The “ear-popping” sensation most people experience during a flight is generally a mild, temporary discomfort for healthy adults and babies. It occurs when your Eustachian tubes, which connect the back of the nose to the middle ear, attempt to equalize with cabin pressure by opening up to let air into the middle ear. When you have a cold, mucous and inflammation from congestion can block these tubes. Because their tubes are narrower than those of adults, infants are more susceptible to these types of blockages, which can cause complications like severe pain and ear damage.
Since flying can be an uncomfortable, and even painful, prospect for an infant with head congestion, evaluate your options carefully before taking the trip. Dr. Jay L. Hoecker, a Mayo Clinic emeritus consultant, suggests talking to your pediatrician before taking a flight with a congested baby to see if he recommends postponing the flight. If you get the go ahead to fly, your doctor might prescribe medications for your baby that can make the flight a more comfortable experience.
Infants with head congestion frequently exhibit a clear, runny nose and might struggle to breathe or refuse to eat due to the congestion. During a flight, your congested baby might cry and fuss shortly before landing because her blocked Eustachian tubes do not allow the air pressure to equalize. The trapped air then pushes on her ear drums, stretching them and causing pain.
While the American Academy of Otolaryngology recommends that older children and adults consider use an over-the-counter decongestant to alleviate ear pain during air travel, this is not an option for infants. The U.S. Food and Drug Administration advises against the use of any type of over-the-counter cold and cough remedies in children younger than two.
If you decide to fly with your baby, you can take some steps to help make the experience less painful for him. Since swallowing activates the muscles that open the Eustachian tubes, breastfeed your baby during take-off and landing, or let him drink a bottle or suck on his pacifier. Feed him regularly during the flight—the liquids help thin out mucous secretions, making them less likely to clog your baby’s Eustachian tubes. Make sure you wake him up prior to descent—the air pressure often increases in the cabin at this point, intensifying the likelihood of ear pain and pressure.
Flying while congested can potentially lead to a ruptured tympanic membrane, or eardrum. Medline Plus states that this complication causes severe pain and requires immediate medical attention. While the eardrum usually heals on its own within one to two months, in severe cases your baby might need surgery to repair her eardrum.