Children’s Ears and Changes in Altitude Changes

The middle ear is where problems originate during changes in altitude like flying in a plane or driving over mountain passes. The middle ear contains Eustachian tubes that open and expand/contract to accommodate for changing air pressures in the environment. Adults have the knowledge and ability to actively “pop” our ears with intention so the pressure doesn’t become too high. Children that are too young to understand this process are at a higher risk for developing problems related to pressure related changes in the middle ear. So if you have descended on a plane or over a mountain pass and your child has been screaming the whole time…this is probably why!!! Their Eustachian tubes are also narrower and shorter than adults putting them at higher risk for problems equalizing pressure changes. Descending is usually when the most intense pressure changes occur but it can become a concern at any point in a trip.

Things you can do to help your baby/children:

1. Encouraging them to swallow (this will help the Eustachian tubes to expand)
2. Giving them a pacifier (in babies and much younger children this sucking can mimic swallowing and help to expand the Eustachian tubes)
3. Give them a bottle (this is even more effective than a pacifier at opening the Eustachian tubes)
4. If they are old enough to chew gum this can be very helpful!
5. If they are old enough to follow directions but don’t have the natural instinct to pop their ears then have them pinch their nostrils closed, fill their cheeks with air, and blow out with the mouth closed directing the air toward the ears. This may have to be repeated several times to achieve effect. (These directions seem to help with understanding the technique)
6. NEVER EVER LET YOUR BABY SLEEP DURING THE DESCENT. Allowing the pressure to build up without relieving it for an entire descent can put your child at risk for an ear drum rupture, especially if they have been congested or have a cold already. You should keep your baby awake for any descent and follow the above advice for pacifier or bottle feeding during this time.
7. Decongestants are okay to pre-medicate adults for altitude changes but not the best option for very young children or babies. If you are planning on traveling with a congested or sick baby and have concerns about altitude pressure changes in the plane or mountains, speak with your healthcare provider before administering any medications.
8. If your baby or child remains fussy, irritable, congested, feverish, or is pulling at their ears they should see a healthcare provider to assess if there is an ear infection (this may be related or unrelated to the altitude changes)

American Academy of Otolargyngology. (2017). Ears and altitude. Retrieved from: http://www.entnet.org/content/ears-and-altitude

Tara Taylor RN, BSN, CEN, CCRN

tarat@ebertfamilyclinic.com

Tara Taylor is a Family Nurse Practitioner at Ebert Family Clinic where she provides adult patient care and participates in high altitude research. She is a passionate advocate for mental health, women’s health, and affordable health care.