Sick above the clouds

The little one screams and cries heartbreakingly. And has been for what feels like five hours. It's around four in the morning at an altitude of 30,000 feet in the middle of the Atlantic. The night flight from Boston to Zurich passes without turbulence, and yet nobody can sleep. Most of the passengers vacillate between pity for the little guy and over-night anger. There are always breaks for crying, but as soon as most of them doze off again, the screaming starts all over again. The four-year-old has an earache. His parents are now also stressed, this is not how they imagined flying.
Travelling by plane is often a challenge for families with children, especially on long-haul flights: The air is dry, space is limited and landing is still miles away. But flying is part of the globalised world: Family members are visited, new jobs are taken up or holidays are taken on other continents. According to Dr Angela Ensslin, Head of Medical Services at Swiss, babies as young as 48 hours old can fly. However, she recommends travelling by plane only after the seventh day of life: «This gives time to get to know the child, and the little ones are more stable and are already gaining weight.» If you absolutely want to fly with your baby earlier, you need a medical certificate from Swiss.

Important medication belongs in your hand luggage

The main problem for children travelling by air is pressure equalisation. According to Angela Ensslin, all children have upper respiratory tract infections several times a year. This can lead to nasal or ear infections, which makes pressure equalisation difficult or impossible. The result is severe earache. In infants, breastfeeding or sucking on a milk bottle or dummy stimulates swallowing, which helps to equalise the pressure. Older children can benefit from lozenges or chewing gum. A decongestant nasal spray can also help. When travelling with children, it is worth carrying this in your hand luggage. A thermometer or antipyretic medication should also be included, as children can suddenly develop a fever. Children who regularly take medication will of course also need it during the flight. «We recommend that children always take their own familiar medication with them,» says Dr Ensslin. This includes a letter from the paediatrician, which can be presented at the security checkpoint if necessary.

Only healthy flying

Children are also more likely to suffer from travel sickness than adults, but this is rare in a modern aircraft. The doctor recommends that children eat something light before departure and always drink enough during the flight.
On board most airlines there is an in-flight pharmacy with the most common medicines in case of an emergency. The cabin crew are also trained in first aid. However, children should be in good health when travelling. According to the doctor, children with infectious diseases in particular should not travel: «Because of the risk of infection, but also because their state of health can deteriorate during the flight.» This also applies to childhood diseases such as chickenpox, measles, mumps or rubella.
Children with chronic illnesses, especially lung diseases, need a medical certificate - the SAF/MEDIF form, which must be issued by their treating doctor - before travelling by air. The airline's medical service will review the case and give its approval or not if the risk of the child's health deteriorating on the flight appears too great. Unrecognised incipient infections in children with asthma or febrile convulsions and other seizures can also be critical.
According to Ensslin, a serious medical emergency can also lead to an unplanned stopover. To prevent this, it is important to prepare a flight well, especially for children.

Tips for travelling by plane with children

• Preparation: In addition to information about the destination regarding climate and medical care, this also includes medication for emergencies and preparations for the flight.
• Planning: Book non-stop flights, i.e. flights without stopovers and without frequent changes. Pay attention to flight times and avoid very early or very late departures.
• Seat: Babies sit on their parents' lap until their second birthday. From their second birthday, children need their own seat. Many airlines have children's fares. A seat by the window is ideal so that the child can see a lot and cannot stand up unobserved.
• Hand luggage: There are certain things that absolutely belong in your hand luggage on a long flight with children: your own blanket, socks, toys, favourite snack, nappies and wet wipes, spare clothes, bottle and dummy, chewing gum or sweets and the most important medication.
• Employment: Travelling by plane is boring, even for children. Think about how you want to keep your child occupied while travelling. Pack toys, books and colouring materials - but also a cuddly toy to put your child to sleep.
• Pressure equalisation: Chewing gum, jelly babies, dummies and drinking bottles are helpful and prevent earache. Put a nasal spray in your hand luggage to be on the safe side.

Petra Seeburger is an intensive care nurse, journalist and communications specialist. She has worked in the healthcare sector for 30 years.