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Dealing with Kids’ Ear Pain while Flying

I was on vacation recently and got a call from the father of one of my little patients.

He was on vacation as well, and told me that his four-year-old daughter started to have some ear pain on the airplane when they were landing. Her pain ended up getting worse and worse, so they took her to the emergency room. She was diagnosed with a double ear infection and placed on antibiotics.

Is it safe to fly soon after starting antibiotics?

She was only going to be on the antibiotics for about 36 to 48 hours prior to their scheduled flight home. Dad was concerned. Was is it safe for her to fly so soon after starting antibiotics?

Because his daughter had never had an ear infection in her life and because she had already began to improve significantly after only being on the antibiotics for 18 hours, I said I thought it was safe to fly home.

I suggested a dose of Ibuprofen before she got on the airplane to help with her pain by helping to decrease the inflammation in her ear a little bit, both in the air and during the equalizing process as the plane took off and landed.

The other factor in her case that I thought made it safe for them to fly home is her age. When children reach her age, four, the Eustachian tube, which is the tube that drains from the middle ear to the back of the nose, is a much more vertical angle than when kids are younger. This means that the Eustachian tube will drain the infection more easily than it does in a younger child, whose tubes are more horizontal.

Benadryl and Ibuprofen for kids on airplanes?

Children with chronic ear infections tend to have chronic inflammation, which makes it a little bit more difficult for their bodies to take care of the infection. Because my little patient doesn’t have chronic ear infections, I didn’t feel she would have chronic inflammation in her Eustachian tube.

With some children I may have recommended some Benadryl in addition to the Ibuprofen, but since this little girl did not have a lot of congestion and she doesn’t have any allergies, I thought the Ibuprofen would be sufficient.

What to do with children when flying

If you have a child who is two years old or younger, their Eustachian tubes are much more horizontal, so it can be a little bit more challenging for us to deal with the fluid in that middle ear, especially if they have chronic ear infections.

For children with ear infections and ear pain, we need to take it on a individual basis. My recommendation will depend upon:

  • The child’s age
  • Their medical history
  • Whether they have recurrent ear infections or is this their first ear infection
  • The child’s history with allergies
  • Does the child have a congested nose? (that’s also going to make it more difficult for them to equalize the pressure)

I do think it is always a good idea to check with your child’s pediatrician if you are traveling with a child who has a newly diagnosed ear infection.

My patient did great with just a dose of ibuprofen before they took off and they were able to come home on their originally scheduled flight.

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