Children's ear problems can derail travel plans

Vacation getaways are some of the best times spent with children, but a child who experiences ear problems during air travel can make things stressful for the whole family.

Most adults have felt the sensation of their ears popping during takeoff and landing on an airplane. For a child, this sensation can become unbearable. Infants and toddlers have the greatest difficulty because of their underdeveloped anatomy, plus cold and flu symptoms can add to the problem.  

“When we change altitude in an airplane, our ears react to the change in pressure,” said Dr. Robert Standring of Southfield-based Ear, Nose & Throat Consultants. “The eustachian tube leading from the middle ear to the back of the nose and throat tries to equalize the pressure on our eardrums, but in children the tube is smaller, so regulating the pressure is more difficult and can result in severe pain.”

Parents can help prevent or relieve that discomfort with some simple measures, but it’s best not to wait until boarding a flight to consider the possibilities. Consulting with the child’s doctor before the trip will allow parents to set up a travel plan.

Standring suggests these tips for air travel:

• Swallowing opens the eustachian tubes and relieves ear pressure, so have your child take frequent sips from a bottle or cup during the flight — especially at descent, when the pressure is the greatest. Place a pacifier in your baby or toddler’s mouth if they don’t want to drink — the sucking motion helps keep their ears clear. 
• Give your child over age 3 gum to chew or a lollipop to suck on when the plane moves away from the gate and during descent. The movement and swallowing help to reduce ear pressure.
• Wake your child before takeoff and landing. We don't swallow as much while we're asleep and your child will feel less pain if she stays awake when major pressure changes are occurring during the flight.

If you already have evidence from past flights that your child will experience ear problems or there is a mild cold present, you can give ibuprofen or acetaminophen a half-hour before taking off to reduce discomfort. Corticosteroid nasal sprays like Flonase and oral decongestants can help to relieve inflammation and pressure symptoms as well. Talk to your doctor about the right type and dosage for your child.

Consulting a specialist

If there are recurrent ear problems each time your child travels by airplane, it may be an indication that you need to consult with an ear, nose and throat specialist.

“Pronounced pain every time you fly can be a red flag for a condition known as eustachian tube dysfunction,” Standring said. “The eustachian tube does the important job of letting fluid drain from the middle ear, but when the tube becomes blocked by congestion or mucus, fluid can build up, causing discomfort, pressure and infection.”

The typical treatment for eustachian tube dysfunction that leads to middle ear infections is a round of antibiotics. Unfortunately, many children don’t respond to antibiotic therapy and, after repeated infections, are at risk of hearing loss or speech problems due to constant fluid in the ears. In this case, an ENT specialist will often recommended the placement of ear tubes to restore the middle ear to normal functioning.

“Ear tubes, or tympanostomy tubes, are tiny cylinders placed through a small incision in the ear drum,” Standring said. "The tubes reopen and replace the function of the eustachian tube, allowing the removal of fluid from the middle ear and eliminating the pain.”

According to the American Academy of Otolaryngology, three or more ear infections in six months or more than four in a year should signal an evaluation for the placement of ear tubes.

“The goal of the tubes is to end the frequent infections that can lead to antibiotic overuse, hearing loss, nerve damage in the ear and face and, although rare, an infection that migrates to the brain,” Standring said. “The procedure lasts about 10 minutes, requiring a short general anesthetic, and there is a quick recovery.”

Generally, the tubes will fall out on their own after about 12-18 months. In a few instances, however, an ENT specialist must remove them. 

“One of the biggest benefits of ear tubes is the reduced use of oral antibiotics,” Standring said. “Children with tubes usually get fewer infections and, if they do, we can treat it effectively with just antibiotic ear drops. The upside is an overall greater wellness for your child. ”

When it comes to planning your family’s next dream vacation, it’s easy to agree with experts who say traveling with healthy children provides the best opportunity to have happier moments, with memories you can treasure for a lifetime.

For more information, go to www.entforyou.com.