Expert Advice on Helping your Child Cope with Earache on Airplanes

If you think being near a crying baby on a flight is a fate worse than death, you haven’t been the parent of that screaming child. With a little preparation, it’s possible to stave off ear pain. We checked in with ENT specialist Dr. David Ho 何志謙醫生 about how to avoid ear pain for the whole family.
 
 

Why do babies and children’s ears hurt on airplanes?

As planes get higher in the air, the pressure in the cabin adjusts to remain similar to ground-level rather than match the outside pressure at 30,000 feet. The area behind the eardrum (known as the middle ear) is hollow and connected to the back of the nose area through a tunnel called Eustachian tube. Ideally, the pressure in your middle ear should be the same as outside. As the cabin pressure rises, from the nose, air travels through the Eustachian tube and equalizes the middle ear pressure every time you swallow.
 
Some people, particularly babies and children, have undeveloped Eustachian tubes (smaller and more horizontal) and need a little help to encourage them to open up. The pain is most likely to occur as the plane at take-off and descent (usually before landing). It’s not always noticeable when the plane starts to descend so it may be worth asking a flight attendant to let you know when descent is beginning.
 
 

Tips to help children’s ears on an airplane

Let it pass
The first thing to know is that this is a temporary pain. Those minutes of holding a screaming baby may feel like hours but as the Eustachian tubes open and the air is able to equalize, the pain will subside.
 
Swallow
Swallowing opens the Eustachian tube and will encourage pressure to equalize. That’s why you feed the infant on take off and on descend.
 
Drink caffeine-free liquids
Along with encouraging swallowing, drinking lots of liquids prevents the nasal passage mucus from losing water and getting thicker, making it harder for the tubes to open.
 
Chew gum or suck on hard candy (+3 years old)
This makes more saliva so you will swallow more.
 
Yawn
If your children can yawn voluntarily, try getting them to yawn as that will stretch open the Eustachian tubes. Or try the contagious yawn game!
 
Stay awake
Counter to our last point, try to keep kids and babies awake during take-off and landing. You’re less likely to swallow asleep, increasing your chances of pain.
 
Painkillers
If you anticipate your child will be in pain during the flight, provide your child with an age-appropriate dose of baby/children’s ibuprofen, acetaminophen/paracetamol half an hour before takeoff or initial descent.
 
Decongestion spray
Using a decongestion spray (Otrivin/Afrin, but these are not for regular use) 1 hour before landing can help the Eustachian tubes to open easier.
 
Breastfeed, pacifier or bottle
While gum or sweet are a clear no-go for little ones, it’s still possible to encourage babies to do a ‘sucking’ motion. Offer a breast, pacifier or bottle during take-off and initial descent.
 
Ear infections, colds and flying
Flying with an ear infection or cold increases the chances of experiencing pain as the middle ear is likely already inflamed, may be filled with mucus, and/or narrowed by inflamed adenoids (immune system tissue located near the Eustachian tubes). There is a chance that barotraumas can occur leading to fluid accumulation or bleeding in the middle ear. Worse still, the ear drum may even rupture.
 
If your child has a poorly timed pre-vacation cold, runny nose or ear infection, it’s wise to get the all-clear from your GP, pediatrician or ENT specialist before flying.
 
 
Dr. David Ho 何志謙醫生 graduated from the University of Melbourne Medical School and obtained Otorhinolaryngology (Ear, Nose & Throat) Specialist training under the Royal Australasian College of Surgeons. Before returning to Hong Kong, he worked at Royal Children’s Hospitals in Melbourne, the biggest pediatric medical centre in the Southern Hemisphere and was a specialist ENT consultant at Royal Melbourne, Alfred and Austin Hospitals. He obtained post-fellowship training in New York, Hong Kong and London, Canada. He is now an honorary assistant professor at the University of Hong Kong and an honorary Specialist ENT Consultant for the Matilda International Hospital. His private practice is in Room 707, Central Building, Central: The Hong Kong ENT & Sleep Surgery Centre (+852 2870 1880).
 
This article was independently written by Healthy Matters and not sponsored. It is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.