Many of us have felt that weird ear-popping sensation when we fly. For kids (especially babies and young children), it can seem especially odd and even scary at first. But it's a common, normal part of flying.
This sometimes 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 kids, 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 those 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 kids 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 doctor may recommend delaying flying, if possible, until the infection is gone to avoid increased pain and possible rupture, or tear, of the eardrum. In kids 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.
Some simple things to try during air travel can help equalize the air pressure in your child's ears and eliminate, or at least decrease, ear pain. Have your child:
Drink plenty of decaffeinated fluids (water is best) throughout the flight. Drinking a lot is very important, not only because it encourages swallowing (which makes the eustachian tubes open), 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 suck on hard candy (only if your child is over 3 years old).
Take a bottle or pacifier or breastfeed. If you bottle-feed, make sure your baby is sitting upright while drinking.
Yawn frequently (if your child can do this intentionally).
Stay awake for takeoff and landing. During sleep, we don't swallow as often, so it's harder to keep the air pressure in the middle ear equalized.
If your child is taking medications that contain antihistamines or decongestants, talk to your doctor about whether to continue them during the flight.
In some cases, a child may continue to have ear pain for longer periods (up to several hours) if the ears don't "pop." You can continue to give your child pain relievers according to the package directions until the pain eases. If it continues for more than several hours, call your doctor for advice.
With a little patience and some simple precautions, though, you can make your next family flight less stressful and more comfortable for both you and your child.