to nearby passengers

◆ Know how to install your infant safety seat properly and do not let anyone tell you differently

◆ Pack extra baby food and supplies

◆ Diaper with care so as not to annoy nearby passengers; try onboard restrooms or wait to use terminal restrooms

◆ Do not be afraid to ask for help

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment.

Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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