1. Can newborns travel safely by air? Commercial jets are safe for healthy newborns. However, infants with a history of serious medical issues (significant premature birth or heart and lung problems around the time of birth), for the first year, even if the infant shows no symptoms, may have difficulty compensating for lower oxygen concentrations at cruising altitudes. Such infants should be medically cleared for air travel.

2. Do airlines have lower age restrictions for newborns? Some do: American Airlines allows infants two days of age to travel. United, Delta and Air Canada, require a letter from a physician for infants less than 7 days of age. Southwest requires a letter for infants less than 14 days of age. Most airlines have their newborn policy stated on their web site. Go to web site and search travel with infants.” Or call the airline.

3. Are infants likely to catch infectious diseases in flight? While there are no statistics, infants are probably no more likely to become ill on planes than in other public places. There are no known cases of infants catching serious infectious diseases during flight, but it is often difficult to determine when/where an illness is caught. Most contagious diseases that affect young children spread through the air. Infants are partially protected by immunity obtained from their mothers, but this immunity varies an wanes over the first few months of life. Cabin air is replaced every few minutes with sterile air from outside or recycled through sophisticated filters. And air circulates from ceiling to floor, not through the entire aircraft, making passengers susceptible only to illnesses from those sitting nearby. (There a few known cases where adults have caught serious diseases in flight.)

4. Should I wait to travel until my child is fully vaccinated? This adds only slight protection. Routine immunizations are generally given at two, four and six months with full immunity not achieved until the six months dose. However, the diseases that these vaccines prevent are unlikely to be present in flight – because the vast majority of people are vaccinated against these diseases. When measles is a threat, a dose should be given at six months in addition to the dose given at a year. For overseas travel, additional vaccines may be indicated.

5. Is there anything I can do to reduce the chances of illness? Not much. Washing your and your infant’s hands and wiping surfaces (organisms can survive for days on seats and armrests) may reduce risk. If possible, change seats if a nearby passenger coughs and sneezes. Travel when planes are less crowded.

6. Do infants need extra drinks to prevent dehydration? No. In-flight dehydration is a myth. Feed infants no more in flight than at home. Adult air travelers erroneously interpret their parched mouths and throats as dehydration. This dry feeling results from air conditioning removing most of the moisture from the cabin air.

7. Does feeding infants too often cause problems? It can. At cruising altitudes the air in the stomach and intestine is already expanded by 20%, the result of lower atmospheric pressure. (This is what gives many adults a bloated feeling.) For infants, sucking adds more and unnecessary air and food to the stomach, which may cause fussiness. Feed infants no more often in flight than at home.

8. Is it OK to sedate infants for long flights? Not really. Our surveys show that “criers” will cry whether they are medicated or not. Surprisingly few infants cry considering that air travel disrupts their sleep and feeding schedules, they rest in unfamiliar and sometimes uncomfortable positions and, if they are on your lap, are disturbed every time you move. There are no studies as to which medications are effective and how much and when to give them. Some sedating medications (antihistamines, for example) make some infants more active.

9. Can infants with respiratory infections and nasal allergies travel by air? It appears to be safe. Surveys of experts (hundreds of pediatricians, pediatric ear nose and throat specialists and other physicians) has failed to find one who has seen an infant with ear damage as a result of flying with these symptoms. Decongestant and nose drops/sprays do not help infants. Air pressure regulating earplugs do not reduce ear discomfort in children.

10. Is air travel safe with ear infections? Yes. The same experts agree. Ear infections actually reduce the chances of ear pain. Pain is due pressure changes in the air in the middle ear as the plane ascends and descends. Most ear infections obliterate this space with fluid, eliminating the chances of pain. Aerating tubes also eliminate the chances of ear aches. These tubes connect the ear canal with the middle ear air space, equalizing pressure. Some infants may suffer from ear pain. Older children do but there is no evidence that the pain damages the ear. Acetaminophen and ibuprofen reduce pain.