Many of us have felt that weird ear-popping sensation when we fly. For children (especially babies and young ones) it can be odd and even frightening at first. But it's a common, normal part of flying.
This uncomfortable sensation is related to pressure changes in the air space behind the eardrum (the middle ear). Normally, the Eustachian tube, a passageway that leads from the middle ear to the back of the throat behind the nose, equalizes the air pressure in the middle ear to the outside air pressure by opening and letting air reach the middle ear. When our ears "pop" while yawning or swallowing, the Eustachian tubes are adjusting the air pressure in the middle ears.
In children, however, the relatively narrow Eustachian tubes might not function as effectively, especially if they're clogged by inflammation and mucus from an ear infection or cold, or blocked by enlarged or swollen adenoids (lumps of immune system tissue located near the openings of the Eustachian tubes).
Whether you're flying, scuba diving, climbing a mountain, or even riding in an elevator, air pressure decreases as you go higher and increases as you go lower. If the pressure isn't equalized, the higher air pressure pushes on one side of the eardrum and causes pain. That explains why so many babies cry during last few minutes of the flight, when the air pressure in the cabin increases as the plane prepares to land.
But the pain is only temporary- it won't cause any lasting problems for children and usually will subside within a few minutes as the Eustachian tubes open to let the air pressure equalize on both sides of the eardrums.
If your child has an ear infection, your ENT doctor may suggest delaying flying, if possible, until the infection is gone to avoid increased pain and possible rupture, or tear, of the eardrum.
In children who have had tubes inserted in the eardrums because of ear fluid problems, the artificial tubes will help the air pressure equalization happen more easily.
Simple tips for easing ear pain
You can do several simple things during air travel which can equalize the air pressure in your child's ears and decrease ear pain. Have your child:
- Drink plenty of fluids throughout the air travel. The best is water. Drinking a lot is very important, not only because it encourages swallowing but also because airplane air is dry, which thickens nasal mucus, making it more likely for the Eustachian tubes to become clogged.
- Take acetaminophen or ibuprofen about a half hour before takeoffs or landings if you know your child has ear pain when flying.
- Chew gum or gobble a hard candy only if your child is over 3 years old.
- Take a bottle or breastfeed. If you bottle-feed, make sure your baby is sitting upright while drinking. Yawn persistently, if your child can do this intentionally.
- During sleep, we don't swallow as often, so it's harder to keep the air pressure in the middle ear equalized. So, stay awake for takeoff and landing.
If your child is taking medicines which contain antihistamines or decongestants
, talk to your ENT doctor about whether they can be continued during the flight.
In some cases, a child may continue to have ear pain for longer duration if the ears don’t “pop.” You can continue to give your child pain relievers. However, if it continues for long, call your ENT doctor.
With some patience and appropriate precautions, you can make your nest family flight less bothersome and more comfortable.