It’s the holiday season which also means the traveling season for many families. Traveling with kids of any age can be challenging; however, flying with infants and babies can be downright scary. But, with enough knowledge and preparation, it doesn’t have to be. That is why we are sharing this article by Claire McCarthy, MD, FAAP & Jennifer Shu, MD, FAAP from healthychildren.org.
When is my baby old enough to fly on an airplane?
Generally, you should avoid flying with your newborn until they are at least 7 days old. Ideally, wait until your baby is two or three months old to fly. Air travel (and being in crowded airports) can increase a newborn's risk of catching an infectious disease.
Should my baby sit on my lap during the flight?
Ideally, no. The Federal Aviation Administration (FAA) doesn't require a ticket for children under the age of 2 years. But that means your baby will be on your lap. If there is turbulence, or worse, it may not be physically possible to protect your baby in your arms. Turbulence is the number one cause of children's injuries on an airplane.
If you do not buy a ticket for your child, you may want to ask if your airline will let you use an empty seat where you can install a car seat for your baby. If your airline's "lap baby" policy allows this, avoid the busiest travel days and times to increase your odds of finding an empty seat next to you.
The safest way for baby to fly
The safest way for your baby to fly is in a child safety restraint―an FAA-approved car seat or airplane harness device. It should be approved for your child's age and size, and installed with the airplane's seat belt. Booster seats cannot be used on airplanes during flight.
Infants weighing less than 20 pounds should be bucked into a rear-facing car seat during airplane travel.
Children who weigh 20 to 40 pounds should be restrained in a car seat. They should not be switched to using just the airplane's lap belt until they reach at least 40 pounds.
There is an FAA-approved alternative to using a car seat on an airplane called the Child Aviation Restraint System (CARES). This airplane safety harness is not meant for infants, however. It is designed for use by toddlers (22 to 44 pounds) and only on airplanes.
Should I bring our car seat on the plane with us? Does that count as luggage?
Car seats, booster seats, and strollers generally don't count as luggage, but policies vary by airline; check with yours before flying. In most cases they can be checked at the gate, where the risk of damage may be lower, at no cost. Consider packing the car seat in a protective bag or box. If your baby has their own airplane seat, bring your car seat with you.
Not all car seats are certified for use in airplanes.
Make sure a label on the car seat says: "This restraint is certified for use in motor vehicles and aircraft."
Which seat on the plane is best for a baby?
Look for rows on the plane with more space, like the bulkhead. Exit rows are out, for safety reasons.
Choose a seat closer to the window, if possible. Aisle seats can be risky for babies during beverage service. Hot drinks being passed to passengers can spill and cause burns, and their little arms and legs can be caught by passing carts. Aisle seats are also closer to falling overhead bin items. If you use a car seat, most airlines require that they be installed in a window seat.
Ensure that your baby's seat is next to you on the plane. Visit the U.S. Department of Transportation Airline Family Seating Dashboard for tips. It shows which airlines guarantee adjacent seats for children under age 13 traveling with an adult at no extra fee.
Is there a way my baby can lie down flat on long flights?
Buckling your baby into a car seat or safety restraint remains the safest option. However, there are other options available to help baby sleep comfortably, especially on long-haul flights.
Airline bassinets. Some airlines offer airline bassinets attached to the plane's bulkhead wall―the wall behind the galley, or toilets or another cabin. In some premium cabins, they can be built into the seat compartment to use in bulkhead rows. Most airline bassinets require the baby to be under 6 months old and/or 20 pounds, and not yet able to sit up unassisted. These bassinets are sometimes called "skycots" or baskets.
Sleeper seat. For an added fee, some international airlines let you book three seats in a row with locking seat extensions. This creates a "sky couch" or sleeper-seat big enough for both parent and child. Some airlines also offer "lie-flat" and "flat-bed" seats.
Inflatable seat extenders. Some airlines let you bring your own inflatable, individual seat extension for your baby to snooze on lying down. Not all airlines permit these to be used, though, so check ahead of time. Your child will need their own seat to use one.
Note: For all options above, your baby would still need to be buckled into a car seat or held on your lap during takeoff, turbulence and landing.
Safe sleep practices still apply on the airplane.
If your baby sleeps on your lap during the flight: stay alert and check on your baby often. Make sure they can breathe easily, and their face is uncovered.
If your baby sleeps on another device during the flight: check that it is firm and flat, with no soft bedding. (See, "How to Keep Your Sleeping Baby Safe.")
Will I be able to get liquid formula or expressed breast milk through security?
Yes, but you have to follow the reasonable quantities rules. This means you're exempt from the 3-1-1 rule limiting liquids to 3.4 ounces (100 mL).
Pack formula, expressed breastmilk, or water for mixing with powder separately and be ready to let the TSA know you have it. You may ask that they not go through the x-ray machine (although this shouldn't cause a health problem). Visit the TSA website for more information.
Any tips for keeping my baby comfortable and content on the plane?
Dress your baby in layers. The temperature in a plane can vary widely, especially if you are stuck waiting on a runway. So, dress your baby in layers of clothing. As you pick out clothing, choose outfits that make diaper changing in a small space easier. Also, pack a change of clothes or two, in case turbulence hits during a diaper change or when you are feeding. Bring plastic bags for soiled clothing.
Be ready for ear pain during take-off and landing. During takeoff and landing, changes in pressure between the outer ear and middle ear can cause discomfort. If your baby has had ear surgery or an ear infection in the past two weeks, ask their doctor if it's OK to fly. Having babies drink from the breast or a bottle, or suck on a pacifier, can help. If your child has a cold or ear infection, a dose of acetaminophen or ibuprofen may help; check with your doctor for the right amount to give your child.
Reduce jet engine noise exposure. Airplane cabin noise hovers around 100 decibels, and is even louder during takeoff. Using cotton balls, small earplugs, or noise-canceling headphones may help to decrease the decibel level your baby is exposed to, and also make it easier for them to sleep or relax.
Keep in mind that sleeping babies are easier for everyone. If possible, travel at a time when your baby naturally sleeps. Or, onsider trying to put off a nap until it's time to fly. Flight delays can cause this to backfire if your exhausted baby decides to scream instead of sleep. But it may be worth a try.
Do not use diphenhydramine, or Benadryl, to help your baby sleep without talking to your doctor.
This medication can have serious side effects, especially if repeated doses are given on long flights. If you get the go-ahead and appropriate dose from your doctor, try it at home first. Some children react to the medicine by getting more awake instead of sleepy.
Consider a diaper change right before boarding the plane. A dry baby is a happy baby. Fortunately, when you do need to change a diaper in-flight, many planes have restroom changing tables. If yours doesn't, ask a flight attendant if there is a spot where you can spread out your changing pad. Some parents resort to diaper-changing on the closed toilet seat. If you try this, be sure to have a hand on your baby at all times and pack a disposable changing pad. Plan for delays; pack plenty of supplies.
Bring distractions. Pack some toys and books and be ready to play with your baby the entire time. A tablet with videos can be a good backup if the toys and books aren't helping anymore (we don't encourage entertainment media for children under the age of 2, but desperate times can sometimes call for desperate measures).
Don't let the glares get to you. Despite the best advanced planning and efforts, babies cry sometimes. Know that you did, and are doing, all you can. At that point, one of the best ways you can calm your baby may be to stay calm yourself. And remember that for every person who is glaring at you, there are plenty of people who have been through it themselves and have lots of sympathy.
Ask for help. Arrange for your airline to help you if you need help making a connecting flight. Carrying a child safety restraint, your baby and luggage through a busy airport can be challenging.
Does my baby need a passport for international travel?
Yes. All U.S. citizens, including infants, need a current passport to travel internationally. Parents or guardians need to apply with their baby in person using the form DS-11. Be sure to bring your baby's birth certificate and a photo taken within the last 6 months.
Passport photos must be taken with nobody else in the photo, which can be tricky with infants. To do this safely if your baby can't sit up yet, lay them on their back on a plain white blanket or sheet to ensure head support without having to hold them. Another option is covering a car seat with the sheet and taking a picture with your child in it.
What about domestic flights?
A valid passport is usually the only identification your baby will need to fly on a domestic flight, unless you need to show proof of age for a discounted child fare. Check with your airline before you leave. Note: Children under age 18 will not be required to get a Real ID.
What is the best time of day to fly with a baby?
It is hard to say whether flying during the day or night with a baby is better. After the first few weeks, some infants may sleep more reliably at nighttime than they do during naptime travel. If you and your baby can sleep on the plane, a late-night flight may be the way to go.
Tips for Families and Links to Airline Webpages (U.S. Department of Transportation)
If you have questions about how to keep your baby safe while traveling this holiday season, reach out to Kids First Pediatrics. Raleigh: (919) 250-3478, Claytong: (919) 267-1499.
*This article is informational but is not a substitute for medical attention or information from your provider.