Family Guide to Flying with a Cold and Earaches

Lots of us have been there: You or your little one have a cold, runny nose and it’s time to fly. I was in my 20s when I first flew with a proper, full-on head cold, and it is a trip I will never forget. It was so painful and I ended up being deaf in one ear for over a month! Since then I’ve made the call twice on whether to fly with a child who had an upper respiratory infection.

If you can, DO AVOID flying with kids with a cold or ear infection. The problem with flying with a blocked nose or an ear infection comes from an inability to equalise the middle ear when the cabin pressure changes due to swelling and fluid build-up in the sinus.  This can cause severe pain, blocked ear and even a burst eardrum, in the worst case.
If you cannot avoid the flight, then there are treatments that can help prevent damage and pain. However, some of these are not available for babies.

Is it safe to fly with a cold?

The NHS advises against flying, stating that It’s not advisable to fly if you have an ear, nose or sinus infection, as the swelling can cause pain, bleeding or a perforated eardrum. 
Similarly, “There’s no point adding stress to your already stressed-out upper respiratory systemWebMD advises against flying.

Sometimes, however, a flight cannot be rescheduled.

We spoke to ENT specialist nurse, Jackie Hunt about what parents need to do to help the child cope with the possible extra discomfort and prevent possible damage from flying with a cold.

Let’s look at that background of the pain:

What is equalising or popping your ears?

There’s a little canal, Eustachian tube, that connects back of the throat to the middle ear. This helps to balance the pressure on both sides of the eardrum.  The Eustachian tube is normally closed and opens when we swallow, yawn or chew. For most of us, just normal swallowing and chewing allows air to travel up the Eustachian tube to equalise the pressure. 

If this little canal gets blocked or closes due to a cold or inflammation a big difference in pressure can occur on either side of the eardrum.  Either pressure builds up or a vacuum is created and either can cause a lot of pain.

What causes earache during take-off and landing?

During take-off and landing, there is a relatively big and quick pressure change in the aircraft cabin. If the Eustachian tube is blocked or partially blocked then we cannot equalise.

Even under normal, healthy circumstances, it’s best to keep kids awake during take-off and landing.

Normally, you’d help your children to equalise:

Helping babies equalise their ears

For babies, perhaps the most tried and tested method is feeding (bottle or breast) or mimicking this with a dummy/ pacifier during take-off and landing. The natural sucking movement of the jaw wiggles the Eustachian tube and provide pressure inside the through sucking to help equalise.

Yawning also helps. Did you know that humans involuntarily copy each other yawning? We can’t help it! (Read more about it on Current Biology.)
This little fact helps us get our babies to yawn if we have eye contact with them and yawn in front of them.

Helping toddlers and kids pop their healthy ears

Toddlers and older children can be taught how to make their ears pop when the pressure changes: They should yawn or swallow.

  • Yawning: the same applies as for babies, mentioned above. Yawn in front of them and they will involuntarily copy you.
  • Swallowing and sucking: Have a lollipop or some hard sweets in your flight survival kit for this.  For older children, I’ve given my 7-year-old, chewing gum with a strong peppermint flavour.
  • Valsalva manoeuvre is often recommended, which is pinching your nose and closing your mouth then trying to breathe out through the nose, creating pressure. Don’t try this, however, if you have the slightest cold! I have tried it and ended up with a blocked ear for weeks.
  • Toynbee manoeuvre can be used when you or your little one have a cold: close your mouth and hold your nose, swallow several times until pressure equalizes. 

However, the problem is that these methods don’t work very well when they have a cold, upper respiratory infection or an ear infection.

Remedies to help kids flying with a cold

Keep the child hydrated

Staying hydrated important during air travel for many reasons (including easing jetlag), but the most important is avoiding dehydration in an unwell child. The cold, flu or upper respiratory infection will contribute to dehydration, as will the notoriously dry air in the aircraft. All of these can make the symptoms of the cold worse- thicker mucus, higher temperature and more discomfort.

Give the child or baby lots of water or watered-down juice, depending on their age, to loosen up the mucus.

Most fluids are good that aren’t full of sugar (which will give them a sugar-high and make it hell in the enclosed space of the aeroplane) or caffeine (which will also give them a high.) Avoid fizzy drink. Also, note that some colourants will have similar stimulating effects as that of caffeine.

If your breastfed baby takes a bottle, I learnt, that giving them a bottle of lukewarm filtered water when they are ill, will stop them constantly want to suckle for comfort and perhaps cause engorgement for you (as it did for me.)

I know, as a parent, you instinctively want to hold back on giving lots of drinks. As it means more trips to the toilet, a bigger chance of accidents, but resist the urge!

TIP: Make sure to have some spare clothes to account for accidents. I tend to pack one change of clothes, at least, for each member of our family in hand luggage, no matter how short the trip. I always have a set or two that would fit more than one child- something that may be a pair of shorts for one, may be long trousers for the youngest.

Use painkillers to pre-empt the pain

If your baby or child is old enough, and can take medication, then the pain relief and the anti-inflammatory effect of ibuprofen should really help.  (Paracetamol has little anti-inflammatory effect, but is good for pain relief.)

Give your child the medicine 30 minutes before take-off, perhaps as you wait for boarding at the gate.

It is important that you NEVER try a new medication or health product for the first time on a flight or just before flying!

Nasal drops or nasal sprays

A remedy we have found super helpful is a simple saline nasal spray

The saline spray (or saline nose drops) keeps the nasal passages hydrated without the side effects of medicated nasal sprays and drops. 

Most children, especially babies, aren’t keen on this. Mine absolutely hate it! But it really does help loosen up the discharge and take away the pain from pressure build-up. They find comfort (after the initial tantrum or cry when you spray it.)

Inhale natural oils

Both peppermint oil and eucalyptus oil are known to have a cooling effect on the mucosal surfaces (due to stimulation of thermoreceptors in these areas) and create the sensation of better airflow.

Two great products to have in your arsenal to fight upper respiratory infections are Olbas oil and Vic Vapour rub.

On a recent EasyJet flight, we were really struggling with a cold and the crew took pity on us: they brought a cup with a tiny bit of hot water and a couple of drops of Olbas oil in it to inhale. It’s strong, but oh so good at clearing the airways!

A strong peppermint- flavoured chewing gum, for children old enough to have chewing gum, will also have a similar effect at opening up the nasal passages. The advantage of chewing gum is the chewing motion also opens the Eustachian tube.

Warm, damp face cloth

If your child accepts a flannel over their face (and only one of my 3 did), a warm, damp flannel (possibly with a drop or two of an oil mentioned above) will have a couple of benefits: breathing in the warm damp air will help increase humidity in the nasal cavity and loosen us the mucus.

The cloth is also a relief around the skin of the nose that has been aggregated by wiping and blowing.

Decongestant for 12 years and above

Decongestants are not recommended for kids under 12.

Only use a decongestant if a physician, preferably a paediatrician, prescribes your child something. A pharmacist will also be able to advise on some products that may be suitable for children over the age of 6- 7 years old.

EarPlanes may help

There are some pressure-regulated ear plugs, EarPlanes, available more and more widely. These slow down the pressure change to the outer ear and give time to the inner ear to adjust. The manufacturers don’t recommend using it with a cold, however, parents have reported success with the kids’ version, even when flying with a cold. (We’ve listed it on our helpful resources page)

Clearing babies’ and kids’ blocked nose

Clearing the nose is a way to reduce the pressure from mucus build-up. Get your child to blow their nose as often as possible.

Unfortunately, babies, toddlers, and sometimes even older children, cannot blow their nose. Any means to get some of the mucus out will help relieve pressure:
For my babies, we used a battery-operated nasal suction vacuum pump.

I have seen parents using one of the tubes, where you suck the end of a long tube to create the vacuum yourself. This is probably more gentle on the little one if you don’t mind doing it. (I, personally, couldn’t)

Practice nose-blowing while waiting in different airport queues with your little one. This video has no sound:

And this video explains the steps once they can blow their nose:

  1. loosen the musus- with a warm, damp cloth or nasal spray
  2. blow gently through each nostril while holding the other closed
https://youtu.be/wxtPrU9w9RE

Let the crew help

The airline staff are there for you and your fellow passengers’ safety and comfort. 

Let them know when you are boarding that your child has an upper respiratory infection.  If they have the facilities, they may be able to give you a warm towel to use for take-off and landing; they may be able to help in making your child more comfortable.

Do you have any further hints and tips?
Any stories about flying with a cold you want to share?

Sources:

Menthol: Effects on nasal sensation of airflow and the drive to breathe- https://link.springer.com/article/10.1007/s11882-003-0041-6#/page-1

Information reviewed by GP Dr Young, Oxford

Monika Roozen

Monika is a mum of 3, an avid traveller, who grew up travelling the world and has continued travelling ever since. She holds a degree in animal sciences, nutrition and business administration and has consulted for several years for the hospitality industry and customer service departments. Monika loves slow travel- taking time for immersive experiences in culture and nature- sailing and snowboarding. Her personal adventures are chronicled in Inspireroo Family Travel Magazine . (Click to see their family mad ventures)

2 thoughts on “Family Guide to Flying with a Cold and Earaches

  1. Pingback: Your Complete Guide to Breastfeeding on a Plane – Family Flight Advisor
  2. Pingback: Is My Child Too Sick to Fly? – Family Flight Advisor

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