When seeing infants in the office, I have often heard parents ask: “We are traveling soon. What should we do (or worry about)?” It’s a very open-ended question that has several possible answers. One of the things I’ve found, though, is most parents have the same concern—one we’ll get to at the end of this blog. (Hint: it has to do with air travel.) However, treating providers have a very different set of concerns when advising parents on travel with their infant. Let’s spend a little time on these sometimes-neglected points.
Although traveling with children (and, one might argue, adults) of any age warrants special attention, it’s a fairly safe statement that the younger the child, the more concerned parents need to be. The Centers for Disease Control and Prevention (CDC) recommend not traveling by air with a baby less than 48 hours old. Checking the policies of two major airlines reveals that one will not take a newborn under 48 hours old, and both require doctor’s notes for an infant under seven days of age to fly. It’s actually not a bad idea to plan to defer travel for several days after the baby is born, if only because so many things can happen in the newborn period—an extended stay to rule out infection, for example.
For those who really want to travel as soon as safely possible after the new arrival, or for those for whom circumstances dictate that they must (for example, I’ve seen military families that needed to relocate a few days after a baby’s birth), it’s worth going over some special risks that traveling infants face, particularly when they’re younger:
- They are more prone to infection. This is due both to their lowered ability to fight infection (that is, lowered immunity), and their inability to receive many vaccines until they’re older.
- Young infants, in particular, need to have a ready food supply (breast milk or formula) for frequent feedings.
- They are more easily stressed by extreme heat or cold—something we’ve all experienced to some degree when we’ve had to play a waiting game on a trip.
- They need special protection from sun and insects. Although sunblocks and children’s insect repellants are generally considered safe, most would recommend a light layer of clothing and application to exposed areas only. (Spraying the clothing with insect repellant is also helpful.)
- They are more likely to undergo injury in a crowded situation (say, boarding an airplane, with the crush of bodies and bags).
It makes sense that the shorter the trip, the less you have to plan for in terms of trip breaks and supplies. But have you thought about what to do if your little one gets sick? Health insurance often isn’t totally set for newborns right away. This may not be a concern with a provider that knows you (say, from your older children), but a distant urgent care center may want payment up front for a sick visit. And realize that it’s generally unlikely that a state Medicaid plan will pay for an out-of-state visit.
International travel can be particularly challenging for those with an infant, even an older one. This is especially true if the trip is outside of developed, non-tropical countries. Many preventive vaccines (such as typhoid vaccine) and medications can only be given after a certain age. Thus, it’s important to take special care with food, water, insects and animals.
It makes sense that the automobile, for the most part, is a pretty flexible way to go if you have an infant. The breaks are easier, and you can always pull off the road if the baby needs to be checked or fed. Flying can be a little more challenging. There’s lots of excellent advice on meeting those challenges here; to this I would like to put special emphasis on considering a seat for the baby. You can then strap him in an approved car seat for the flight. Airlines often offer special discounts, but if it’s really not affordable, you may have some luck finding an empty seat next to you—middle seats are often filled last. You can then occupy the middle seat and, assuming you’ve reserved a window seat, secure the little one in the car seat there.
And now to discuss that question that parents really want to know: “What about my baby’s ears?” I’ve not found this issue to be very much on the radar of the pediatric community; in fact, I was in practice for 22 years before I first heard it discussed at a professional gathering. Airplane cabins are pressurized, and I’ve always suspected that much baby crying during descent is from the surprise of descending (something, incidentally, I don’t really enjoy either). That said, some ear discomfort is possible, and nursing or sucking may alleviate that. As far as babies with ear infections go where flying is concerned, the advice appears to be mixed, and it’s a good idea to check and see how your provider feels on that topic. For the most part, it appears that otherwise healthy infants seldom suffer significant damage from flying with an ear infection.
Your baby has a lifetime to experience the joys of travel. If you do travel with her when she’s young, take a few extra precautions to ensure she’s safe and healthy. And for safety’s sake, you may just want to consider waiting a bit.