One of the things that’s so great about my job is that, no matter where I am or what I am doing, I always seem to learn something new about our industry.

With so many rules and regulations already, and constant changes, it’s tough to keep track of it all…all one need do is look at the Operations Manual that I am required to carry with me when working and you can see for yourself how daunting that task can be.

Yesterday, I was privy to one of those “Ah, I didn’t know that” moments, albeit it might have been a disaster for the passenger had some of the circumstances been different.

There was a couple who approached the boarding area for their flight with twin newborns…we are talking 6-DAY OLD newborns. They were tiny and pink and one of them was quite vocal in that clear high-pitched cry that only a newborn can produce.  The Customer Service Agent who was assisting them fawned over them, like a proud grandmother.  During her conversation with them, she inquired about their age.  After learning they were less than a week old, she kindly handed the boarding cards to the parents and sent them on their way.  You could see they were excited to be getting the infants to their new home.  It was a precious sight.

The moment was soon diminished when a Customer Service Supervisor approached the parents in the gate area a few minutes later and declared, “I’ve been advised that your babies are less than seven days old.  I’m very sorry but I cannot allow you to travel with these infants today!”  The couple looked shocked and then angry, while the passengers around them produced in unison a hushed gasp. The supervisor proceeded to explain that since the babies were less than 7 days old, airline policy required a physician’s release and declaration of the babies’ health in order for them to travel unhindered.

As luck would have it, one of the parents was a licensed physician, and after producing his medical card and producing a statement of health for each child, the supervisor approved their travel. But what would have happened had neither parent been a doctor? The supervisor did try to find a way to get the matter resolved, offering to accept a fax from the children’s doctor if one could be sent in to the airport prior to departure. Being that it was Sunday, that may have proved next to impossible, had they not worked it out as they had.

Traveling with newborns is a challenge for a number of reasons. One of the most obvious is the exposure an infant this young has to the harsh environment of an airplane interior. A newborn’s immune system isn’t fully developed just after birth and it takes time for their body to adjust to the exposure of bacteria and viruses in the open air, especially in public places. Add to that the recycled air inside the airplane during flight, and then top it off with the pressurization of the fuselage that simulates conditions of altitude of between 5,000 and 7,000 feet at a gradual rate of pressurization. While we adults and most children can handle this pressure without complications, newborns are most vulnerable because their bodies haven’t learned how to equalize the pressure in their ears and sinus cavities. Also, newborns may still have large quantities of liquid in their sinus cavities after the transition from fetus to independence after birth.

Many physicians recommend that newborns don’t travel by air until they are 4 to 6 weeks old, especially if the baby has breathing complications, which can be exacerbated in a low-oxygen environment like a pressurized airplane cabin. Supplemental oxygen for the baby may be necessary (and must be ordered in advance by the physician through the airline prior to travel)[1].

Most every major airline has limited restrictions for flying with newborns less than 10 days old. Every airline has their own policy; even though the majority doesn’t charge additional fees to fly with your baby (he/she must be held, unless you purchase a ticket in order to accommodate the baby’s carrier) each carrier has specific rule regarding newborns flying under 10 days old, and almost every carrier requires a physician’s release and a certificate of health in order to allow them access to the plane. Check with your specific airline for details[2].

The most important thing to remember about handling this new person’s venture into the world of air travel is to make them as comfortable and safe as possible in this strange, new environment. Be mindful of their exposure to other passengers and monitor their comfort levels on takeoff and landing to ensure they aren’t being caused discomfort from the change in cabin pressure.

Make sure you talk to your doctor if you have additional questions on topics that weren’t discussed here[3] [4]. Before you know it, he or she will become a seasoned world traveler in no time!

[1] MayoClinic.com, Health Information, Toddlers and Infants, “Air Travel with Infant: Is it Safe?” Jay L. Hoecker, M.D., http://bit.ly/rloB6v

[2] Babycenter.com, For You, “Flying with small children: Checklist of questions to ask your airline,” http://bit.ly/pvvcnt

[3]  iVillage.com, Pregnancy and Parenting, “Babies: Is it safe to travel by plane with a newborn?” Robert W. Steele, MD, January 1, 2010 http://bit.ly/mXYjZr

[4] BabiesToday.com, Pregnancy Today, Newborn Health, “Keeping Newborns Healthy When Traveling: On An Airplane with a Newborn,” Alex Powell, http://bit.ly/o381du

Well, it was bound to happen at some point.

Imagine the following scenario (if you are a frequent airline traveler, this won’t be a stretch!):

You are seated at the window seat on a full airplane—there is not one available empty seat.  The plane was delayed due to weather, and now the aircraft that you have just boarded has run into a mechanical issue, that will need the care of a ground mechanic there at your gate.  The temperature is warm in the cabin and there is very little air circulating.

Seated next to you is a young woman, about 26 or 27.  She looks haggard at best—hair disheveled, clothes somewhat rumpled and her faced is pretty flushed with frustration and agony.  Why?  Seated in her lap is a 14 month old infant who, despite all attempts by the mother to calm her, is screaming profusely.  The uncomfortable temperature in the cabin is exacerbating the problem.  The child’s voice is somewhat hoarse and the sobs have entered that all-to-common phase of stuttered heaves.

The mother, noticing your icy glances periodically, has apologized many times to you and the other surrounding passengers, explaining that little Suzie has an ear infection and is currently on anti-biotics which, she believes, is upsetting her stomach.  Claustrophobia, which you don’t suffer from under normal conditions, is beginning to set in and you can feel your pulse quickening, your temper bubbling up, and you just want to go all “Steven Slater” on the child, imagining that you would feel SO much better!

Although this fictitious scene is very extreme, there are times when even a much calmer, similar situation feels like it could escalate into this very story.  But is there a practical solution to this frequently increasing setting?  Should the airline be getting involved?  Are your rights as a passenger being violated?

The fact of the matter is pretty simple: this is one of the many realities of airline travel today and finding a solution to it seems much more elusive than it feels it should.

Brian Williams of NBC Nightly News reported last night that there is a growing opinion among frequent flyers, especially business travelers who either do not have children or whose children are well past this stage and are fairly well-behaved on airplanes, that families should be segregated into a special section of the cabin (most opinions say the extreme aft of the plane) similar to the “smoking sections” that were common in airplanes of yesteryear.

The idea, which seems simple at first, becomes much more complex when you factor in a whole host of mitigating factors, like status of the passenger, ticket pricing, the rights of the parents or the child and a myriad of other topics.  While it’s easy to suggest that people traveling with their family should be segregated to a certain section of the airplane, enforcement of such an idea become nearly impossible.

As a flight attendant, I already can tell you that this “idea” won’t hold water in today’s airline world.  We, as the safety professionals onboard, can barely get some folks to comply with Federal Air Regulations as currently written—I couldn’t imagine seeing my flying partners trying to contain families in a restricted section of the cabin.

In the past, I have fielded requests from annoyed business men and women who try to intimidate me with their own personal status or the price of their ticket because another passenger decided to travel in first class or business class with their infant and the child is being less than cooperative.  In cases such as this, my hands are pretty much tied.  I usually make an effort to assist the parent of the child to see if there is something they might need in an effort to calm the infant, but this may not always work.

For us adults, airline travel is already stressful enough—most of it self-inflicted—but for a small child, there are other factors that most grown-ups fail to think about:

• Cabin pressurization: most airplanes are pressurized to simulate the atmosphere of approximately 7,000 feet.  Most teens and adults can self-regulate the pressure behind the eardrums to avoid pain in the sensitive areas of the aural cavity and the sinuses.  For small children, this is much more challenging and for newborns and young toddlers, the only method they have to communicate their discomfort is by crying—and even at times screaming.
• Federal Air Regulations: this may sound ridiculous, but at home or out in public, when small kids gotta go, parents are inclined to find a place for them as soon as possible to relieve themselves.  They know that their ability to “hold it” is limited and if they are already out of the diaper phase, it’s important to let them use the facilities as soon as possible.  The challenge on an airplane is that turbulence is usually unpredictable and sometimes a child’s need to go is in direct conflict with the seat belt sign being turned on for their physical protection against injury during rough air.
• Illness: this is very close to the first bullet point regarding the stabilization of pressure in the ears and sinuses, except that if the child is suffering from a cold or sinus infection, there are limited choices a parent has to offer relief.  Small infants are not always able to be given strong enough medications like adults can to gain relief from pain, and if a child is on anti-biotics, many can cause side effects, including stomach discomfort which adds to the problem.
• Restlessness: children are full of energy—they have a natural tendency to move around…a lot!  Airplane cabins offer very limited space for a child to move, and considering all the activity taking place in the aisle, between flight attendant services and other passenger movement, it is nearly impossible for children to release that pent up energy.  Parents need to be prepared for this and find activities that a child can do at their seat to absorb some of that disquiet.
• Behavioral phases: ah yes, the “terrible twos” among many other developmental behavioral stages of a child’s growth can be a disastrous ingredient when mixed in with airline travel.  Parents are often the recipient of the ire of the surrounding passengers and must learn to empathize with those folks who may not understand their situation or appreciate the challenges of parenthood.  A focus on what calms a child (a favorite toy or object, like a blanket), plus actually spending quality time with the child in keeping their attention focused can go a long way towards minimizing emotional outbreaks or temper tantrums.

By no means is this a complete list and I invite feedback and suggestions from readers.  Tell us your suggestions and/or observations regarding traveling with small children, and any tricks or secrets to making the most of a bad situation.

There are also a few great resources that parents can take advantage of before traveling with their children to get tips and pointers on what to do, like AboutBabyTravel.com and BabyGoes2.com.

In a perfect airline world, children would be complete angels and business men and women would be satisfied to get their work done or gain a few extra moments of rest before that very important business meeting.  Unfortunately the only way to avoid the complicated issue of children on airplanes is to charter your own flight or buy your own jet.

Remember, even though you bought a ticket to fly, airline travel is PUBLIC transportation, so your ticket buys you all that goes with it!

Safe travels!