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Preventing a toddler’s ears from hurting during air travel.
Q: Preventing a toddler’s ears from hurting during air travel.
A: Vivian, it’s usually only the take-off and landing which can be painful for young children’s ears when the air pressure in the cabin is changing.

Why do babies' ears hurt when the cabin pressure changes? Our ears naturally adjust to changes in air pressure through our Eustachian tubes which connect the middle ear, behind the ear drum, to the back of the nose/throat. During take off and landing, you might feel the pressure and popping in your ears, and you might yawn, chew gum or swallow which helps your Eustachian tubes open up so your ears will adjust to the pressure. Babies, however, have narrower Eustachian tubes, and sometimes they don’t open up as easily to equalize the pressure. This can cause pain for the baby and lead to fussiness and crying.

Some babies experience ear pain on airplanes, and others don’t. A good way to help prevent the ear pain is to have your baby drink from a bottle or cup during take-off and landing. (Remember that it's safest to have your baby strapped into her carseat in her own airplane seat for take-off and landing.) Make sure that both you and your baby drink plenty of fluids during the flight because the dry air on airplanes tends to dehydrate most people a little. Your baby is more likely to experience ear pain if she has nasal congestion from a cold or allergies, which can cause swelling of the Eustachian tubes. If that’s the case with your baby, you might ask the pediatrician whether you should give your baby an antihistamine/decongestant for the flight.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician