Are we there yet? Flying with children this summer

I like flying. While I detest the modern airport experience, once we are above the clouds I like nothing better than looking out and reflecting on the world below. Air mindfulness, I call it.

On my most recent trip, the outward and return sectors could not have been more different. Going out, the plane was packed and had an unusually high percentage of infants and toddlers on board. Coming back, while passenger numbers were also high, there were just three families shepherding more than one child through the aircraft. The big difference? Noise levels.

Part of my air mindfulness routine is to put on a pair of well-fitting “over ear” earphones. They’re pretty good at blocking out ambient noise; but, on the flight out, for the first time ever, they were defeated by a loud chorus of crying, screaming children that lasted throughout the 2 ½-hour flight.

Poor Dr H and his First World problems, I hear you say. And you are absolutely right: my loss of tranquillity at 38,000 feet was nothing compared to the stress levels experienced by the parents of the reluctant paediatric flyers.

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While none of us really want to be packed like sardines into a tin can, asking children to stay still in a confined space that comes complete with strange noises and sensations will not win any travel experience prizes. But the economic air travel model of today is firmly based on high passenger load factors, so the flying experience isn’t going to change any time soon.

From a physiological perspective, what might be adding to children's discomfort when they fly? In a paper entitled Effect of Aircraft-Cabin Altitude on Passenger Discomfort in the New England Journal of Medicine, the authors write that people who "travel to terrestrial altitudes above 6,500 feet experience acute mountain sickness, a syndrome characterised by symptoms of headache, nausea, vomiting, anorexia, lassitude, and sleep disturbance".

Altitude-related discomfort

When we get on a plane and are flying at 38,000 feet, the cabin is pressurised at 8,000 feet, an altitude equivalent to living high in the Colombian mountains. The researchers simulated these conditions in 500 volunteers. While none were children, they found that altitude-related discomfort was worse in younger age groups. The symptoms that most contributed to passenger discomfort were backache, headache, light-headedness, shortness of breath and impaired co-ordination.

Another pressure-related effect is bloating. A swollen, gas-filled tummy, itself uncomfortable, leads to stomach pain and constipation. And then there is ear pain – experienced by 15 per cent of children – most of which occurs during aircraft descent.

Bottle or breastfeeding a baby decompresses their Eustachian tubes and releases pressure on the eardrum. Older children can chew a sweet, blow up a balloon or, if old enough, may be taught how to carry out a Valsalva manoeuvre such as holding their nose and blowing.

Dehydration won’t help young children’s mood either. They experience headaches and tiredness when dehydrated. And tastebuds are numbed at high altitude, meaning their favourite tipple doesn’t taste right, thus threatening efforts to keep them hydrated.

Low humidity causes dry eyes and blocked noses. Older planes, made largely of metal, must maintain low humidity levels to avoid the corrosive effect of water on vital structures.

There is good news for kids (and their parents) with the latest models. The Boeing 787 and Airbus 350 are made of carbon fibre, which has allowed designers to retain in the cabin more of the moisture generated by passengers. In addition, composite materials allow the new aircraft to be pressurised to lower levels, thereby reducing much of the pressure-related symptoms as well. Passengers on these planes consistently report arriving more refreshed and alert.

Whatever type of plane wings you and your children to your dream holiday this summer, have fun; and don’t mind that man frantically adjusting his earphones in 8F.

@muirishouston