Traveling with children

Traveling with children is one of the most beautiful experiences in life. Seeing their faces light up as they explore new places, enjoying time together as a family in a different city or country—it’s all wonderful. However, at the same time, we must be cautious because unexpected situations can happen at any moment.

Preventing Motion Sickness

Motion sickness in cars, buses, trains, planes, or boats tends to occur between the ages of 2 and 12, especially if there is a family history. To prevent it, it is essential to avoid looking out of side windows or fixating on a single point. Similarly, reading, watching screens, or drawing is not recommended. It is also best to avoid heavy meals or carbonated drinks before traveling, advises Dr. Cristina Alfaro Iznaola, a pediatrician on our team.

Dr. Alfaro also provides several recommendations to help prevent motion sickness or discomfort in children during a journey:

If traveling by car:

• Take breaks every 1.5 to 2 hours.
• Take advantage of nap time for travel.
• Encourage looking straight ahead at the horizon. For example, play “I Spy,” look for shapes in the clouds, read license plates, etc.
• Let them sit in the middle seats.
• Carry bags (without holes) or a small bucket, towels, wipes, and spare clothes that are easily accessible, just in case.

Regarding medication, Dr. Alfaro recommends the following:

• Children under 2 years old: sedating antihistamine or NauZen® patches (officially recommended from age 3, but they can be placed on the front seat, away from the child, instead of directly on their clothing).
• Children aged 2 and above: dimenhydrinate (commonly known as Biodramina®).
• Children aged 12 and above: meclizine chewing gum (Chiclida® brand).

If traveling by boat, plane, or train:

• Administer one of the mentioned medications at least half an hour before the journey begins.
• On a boat, try to position the child in the center deck to gaze at the horizon instead of being inside the cabin.
• On a plane or train, it is better to sit in the front seats and face the direction of travel.
• Encourage them to eat light snacks frequently (e.g., green apple, ginger biscuits) and keep them hydrated with small sips of water or even hypotonic oral rehydration solution.
• Avoid reading or fixating on any object, and wearing sunglasses can be helpful if outdoors.

What to Do When Motion Sickness Occurs

Motion sickness occurs due to a coordination mismatch between what the child sees through their eyes (the motion when traveling) and their inner ear (responsible for balance), which perceives them as sitting still. General discomfort, vomiting, and paleness are common symptoms of motion sickness.

If your child experiences motion sickness despite the previous advice, do not worry—it is normal and quite common in children. In such cases, Dr. Alfaro recommends, “If they have already become sick, it is best to stop as soon as possible, as long as it does not pose a risk to everyone. If they have vomited, clean the area as best as possible and apply baking soda (if available) to remove odor and stains.”

Dr. Alfaro also advises giving the child a break, especially when traveling by car. Let them “recover outdoors for at least 30-45 minutes before continuing the journey.” It is also important to ensure that they “drink small sips of water or juice, have something sweet (offer a candy or sugar cube) and, once you see they have recovered, continue the journey while following the previous recommendations.”

If vomiting persists despite these measures, the doctor recommends “suspending the trip and seeking medical evaluation if signs of dehydration are present, such as dry oral mucosa, sunken eyes, crying without tears, or extreme weakness.”

If motion sickness occurs on a boat, it is best to go to the deck and have the child look at the horizon, as mentioned earlier by the doctor. When flying, if your child experiences motion sickness, encourage them to take a walk down the aisles and refresh themselves in the restroom by washing their face and wetting the back of their neck.

Managing Jet Lag in Young Children

Believe it or not, children adapt better to time changes than adults, “more than we imagine,” says Dr. Alfaro. However, to ensure the well-being of children during trips involving time zone changes, the doctor provides the following tips to make jet lag more bearable:

Ensure good sleep hygiene on the day and night before the trip.

If traveling overnight, try to start the journey at the beginning of the night or when the child is already in deep sleep (approximately the first 4 hours of sleep).

If there is a time difference of more than 6 hours, try to mimic the destination’s schedule as soon as possible. This can be achieved by allowing “emergency naps” that should not exceed 2 or 2.5 hours. Aim to put them to bed as early as possible within a normal timeframe. For example, if flying to New York, which has a 6-hour time difference from mainland Spain, arriving at the

destination at 2 PM local time (8 PM in Spain), you could allow a nap until 4:30 PM in New York (10:30 PM in Spain) and put them to bed around 7:30-8 PM in New York (1:30-2 AM in Spain).

Melatonin can be a great ally, especially when combined with tryptophan, to help reset the circadian rhythm. However, it is always recommended to use it under medical supervision and for a limited time.

During long flights, unless extreme anxiety is present, medication is not recommended. Instead, help keep the child entertained for as long as possible.

What Should Not Be Forgotten on a Trip with Children?

“When traveling with children, it is essential to carry a first aid kit with all the basics that may be needed in case immediate or early medical assistance is not available,” says Dr. Alfaro. Here are some essential items to include:

• For fever (temperature >38°C) or pain: paracetamol (liquid or suppositories), ibuprofen (liquid), or metamizole (drops).
• For vomiting and diarrhea: hypotonic oral rehydration solution and probiotics (e.g., Bivos®, Reuteri®, Ultralevura®) or even Xilaplus® sachets for diarrhea.
• For wounds: sterile saline solution, 2% chlorhexidine (Cristalmina®), adhesive skin closure strips, gauze, bandages, dressings, and adhesive band-aids.
• For insect bites: mosquito net and mosquito repellent, following these recommendations:
  • Between 0 and 2 months: mosquito patches like Squitos® or applying DEET to the area where the child sleeps or rests, but never directly on their skin.
  • Between 2 months and 1 year: botanical oils in roll-on form.
  • From 1 year old: IR3535 spray on the skin.
  • From 2 years old: DEET in 10-30% concentration, IR3535 spray, or picaridin.
  • From 3 years old: DEET in 10-30% concentration, IR3535 spray, picaridin, or PMD.
  • If there are already insect bites: ammonia stick (Goibi Pic® from 1 year old or Afterbite Extrem® from 2 years old).
  • You can find more information about prevention and treating insect bites here.
• And if the child has a chronic illness, never forget their regular medication! (e.g., salbutamol, injectable adrenaline, oral corticosteroids, antihistamines, etc.).