can newborn travel by air

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• Infant and toddler health

Is air travel safe for an infant?

Air travel is typically safe for most healthy, full-term infants after the first few weeks. Air travel may not be a good idea for babies born before their due date, called premature or pre-term.

Babies born early may still need time for their lungs to mature. So check with a healthcare professional before flying in a pressurized cabin or visiting high-altitude places.

And any infant with heart or lung problems should be cleared for air travel by a healthcare professional.

As you plan your trip, here are some things to keep in mind, such as the baby's age, your health and some basics of flying.

The baby's age, overall health

Experts caution against flying in the first seven days after a baby is born. Some healthcare professionals suggest not traveling for the first few months.

In general, babies and adults face the same risk of exposure to illness from travel. But a baby's immune system is still learning how to protect against germs. And in most cases, a baby's illness needs to be more closely watched by a healthcare professional.

Caregiver health and planning

It is important for caregivers to think about their own health too. Flying with a child can cause added sleep loss and stress. And adults are at risk for new germs and illness, as well.

Finding out what illnesses are spreading in your area and where you're going can help you prepare and take thoughtful action. And basic things like handwashing are even more important to prevent the spread of germs while traveling.

The baby's ears

Offering a baby something to suck on may help relieve the baby's ear discomfort. You can offer the baby a breast, bottle or pacifier to suck on during takeoff and the start of the landing process. It might help to try to time feedings so that your baby is hungry during these times.

Ask a healthcare professional when it's safe to fly with babies who have had ear surgery or an ear infection.

Also, airplane cabin noise levels are loud, mainly during takeoff. Cotton balls, noise-canceling headphones or small earplugs may limit your baby's exposure to this noise. This may help make it easier for your baby to sleep.

The baby's safety seat

Most infant car seats are certified for air travel. Airlines often allow infants to ride on a caregiver's lap during flight. But the Federal Aviation Administration recommends that infants ride in properly secured safety seats.

If you choose not to purchase a ticket for your infant, ask about open seats when you board the plane. It's possible an open seat could be assigned to your infant.

Don't be tempted to give your baby medicine, such as diphenhydramine (Benadryl, others), to help the baby sleep during the flight. The practice isn't recommended, and sometimes the medicine can have the opposite effect.

Jay L. Hoecker, M.D.

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• Jana LA, et al. Flying the family-friendly skies. In: Heading Home With Your Newborn: From Birth to Reality. 4th ed. American Academy of Pediatrics; 2020. https://www.aap.org/en/shopaap. Accessed Oct. 30, 2023.
• Newborn-flying and mountain travel. Pediatric Patient Education. https://publications.aap.org/patiented. Accessed Oct. 30, 2023.
• Centers for Disease Control and Prevention. Traveling safely with infants & children. In: CDC Yellow Book 2024. https://wwwnc.cdc.gov/travel/yellowbook/2024/family/infants-and-children. Accessed Oct. 30, 2023.
• AskMayoExpert. Infant Fever. Accessed Nov. 18, 2023.
• Schmitt BD. Pediatric Telephone Protocols: Office Version. 17th ed. American Academy of Pediatrics; 2021.
• Child safety on airplanes. Federal Aviation Administration. https://www.faa.gov/travelers/fly_children/. Accessed Nov. 18, 2023.

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Safety & Prevention

Flying with Baby: Parent FAQs

By: Claire McCarthy, MD, FAAP & Jennifer Shu, MD, FAAP

Taking a baby on a plane is something that most parents approach with caution. Infants and air travel can both be unpredictable, and they don't always mix well. But some advanced planning and preparation can help make for a better experience for your baby, for you, and for everyone else on the plane.

Here are answers to some questions you may have before traveling with an infant, along with tips for a smoother and safer flight.

When is my baby old enough to fly on an airplane?

Generally, you should avoid flying with your newborn until they are at least 7 days old. Ideally, wait until your baby is two or three months old to fly. Air travel (and being in crowded airports) can increase a newborn's risk of catching an infectious disease.

Should my baby sit on my lap during the flight?

Ideally, no. The Federal Aviation Administration (FAA) doesn't require a ticket for children under the age of 2 years. But that means your baby will be on your lap. If there is turbulence, or worse, it may not be physically possible to protect your baby in your arms. Turbulence is the number one cause of children's injuries on an airplane.

If you do not buy a ticket for your child, you may want to ask if your airline will let you use an empty seat where you can install a car seat for your baby. If your airline's "lap baby" policy allows this, avoid the busiest travel days and times to increase your odds of finding an empty seat next to you.

The safest way for baby to fly

The safest way for your baby to fly is in a child safety restraint ―an FAA-approved car seat or airplane harness device . It should be approved for your child's age and size, and installed with the airplane's seat belt. Booster seats cannot be used on airplanes during flight.

• Infants weighing less than 20 pounds should be bucked into a rear-facing car seat during airplane travel.
• Children who weigh 20 to 40 pounds should be restrained in a car seat. They should not be switched to using just the airplane's lap belt until they reach at least 40 pounds.

There is an FAA-approved alternative to using a car seat on an airplane called the Child Aviation Restraint System ( CARES ). This airplane safety harness is not meant for infants, however. It is designed for use by toddlers (22 to 44 pounds) and only on airplanes.

Should I bring our car seat on the plane with us? Does that count as luggage?

Car seats, booster seats, and strollers generally don't count as luggage, but policies vary by airline; check with yours before flying. In most cases they can be checked at the gate, where the risk of damage may be lower, at no cost. Consider packing the car seat in a protective bag or box. If your baby has their own airplane seat, bring your car seat with you.

Not all car seats are certified for use in airplanes.

Make sure a label on the car seat says: "This restraint is certified for use in motor vehicles and aircraft."

Which seat on the plane is best for a baby?

Look for rows on the plane with more space , like the bulkhead. Exit rows are out, for safety reasons.

Choose a seat closer to the window, if possible . Aisle seats can be risky for babies during beverage service. Hot drinks being passed to passengers can spill and cause burns , and their little arms and legs can be caught by passing carts. Aisle seats are also closer to falling overhead bin items. If you use a car seat, most airlines require that they be installed in a window seat.

Ensure that your baby's seat is next to you on the plane. Visit the U.S. Department of Transportation Airline Family Seating Dashboard for tips. It shows which airlines guarantee adjacent seats for children under age 13 traveling with an adult at no extra fee.

Is there a way my baby can lie down flat on long flights?

Buckling your baby into a car seat or safety restraint remains the safest option. However, there are other options available to help baby sleep comfortably, especially on long-haul flights.

Airline bassinets. Some airlines offer airline bassinets attached to the plane's bulkhead wall―the wall behind the galley, or toilets or another cabin. In some premium cabins, they can be built into the seat compartment to use in bulkhead rows. Most airline bassinets require the baby to be under 6 months old and/or 20 pounds, and not yet able to sit up unassisted. These bassinets are sometimes called "skycots" or baskets.

Sleeper seat . For an added fee, some international airlines let you book three seats in a row with locking seat extensions. This creates a "sky couch" or sleeper-seat big enough for both parent and child. Some airlines also offer "lie-flat" and "flat-bed" seats.

Inflatable seat extenders . Some airlines let you bring your own inflatable, individual seat extension for your baby to snooze on lying down. Not all airlines permit these to be used, though, so check ahead of time. Your child will need their own seat to use one.

Note: For all options above, your baby would still need to be buckled into a car seat or held on your lap during takeoff, turbulence and landing.

Safe sleep practices still apply on the airplane.

• If your baby sleeps on your lap during the flight: stay alert and check on your baby often. Make sure they can breathe easily, and their face is uncovered.
• If your baby sleeps on another device during the flight: check that it is firm and flat, with no soft bedding. (See, " How to Keep Your Sleeping Baby Safe .")

Will I be able to get liquid formula or expressed breast milk through security?

Yes, but you have to follow the reasonable quantities rules. This means you're exempt from the 3-1-1 rule limiting liquids to 3.4 ounces (100 mL).

Pack formula, expressed breastmilk, or water for mixing with powder separately and be ready to let the TSA know you have it. You may ask that they not go through the x-ray machine (although this shouldn't cause a health problem). Visit the TSA website for more information.

Any tips for keeping my baby comfortable and content on the plane?

Dress your baby in layers. The temperature in a plane can vary widely, especially if you are stuck waiting on a runway. So, dress your baby in layers of clothing. As you pick out clothing , choose outfits that make diaper changing in a small space easier. Also, pack a change of clothes or two, in case turbulence hits during a diaper change or when you are feeding. Bring plastic bags for soiled clothing.

Be ready for ear pain during take-off and landing. During takeoff and landing, changes in pressure between the outer ear and middle ear can cause discomfort. If your baby has had ear surgery or an ear infection in the past two weeks, ask their doctor if it's OK to fly. Having babies drink from the breast or a bottle, or suck on a pacifier, can help. If your child has a cold or ear infection, a dose of acetaminophen or ibuprofen may help; check with your doctor for the right amount to give your child.

Reduce jet engine noise exposure . Airplane cabin noise hovers around 100 decibels, and is even louder during takeoff. Using cotton balls, small earplugs, or noise-canceling headphones may help to decrease the decibel level your baby is exposed to, and also make it easier for them to sleep or relax.

Keep in mind that sleeping babies are easier for everyone. If possible, travel at a time when your baby naturally sleeps. Or, onsider trying to put off a nap until it's time to fly. Flight delays can cause this to backfire if your exhausted baby decides to scream instead of sleep. But it may be worth a try.

Do not use diphenhydramine, or Benadryl, to help your baby sleep without talking to your doctor.

This medication can have serious side effects , especially if repeated doses are given on long flights. If you get the go-ahead and appropriate dose from your doctor, try it at home first. Some children react to the medicine by getting more awake instead of sleepy.

Consider a diaper change right before boarding the plane. A dry baby is a happy baby. Fortunately, when you do need to change a diaper in-flight, many planes have restroom changing tables . If yours doesn't, ask a flight attendant if there is a spot where you can spread out your changing pad. Some parents resort to diaper-changing on the closed toilet seat. If you try this, be sure to have a hand on your baby at all times and pack a disposable changing pad. Plan for delays; pack plenty of supplies.

Bring distractions . Pack some toys and books and be ready to play with your baby the entire time. A tablet with videos can be a good backup if the toys and books aren't helping anymore (we don't encourage entertainment media for children under the age of 2 , but desperate times can sometimes call for desperate measures).

Don't let the glares get to you . Despite the best advanced planning and efforts, babies cry sometimes. Know that you did, and are doing, all you can. At that point, one of the best ways you can calm your baby may be to stay calm yourself. And remember that for every person who is glaring at you, there are plenty of people who have been through it themselves and have lots of sympathy.

Ask for help . Arrange for your airline to help you if you need help making a connecting flight. Carrying a child safety restraint, your baby and luggage through a busy airport can be challenging.

Does my baby need a passport for international travel?

Yes. All U.S. citizens, including infants, need a current passport to travel internationally. Parents or guardians need to apply with their baby in person using the form DS-11 . Be sure to bring your baby's birth certificate and a photo taken within the last 6 months.

Passport photos must be taken with nobody else in the photo, which can be tricky with infants. To do this safely if your baby can't sit up yet , lay them on their back on a plain white blanket or sheet to ensure head support without having to hold them. Another option is covering a car seat with the sheet and taking a picture with your child in it.

What about domestic flights?

A valid passport is usually the only identification your baby will need to fly on a domestic flight, unless you need to show proof of age for a discounted child fare. Check with your airline before you leave. Note: Children under age 18 will not be required to get a Real ID .

What is the best time of day to fly with a baby?

It is hard to say whether flying during the day or night with a baby is better. After the first few weeks, some infants may sleep more reliably at nighttime than they do during naptime travel. If you and your baby can sleep on the plane, a late-night flight may be the way to go.

More information

Travel Safety Tips

Holiday Travel Tips

Flying With Children Safely (FAA.gov)

Tips for Families and Links to Airline Webpages (U.S. Department of Transportation)

Destination-Specific Vaccine Recommendations for Travelers—Including Travelers with Children (CDC.gov)

Flying With a Baby? Here’s What to Know Before You Go

Medical review policy, latest update:, how old should a baby be to fly, read this next, what do children need to fly, tips for flying with an infant.

What to Expect the First Year , 3rd edition, Heidi Murkoff.  WhatToExpect.com, Do Babies Need Passports? , May 2019.  WhatToExpect.com, Should You Bring Your Child’s Car Seat on an Airplane? , August 2021. WhatToExpect.com, Your Ultimate Guide to Traveling While Breastfeeding , August 2020. American Academy of Pediatrics, Family Friendly Flying , November 2015.  American Academy of Pediatrics, Flying With Baby: Parent FAQs , November 2019.   American Airlines, Traveling With Children .  Delta Air Lines, Infant Air Travel , 2021.  Federal Aviation Administration, Flying With Children , March 2021.  Transportation Security Administration, Coronavirus (COVID-19) FAQ .  Transportation Security Administration, Identification .  Transportation Security Administration, Will Minors Need to Have a State ID to Fly Domestically? United Airlines, Traveling With Children , 2021.  U.S. Customs and Border Protection, Children – Child Traveling With One Parent or Someone Who Is Not a Parent or Legal Guardian or a Group , December 2019.

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• Section 7 - Travel & Breastfeeding
• Section 7 - Vaccine Recommendations for Infants & Children

Traveling Safely with Infants & Children

Cdc yellow book 2024.

Author(s): Michelle Weinberg, Nicholas Weinberg, Susan Maloney

Children increasingly are traveling and living outside their home countries. Although data about the incidence of pediatric illnesses associated with international travel are limited, the risks that children face when traveling are likely similar to those faced by their adult travel companions.

Compared with adults, however, children are less likely to receive pretravel advice. In a review of children with posttravel illnesses seen at clinics in the GeoSentinel Global Surveillance Network, 51% of all children and 32% of children visiting friends and relatives (VFRs) had received pretravel medical advice, compared with 59% of adults. The most commonly reported health problems among child travelers are dermatologic conditions, including animal and arthropod bites, cutaneous larva migrans, and sunburn; diarrheal illnesses; respiratory disorders; and systemic febrile illnesses, especially malaria.

Motor vehicle and water-related injuries, including drowning, are other major health and safety concerns for child travelers. See Box 7-03 for recommendations on assessing and preparing children for planned international travel.

Box 7-03 Assessing & preparing children for international travel: a checklist for health care providers

☐ Review travel-related and routine childhood vaccinations. The pretravel visit is an opportunity to ensure that children are up to date on their routine vaccinations.

☐ Assess all anticipated travel-related activities.

☐ Provide preventive counseling and interventions tailored to specific risks, including special travel preparations and any treatment required for infants and children with underlying health conditions, chronic diseases, or immunocompromising conditions.

☐ For children who require medications to manage chronic health conditions, caregivers should carry a supply sufficient for the trip duration.

☐ For adolescents traveling in a student group or program (see also Sec. 9, Ch. 8, Study Abroad & Other International Student Travel ), consider providing counseling on the following:

• Disease prevention
• Drug and alcohol use
• Empiric treatment and management of common travel-related illnesses
• Risks of sexually transmitted infections and sexual assault

☐ Give special consideration to travelers visiting friends and relatives in low- and middle-income countries and assess risks for malaria, intestinal parasites, and tuberculosis.

☐ Consider advising adults traveling with children and older children to take a course in basic first aid before travel.

☐ For coronavirus disease 2019 (COVID-19) safety measures for children—including mask use, testing, and vaccination—see Sec. 5, Part 2, Ch. 3, COVID-19 .

Travel-Associated Infections & Diseases

Arboviral infections.

Pediatric VFR travelers with frequent or prolonged travel to areas where arboviruses (e.g., chikungunya, dengue, Japanese encephalitis, yellow fever, and Zika viruses) are endemic or epidemic could be at increased risk for infection. Children traveling to areas with arboviruses should use the same mosquito protection measures described elsewhere in this chapter (also see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ). Unlike mosquitoes that transmit malaria, the Aedes mosquitoes that transmit chikungunya, dengue, yellow fever, and Zika are aggressive daytime biters; they also bite at night, especially in areas with artificial light. Consider dengue or other arboviral infections in children with fever if they recently returned from travel in endemic areas. Vaccination against dengue, tick-borne encephalitis, and yellow fever could be indicated for some children (see Sec. 7, Ch. 4, Vaccine Recommendations for Infants & Children , for details).

Diarrhea & Vomiting

Diarrhea and associated gastrointestinal illnesses are among the most common travel-related problems affecting children. Infants and children with diarrhea can become dehydrated more quickly than adults. The etiology of travelers’ diarrhea (TD) in children is similar to that in adults (see Sec. 2, Ch. 6, Travelers’ Diarrhea ).

Adults traveling with children should ensure the children follow safe food and water precautions and frequently wash their hands to prevent foodborne and waterborne illness. For infants, breastfeeding is the best way to reduce the risk for foodborne and waterborne illness (see Sec. 7, Ch. 2, Travel & Breastfeeding ). Infant formulas available abroad might not have the same nutritional composition or be held to the same manufacturing safety standards as in the traveler’s home country; parents feeding their child formula should consider whether they need to bring formula from home. If the infant is fed with formula, travelers should consider using liquid formula, which is sterile. Use of powdered infant formula has been associated with Cronobacter infection; infants <3 months old, infants born prematurely, and infants with weakened immune systems are at greatest risk. Parents should take extra precautions for preparing powdered infant formula .

Travelers should disinfect water served to young children, including water used to prepare infant formula (see Sec. 2, Ch. 8, Food & Water Precautions , and Sec. 2, Ch. 9, Water Disinfection , for details on safety practices). In some parts of the world, bottled water could be contaminated and should be disinfected to kill bacteria, viruses, and protozoa before consumption.

Similarly, travelers with children should diligently follow food precautions and ensure foods served to children are cooked thoroughly and eaten while still hot; caregivers should peel fruits typically eaten raw immediately before consumption. Additionally, adults should use caution with fresh dairy products, which might not be pasteurized or might be diluted with untreated water. For short trips, parents might want to bring a supply of safe snacks from home for times when children are hungry and available food might not be appealing or safe (see Sec. 2, Ch. 8, Food & Water Precautions , for more information).

Adult travelers with children should pay scrupulous attention that potable water is used for handwashing and cleaning bottles, pacifiers, teething rings, and toys that fall to the floor or are handled by others. After diaper changes, especially for infants with diarrhea, parents should be particularly careful to wash hands well to avoid spreading infection to themselves and other family members. When proper handwashing facilities are not available, hand sanitizer containing ≥60% alcohol can be used as a disinfecting agent. Because alcohol-based hand sanitizers are not effective against certain pathogens, however, adults and children should wash hands with soap and water as soon as possible. In addition, alcohol does not remove organic material, and people should wash visibly soiled hands with soap and water.

Chemoprophylaxis with antibiotics is not generally used in children; typhoid vaccine might be indicated, however (see Sec. 5, Part 1, Ch. 24, Typhoid & Paratyphoid Fever ).

Antibiotics

Azithromycin.

Few data are available regarding empiric treatment of TD in children. Antimicrobial options for empiric treatment of TD in children are limited. In practice, when an antibiotic is indicated for moderate to severe diarrhea, some clinicians prescribe azithromycin as a single daily dose (10 mg/kg) for 3 days. Clinicians can prescribe unreconstituted azithromycin powder before travel, with instructions from the pharmacist for mixing it into an oral suspension prior to administration. Although resistance breakpoints have not yet been determined, elevated minimum inhibitory concentrations for azithromycin have been reported for some gastrointestinal pathogens. Therefore, counsel parents to seek medical attention for their children if they do not improve after empiric treatment. Before prescribing azithromycin for empiric TD treatment, review possible contraindications and the risks for adverse reactions (e.g., QT prolongation and cardiac arrhythmias).

Fluoroquinolones

Although fluoroquinolones frequently are used for empiric TD treatment in adults, these medications are not approved by the US Food and Drug Administration (FDA) for this purpose in children aged <18 years because of cartilage damage seen in animal studies. The American Academy of Pediatrics (AAP) suggests that fluoroquinolones be considered for treatment of children with severe infections caused by multidrug-resistant strains of Campylobacter jejuni , Salmonella species, Shigella species, or Vibrio cholerae .

Fluoroquinolone resistance in gastrointestinal organisms has been reported from some countries, particularly in Asia. In addition, use of fluoroquinolones has been associated with tendinopathies, development of Clostridioides difficile infection, and central nervous system side effects including confusion and hallucinations. Routine use of fluoroquinolones for prophylaxis or empiric treatment for TD among children is not recommended.

Rifaximin is approved for use in children aged ≥12 years but has limited use for empiric treatment since it is only approved to treat noninvasive strains of Escherichia coli . Children with bloody diarrhea should receive medical attention, because antibiotic treatment of enterohemorrhagic E. coli , a cause of bloody diarrhea, has been associated with increased risk for hemolytic uremic syndrome (see Sec. 5, Part 1, Ch. 7, Diarrheagenic Escherichia coli ).

Antiemetics & Antimotility Drugs

Antiemetics generally are not recommended for self- or family-administered treatment of children with vomiting and TD. Because of the association between salicylates and Reye syndrome, bismuth subsalicylate (BSS), the active ingredient in both Pepto-Bismol and Kaopectate, is not generally recommended to treat diarrhea in children <12 years old. In certain circumstances, however, some clinicians use it off-label, with caution. Care should be taken if administering BSS to children with viral infections (e.g., influenza, varicella), because of the risk for Reye syndrome. BSS is not recommended for children aged <3 years.

Use of antiemetics for children with acute gastroenteritis is controversial; some clinical practice guidelines include the use of antiemetics, others do not. A Cochrane Collaboration Review of the use of antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents showed some benefits with dimenhydrinate, metoclopramide, or ondansetron. Guidelines from the Infectious Diseases Society of America suggest that an antinausea and antiemetic medication (e.g., ondansetron) can facilitate tolerance of oral rehydration in children >4 years of age, and in adolescents with acute gastroenteritis.

A recent systematic review and network meta-analysis comparing several antiemetics in acute gastroenteritis in children showed that ondansetron was the best intervention to reduce vomiting and prevent hospitalization and the need for intravenous rehydration. Routine use of these medications as part of self-treatment for emesis associated with TD in children has not yet been studied, however, and is not generally recommended.

Antimotility drugs (e.g., the opioid receptor agonists loperamide and diphenoxylate), generally should not be given to children <18 years of age with acute diarrhea. Loperamide is particularly contraindicated for children aged <2 years because of the risks for respiratory depression and serious cardiac events. Diphenoxylate and atropine combination tablets should not be used for children aged <2 years, and should be used judiciously in older children because of potential side effects (see Sec. 2, Ch. 6, Travelers’ Diarrhea ).

Fluid & Nutrition Management

The biggest threat to an infant with diarrhea and vomiting is dehydration. Fever or increased ambient temperature increases fluid loss and accelerates dehydration. Advise adults traveling with children about the signs and symptoms of dehydration and the proper use of oral rehydration solution (ORS). Advise adults traveling with children to seek medical attention for an infant or young child with diarrhea who has signs of moderate to severe dehydration, bloody diarrhea, body temperature >101.3°F (38.5°C), or persistent vomiting (unable to maintain oral hydration). Adequate hydration is the mainstay of TD management.

Oral Rehydration Solution: Use & Availability

Counsel parents that dehydration is best prevented and treated by ORS in addition to the infant’s usual food. While seeking medical attention, caregivers should provide ORS to infants by bottle, cup, oral syringe (often available in pharmacies), or spoon. Low-osmolarity ORS is the most effective agent in preventing dehydration, although other formulations are available and can be used if they are more palatable to young children. Homemade sugar-salt solutions are not recommended.

Sports drinks are designed to replace water and electrolytes lost through sweat, and do not contain the same proportions of electrolytes as the solution recommended by the World Health Organization for rehydration during diarrheal illness. Drinks with a high sugar content (e.g., juice, soft drinks) can worsen diarrhea. If ORS is not readily available, however, offer children whatever safe liquid they will take until ORS is obtained. Breastfed infants should continue to breastfeed (for more details, see Sec. 7, Ch. 2, Travel & Breastfeeding ).

ORS can be made from prepackaged glucose and electrolytes packets available at stores or pharmacies in almost all countries. Some pharmacies and stores that specialize in outdoor recreation and camping supplies also sell ORS packets.

ORS is prepared by adding 1 packet to boiled or treated water (see Sec. 2, Ch. 9, Water Disinfection ). Advise travelers to check packet instructions carefully to ensure that the contents are added to the correct volume of water. Once prepared, ORS should be consumed or discarded within 12 hours if held at room temperature, or within 24 hours if kept refrigerated. A dehydrated child will usually drink ORS avidly and should continue to receive ORS if dehydration persists.

As dehydration lessens, the child might refuse the salty-tasting ORS, and adults can offer other safe liquids. An infant or child who has been vomiting will usually keep ORS down if it is offered by spoon or oral syringe in small sips; adults should offer these small sips frequently, however, so the child can receive an adequate volume of ORS. Older children will often drink well by sipping through a straw. Severely dehydrated children often will be unable to drink adequately. Severe dehydration is a medical emergency that usually requires administration of fluids by intravenous or intraosseous routes.

In general, children weighing <22 lb (10 kg) who have mild to moderate dehydration should be administered 2–4 oz (60–120 mL) of ORS for each diarrheal stool or vomiting episode. Children who weigh ≥22 lb (10 kg) should receive 4–8 oz (120–240 mL) of ORS for each diarrheal stool or vomiting episode. AAP provides detailed guidance on rehydration for vomiting and diarrhea.

Diet Modification

Breastfed infants should continue nursing on demand. Formula-fed infants should continue their usual formula during rehydration and should receive a volume sufficient to satisfy energy and nutrient requirements. Lactose-free or lactose-reduced formulas usually are unnecessary. Diluting formula can slow resolution of diarrhea and is not recommended.

Older infants and children receiving semisolid or solid foods should continue to receive their usual diet during the illness. Recommended foods include cereals, fruits and vegetables, starches, and pasteurized yogurt. Travelers should avoid giving children food high in simple sugars (e.g., undiluted apple juice, presweetened cereals, gelatins, soft drinks) because these can exacerbate diarrhea by osmotic effects. In addition, foods high in fat tend to delay gastric emptying, and thus might not be well tolerated by ill children.

Travelers should not withhold food for ≥24 hours. Early feeding can decrease changes in intestinal permeability caused by infection, reduce illness duration, and improve nutritional outcome. Although highly specific diets (e.g., the BRAT [bananas, rice, applesauce, toast] diet) or juice-based and clear fluid diets commonly are recommended, such severely restrictive diets have no scientific basis and should be avoided.

Malaria is among the most serious and life-threatening infections acquired by pediatric international travelers. Pediatric VFR travelers are at particularly high risk for malaria infection if they do not receive prophylaxis. Among people reported with malaria in the United States in 2017, 17% were children <18 years old; 89% had traveled to Africa. Seventy percent of the children who were US residents also were VFR travelers, and 61% did not take malaria chemoprophylaxis.

Children with malaria can rapidly develop high levels of parasitemia and are at increased risk for severe complications of malaria, including seizures, coma, and death. Initial symptoms can mimic many other common causes of pediatric febrile illness, which could delay diagnosis and treatment. Among 33 children with imported malaria diagnosed at 11 medical centers in New York City, 11 (32%) had severe malaria and 14 (43%) were initially misdiagnosed. Counsel adults traveling with children to malaria-endemic areas to use preventive measures, be aware of the signs and symptoms of malaria, and seek prompt medical attention if symptoms develop.

Antimalarial Drugs

Pediatric doses for malaria prophylaxis are provided in Table 5-27 . Calculate dosing based on body weight. Medications used for infants and young children are the same as those recommended for adults, except atovaquone-proguanil, which should not be used for prophylaxis in children weighing <5 kg because of lack of data on safety and efficacy. Doxycycline should not be recommended for malaria prophylaxis for children aged <8 years. Although doxycycline has not been associated with dental staining when given as a routine treatment for some infections, other tetracyclines might cause teeth staining.

Atovaquone-proguanil, chloroquine, and mefloquine have a bitter taste. Mixing pulverized tablets in a small amount of food or drink can facilitate the administration of antimalarial drugs to infants and children. Clinicians also can ask compounding pharmacists to pulverize tablets and prepare gelatin capsules with calculated pediatric doses. A compounding pharmacy can alter the flavoring of malaria medication tablets so that children are more willing to take them. The Find a Compounder section on the Alliance for Pharmacy Compounding website (281-933-8400) can help with finding a compounding pharmacy. Because overdose of antimalarial drugs, particularly chloroquine, can be fatal, store medication in childproof containers and keep out of the reach of infants and children.

Personal Protective Measures & Repellent Use

Children should sleep in rooms with air conditioning or screened windows, or sleep under mosquito nets when air conditioning or screens are not available. Mosquito netting should be used over infant carriers. Children can reduce skin exposed to mosquitoes by wearing long pants and long sleeves while outdoors. Clothing and mosquito nets can be treated with an insect repellent/insecticide (e.g., permethrin) that repels and kills ticks, mosquitoes, and other arthropods. Permethrin remains effective through multiple washings. Clothing and mosquito nets should be retreated according to the product label. Permethrin should not be applied to the skin.

Although permethrin provides a longer duration of protection, recommended repellents that can be applied to skin also can be used on clothing and mosquito nets (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods , for more details about these protective measures). The Centers for Disease Control and Prevention (CDC) recommends using US Environmental Protection Agency (EPA)–registered repellents containing one of the following active ingredients: DEET ( N,N -diethyl- m -toluamide); picaridin; oil of lemon eucalyptus (OLE); PMD (para-menthane-3,8-diol); IR3535; or 2-undecanone (methyl nonyl ketone). Repellent products must state any age restriction; if no age restriction is provided, EPA has not required a restriction on the use of the product. Most EPA-registered repellents can be used on children aged >2 months, except products containing OLE or PMD that specify they should not be used on children aged <3 years. Insect repellents containing DEET, picaridin, IR3535, or 2-undecanone can be used on children without age restriction.

Many repellents contain DEET as the active ingredient. DEET concentration varies considerably between products. The duration of protection varies with DEET concentration; higher concentrations protect longer; products with DEET concentration >50% do not, however, offer a marked increase in protection time.

The EPA has approved DEET for use on children without an age restriction. If used appropriately, DEET does not represent a health problem. The AAP states that the use of products with the lowest effective DEET concentrations (i.e., 20%–30%) seems most prudent for infants and young children, on whom it should be applied sparingly. For more tips on protecting babies and children from mosquito bites , see  Box 7-04 .

Combination products containing repellents and sunscreen are generally not recommended because instructions for use are different, and sunscreen might need to be reapplied more often and in larger amounts than repellent. In general, apply sunscreen first, and then apply repellent. Mosquito coils should be used with caution in the presence of children to avoid burns and inadvertent ingestion. For detailed information about repellent use and other protective measures, see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods .

Box 7-04 Protecting infants & children from mosquito bites: recommendations for travelers

Dress children in clothing that covers arms and legs.

Cover strollers and baby carriers with mosquito netting.

Properly use insect repellent

• Always follow all label instructions.
• In general, do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children <3 years old.
• Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin.
• Adults should spray insect repellent onto their hands and then apply to a child’s face.

Depending on travel destination and activities, animal exposures and bites might be a health risk for pediatric travelers. Worldwide, rabies is more common in children than adults. In addition to the potential for increased contact with animals, children also are more likely to be bitten on the head or neck, leading to more severe injuries. Counsel children and their families to avoid all stray or unfamiliar animals and to inform adults of any animal contact or bites. Bats throughout the world have the potential to transmit rabies virus.

Travelers should clean all bite and scratch wounds as soon as possible after the event occurs by using soap and water, or povidine iodine if available, for ≥20 minutes to prevent infections, (e.g., rabies). Wounds contaminated with necrotic tissue, dirt, or other foreign materials should be cleaned and debrided promptly by health care professionals, where possible. A course of antibiotics might be appropriate after animal bites or scratches, because these can lead to local or systemic infections. For mammal bites and scratches, children should be evaluated promptly to assess their need for rabies postexposure prophylaxis (see Sec. 4, Ch. 7, Zoonotic Exposures: Bites, Stings, Scratches & Other Hazards ; and Sec. 5, Part 2, Ch. 18, Rabies ).

Because rabies vaccine and rabies immune globulin might not be available in certain destinations, encourage families traveling to areas with high risk for rabies exposure to seriously consider preexposure rabies vaccination and to purchase medical evacuation insurance, depending on their destination and planned travel activities (see Sec. 7, Ch. 4, Vaccine Recommendations for Infants & Children , and Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Soil & Water Contact: Infections & Infestations

Children are more likely than adults to have contact with soil or sand, and therefore could be exposed to diseases caused by infectious stages of parasites in soil, including ascariasis, hookworm, cutaneous or visceral larva migrans, strongyloidiasis, and trichuriasis. Children and infants should wear protective footwear and play on a sheet or towel rather than directly on the ground. Clothing should not be dried on the ground. In countries with a tropical climate, clothing or diapers dried in the open air should be ironed before use to prevent infestation with fly larvae.

Schistosomiasis is a risk to children and adults in endemic areas. While in schistosomiasis- endemic areas (see Sec. 5, Part 3, Ch. 20, Schistosomiasis ), children should not bathe, swim, or wade in fresh, unchlorinated water (e.g., lakes, ponds).

Noninfectious Hazards & Risks

Although air travel is safe for most newborns, infants, and children, people traveling with children should consider a few issues before departure. Children with chronic heart or lung problems might be at risk for hypoxia during flight, and caregivers should consult a clinician before travel.

Ear pain can be troublesome for infants and children during descent. Pressure in the middle ear can be equalized by swallowing or chewing; thus, infants should nurse or suck on a bottle, and older children can try chewing gum. Antihistamines and decongestants have not been shown to be of benefit. No evidence suggests that air travel exacerbates the symptoms or complications associated with otitis media.

Travel to different time zones, jet lag, and schedule disruptions can disturb sleep patterns in infants and children, just as in adults (Sec. 8, Ch. 4, Jet Lag ).

Safety Restraints

Travelers also should ensure that children can be restrained safely during a flight. Severe turbulence or a crash can create enough momentum that an adult cannot hold onto a child. The safest place for a child on an airplane is in a government-approved child safety restraint system (CRS) or device. The Federal Aviation Administration (FAA) strongly urges travelers to secure children in a CRS for the duration of the flight. Car seats cannot be used in all seats or on all planes, and some airlines might have limited safety equipment available. Travelers should check with the airline about specific restrictions and approved child restraint options. FAA provides additional information .

Altitude Illness & Acute Mountain Sickness

Children are as susceptible to the deleterious effects of high elevation travel as adults (see Sec. 4, Ch. 5, High Elevation Travel & Altitude Illness ). Slow ascent is the preferable approach for avoiding acute mountain sickness (AMS). Young children unable to talk can show nonspecific symptoms (e.g., loss of appetite or irritability, unexplained fussiness, changes in sleep and activity patterns). Older children might complain of headache or shortness of breath. If children demonstrate unexplained symptoms after an ascent, descent could be necessary.

Acetazolamide is not approved for pediatric use in children aged <12 years for altitude illness but is generally safe for use in children for other indications. Some providers prescribe acetazolamide to prevent AMS in pediatric travelers <12 years of age when a slow ascent is not feasible. The dose is 2.5 mg/kg every 12 hours, up to a maximum of 125 mg per dose, twice a day. No liquid formulation is available, but tablets can be crushed or packaged by a compounding pharmacy for a correct dose.

Drinking Water Contaminants

Drinking water disinfection does not remove environmental contaminants (e.g., lead or other metals). Travelers might want to carry specific filters designed to remove environmental contaminants, particularly for travel where the risk for exposure is greater due to larger amounts of water consumed (e.g., long-term travel or when living abroad). Filters should meet National Science Foundation (NSF) and American National Standards Institute (ANSI) standards 53 or 58 .

Accommodations: Hotels & Other Lodgings

Conditions at hotels and other lodgings abroad might not be as safe as those in the United States; adults traveling with children should carefully inspect accommodations for paint chips, pest poisons, inadequate balcony or stairway railings, or exposed wiring.

Adult caregivers should plan to provide a safe sleeping environment for infants during international travel. Caregivers should follow general recommendations from the AAP task force on preventing sudden infant death syndrome (SIDS) and other sleep-related causes of infant death. Cribs in some locations might not meet US safety standards. Additional information about crib safety is available from the US Consumer Product Safety Commission .

Motor Vehicles

Vehicle-related injuries are the leading cause of death in children who travel. Whenever traveling in an automobile or other vehicle, children should be properly restrained in a car seat, booster seat, or with a seat belt, as appropriate for their age, height, and weight. See information about child passenger safety . Car seats often must be brought from home because well-maintained and approved seats might not be available (or limited in availability) in other countries.

In general, children ≤12 years of age are safest when properly buckled in the rear seat of the car while traveling; no one should ever travel in the bed of a pickup truck. Advise families that cars might lack front or rear seatbelts in many low- and middle-income countries. Traveling families should attempt to arrange transportation or rent vehicles with seatbelts and other safety features.

All family members should wear helmets when riding bicycles, motorcycles, or scooters. Pedestrians should take caution when crossing streets, particularly in countries where cars drive on the left, because children might not be used to looking in that direction before crossing.

Water-Related Injuries & Drowning

Drowning is the second leading cause of death in young travelers. Children might not be familiar with hazards in the ocean or in rivers. Swimming pools might not have protective fencing to keep toddlers and young children from accessing pool areas unattended. Adults should closely supervise children around water. An adult with swimming skills should be within an arm’s length when infants and toddlers are in or around pools and other bodies of water; even for older children and better swimmers, the supervising adult should focus on the child and not be engaged with any distracting activities.

Water safety devices (e.g., personal flotation devices [lifejackets]) might not be available abroad, and families should consider bringing these from home. In addition, adults should ensure children wear protective footwear to avoid injury in many marine environments.

Sun Exposure

Sun exposure, and particularly sunburn before age 15 years, is strongly associated with melanoma and other forms of skin cancer (see Sec. 4, Ch. 1, Sun Exposure ). Exposure to ultraviolet (UV) light is greatest near the equator, at high elevations, during midday (10 a.m.–4 p.m.), and where light is reflected off water or snow.

Physical, also known as inorganic, UV filters (sunscreens) generally are recommended for children aged >6 months. Less irritating to children’s sensitive skin than chemical sunscreens, physical UV filters (e.g., titanium oxide, zinc oxide) should be applied as directed and reapplied as needed after sweating and water exposure. Babies aged <6 months require extra protection from the sun because of their thinner and more sensitive skin; severe sunburn in young infants is considered a medical emergency.

Advise parents that babies should be kept in the shade and dressed in clothing that covers the entire body. A minimal amount of sunscreen can be applied to small, exposed areas, including the infant’s face and hands. For older children, sun-blocking shirts made for swimming preclude having to apply sunscreen over the entire trunk. Hats and sunglasses also reduce sun injury to skin and eyes.

If both sunscreen and a DEET-containing insect repellent are used, apply the sunscreen first and the insect repellent second (i.e., over the sunscreen). Because insect repellent can diminish the level of UV protection provided by the sunscreen by as much as one-third, children should also wear sun-protective clothing, reapply sunscreen, or decrease their time in the sun, accordingly.

Other Considerations

Identification.

In case family members become separated, each infant or child should carry identifying information and contact numbers in their clothing or pockets. Because of concerns about illegal transport of children across international borders, parents traveling alone with children should carry relevant custody papers or a notarized permission letter from the other parent.

As with adult travelers, verify insurance coverage for illnesses and injuries while abroad before departure. Travelers should consider purchasing special medical evacuation insurance for an airlift or air ambulance transport to facilities capable of providing adequate medical care (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Travel Stress

Changes in schedule, activities, and environment can be stressful for children. Travelers can help decrease these stresses by including children in planning for the trip and bringing along familiar toys or other objects. For children with chronic illnesses, make decisions regarding timing and itinerary in consultation with the child’s health care providers.

The following authors contributed to the previous version of this chapter: Michelle S. Weinberg, Nicholas Weinberg, Susan A. Maloney

Bibliography

Ashkenazi S, Schwartz E. Traveler’s diarrhea in children: new insights and existing gaps. Travel Med Infect Dis. 2020;34:101503.

Fedorowicz Z, Jagannath VA, Carter B. Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents. Cochrane Database Syst Rev. 2011;2011(9):CD005506.

Goldman-Yassen AE, Mony VK, Arguin PM, Daily JP. Higher rates of misdiagnosis in pediatric patients versus adults hospitalized with imported malaria. Pediatr Emerg Care. 2016;32(4):227–31.

Hagmann S, LaRocque R, Rao S, Jentes E, Sotir M, Brunette G, et al.; Global TravEpiNet Consortium. Pre-travel health preparation of pediatric international travelers: analysis from the Global TravEpiNet Consortium. J Pediatric Infect Dis Soc. 2013;2(4):327–34.

Hagmann S, Neugebauer R, Schwartz E, Perret C, Castelli F, Barnett ED, et al. Illness in children after international travel: analysis from the GeoSentinel Surveillance Network. Pediatrics. 2010;125(5):e1072–80.

Han P, Yanni E, Jentes E, Hamer D, Chen L, Wilson M, et al. Health challenges of young travelers visiting friends and relatives compared with those traveling for other purposes. Pediatr Infect Dis J. 2012;31(9):915–9.

Herbinger KH, Drerup L, Alberer M, Nothdurft HD, Sonnenburg F, Loscher T. Spectrum of imported infectious diseases among children and adolescents returning from the tropics and subtropics. J Travel Med. 2012;19(3):150–7.

Hunziker T, Berger C, Staubli G, Tschopp A, Weber R, Nadal D, et al. Profile of travel-associated illness in children, Zurich, Switzerland. J Travel Med. 2012;19(3):158–62.

Mace K, Lucchi N, Tan K. Malaria surveillance—United States, 2017. MMWR Surveill Summ. 2021;70(2):1–40.

Niño-Serna LF, Acosta-Reyes J, Veroniki AA, Florez ID. Antiemetics in children with acute gastroenteritis: a meta-analysis. Pediatrics. 2020;145(4):e20183696.

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Safety When Traveling With a Newborn

Jaunty Junto / Digital Vision / Getty Images

While you can travel with a newborn baby, including airplane travel , it doesn't mean that you should . A lot depends on your baby's age and health. Generally, travel before one week old is not recommended and many doctors will also advise you to limit travel for several months. Using caution is not about the oxygen levels, the pressurized cabin on the plane, or the effects of high altitude. There is no proven connection between airplane travel and SIDS .

Instead, most experts advise limiting newborns' and younger infants' exposure to large groups of people so that they don't get sick. Traveling through an airport , onto an airplane (or two), through another airport (or two), and then visiting a lot of people—even if they are family members—exposes your baby to viral illnesses and other infections. This exposure is the main issue to consider when you travel with a baby, especially by air.

Vaccine-preventable diseases are also a concern at this age, as babies haven't had time to get vaccines and be fully protected against these illnesses. From measles and pertussis to the flu, it isn't a good idea to expose a newborn baby or young infant to these diseases unnecessarily, whether in an airport or at your destination. Traveling by bus or train would also expose your baby to many unfamiliar people and diseases.

Air Travel With a Baby

If you do plan to fly, check with your pediatrician to get clearance as well as the carrier that you are using. Each airline has its own policy. American Airlines, for example, allows babies as young as two days old to fly, but babies one week old and younger must have a medical form completed by a physician.

Keep in mind that travel could be stressful for both a new mom and a brand-new baby, especially if a flight is delayed or canceled. Add to that all the supplies that you need for your newborn, including clothes, diapers, bottles, and of course, a car seat for the plane.

Sometimes travel is essential, such as if you have adopted a baby and need to get back home. Otherwise, according to the American Academy of Pediatrics (AAP), it might be best to wait to fly until your baby is two to three months old and has a more mature immune system and a more predictable schedule.

If you fly with a baby, ideally:

• Be prepared for everything (delays, diaper disasters, minor illnesses)
• Bring some help with you (as in another adult or teen)
• Bring your baby's birth certificate as proof of age
• Fly during an off-peak time
• Get a nonstop flight
• Get your pediatrician's opinion before you go

Driving With a Baby

Driving is better than flying with a newborn since the baby is exposed to far fewer people. However, driving can still be stressful. Especially on a longer trip, you will have to stop every few hours for feedings , diaper changes , and simply to comfort your baby. As well, parents of a newborn are likely going to be a little sleep-deprived, which is not the best condition to drive a long distance.

If you do go on a road trip, it's essential that your baby is in a safe, rear-facing car seat while the car is in motion. If your baby falls asleep in the car seat, but sure that they have proper airflow around their face and that you are routinely checking on them.

The bottom line is that, unless you have a well-rested driver, you should aim to put off traveling until your newborn is a little older unless travel is essential.

American Academy of Pediatrics. Flying with babies: parent FAQs .

Sohail MR, Fischer PR. Health risks to air travelers . Infect Dis Clin North Am . 2005;19(1):67-84. doi:10.1016/j.idc.2004.10.001

American Airlines. Traveling with children .

Insana SP, Montgomery-Downs HE. Sleep and sleepiness among first-time postpartum parents: a field- and laboratory-based multimethod assessment .  Dev Psychobiol . 2013;55(4):361-372. doi:10.1002/dev.21040

American Academy of Pediatrics. Car seats: information for families .

Weinberg MS. Vaccine Recommendations for Infants & Children . CDC Health Information for International Travel (Yellow Book). 2016 edition.

By Vincent Iannelli, MD Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.

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Karl Neumann; Air travel safe for healthy newborns when parents take precautions. AAP News March 2002; 20 (3): 134–135. 10.1542/20.3.134

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Healthy newborn infants can travel safely by air. Physiologically, they are fit to fly. And major airlines have removed all restrictions that formerly banned such travel in the first few weeks of life. The restrictions stemmed from the early days of aviation and were based on the facts that the aircraft of that day were not pressurized, that oxygen was sometimes required during flights, and that little was known about newborn physiology and how infants would fare in flight. The old regulations often are still cited in travel medicine, pediatric literature and the lay press.

Dr. Neumann

Present day commercial jet airliners generally cruise at altitudes between 30,000 and 40,000 feet. The aircraft are not totally pressurized, resulting in a simulated cabin atmospheric pressure of between 5,000 and 8,000 feet. At this atmospheric pressure, the arterial blood oxygen saturation of healthy passengers of all ages decreases from near 100% at sea level to about 90% to 92%, a saturation level that is well tolerated by healthy newborns and infants. (And also is well tolerated by older children and adults. Passengers, for the most part, sit and do not exert themselves. Even flight attendants who push heavy carts up and down the aisles rarely become short of breath.) The oxygen dissociation curve is very helpful in maintaining oxygen saturation at a high level at all ages. Healthy newborns have well-developed lungs and usually have high hemoglobin levels, which may be an additional safety factor.

When contacted by phone, the seven largest U.S. airlines and the four largest foreign airlines that serve the United States indicated they do not have lower age restrictions for infants to travel by air. Four of the U.S. airlines suggest that parents of infants less than a week old “check with their doctor,” or “have a note from a doctor” saying that the infant is in good health. However, such a note is rarely, if ever, asked for by check-in and boarding gate attendants. Other information that spokespeople and reservation agents read from their computer listing include: only one infant per row because of oxygen mask considerations; parents should consider using an infant safety seat; and exposure to infection aboard the aircraft could be a problem for infants of this age. Nevertheless, airline rules change frequently, and parents should consult airlines shortly prior to travel.

Air travel may not be safe for an infant with severe anemia, congenital heart disease (especially abnormalities of the right side of the heart) and poorly or abnormally developed lungs. It is important to note that some of these conditions may not be present or recognized at birth, and may become symptomatic during flight or while the family is visiting a high altitude destination. Children and adults with sickle cell disease, for example, may do poorly at the atmospheric pressure existing at cruising altitudes, but infants with this condition may not be symptomatic in the first few months of life.

Individuals with sickle cell trait generally have no problems, but there appears to be rare exceptions, and the parents of such children should be aware that their child could become symptomatic. Despite one article in a major medical journal stating that a history of recent air travel is a risk factor for SIDS ( BMJ . 1998 ; 316 : 873 -874 ), the consensus of experts is that there is no such association.

There are no data to determine whether newborns and infants are at increased risk of infectious diseases during air travel. Many adult frequent flyers claim that they experience more upper-respiratory infections after flights than at other times. Speculation implicates prolonged and close togetherness in an enclosed space, recirculating cabin air, exposure to travelers from distant parts of the world where different strains of organisms circulate, changes in the immune system due to the stresses of travel, and the extreme dryness in the cabin air. Dry air results in a lack of moisture in the nasal passages. This may facilitate organisms passing through. Saline nose drops may alleviate this.

There are several documented cases of adults acquiring tuberculosis during long flights and acquiring influenza in an aircraft standing on the tarmac for many hours with no operational ventilation system. In one tuberculosis incident, the passengers who acquired the disease were all sitting near an infected, heavily coughing passenger. The U.S. Centers for Disease Control and Prevention believes that such incidents are exceedingly rare.

Currently, there is debate about air quality in the aircraft cabin. In recent years, to save fuel, airlines have changed the method of supplying air to aircraft in flight. Under the old system, air was exchanged every few minutes. Under the new system, half the air in the cabin is passed through sophisticated systems and re-circulated. The result is that the air that passengers breathe is about half re-circulated air.

Fresh air is taken in from the outside and is virtually sterile; there are no microorganisms in the air at 30,000 feet. Moreover, the outside air passes through the very hot engines killing any organisms, and is then cooled. This is a very expensive process. Recirculated air passes through sophisticated filters, making it virtually as microorganism-free as fresh air. But some experts question whether the filters in use eliminate all viruses. The consensus appears to be that the risk of acquiring infection in-flight is small but that it does exist.

Parents have few options for protecting their infants from risks of exposure to microorganisms in flight. These options are largely unproven and impractical, and include:

• flying at off-hours when there tend to be fewer passengers;

• traveling first class where there is less crowding and, therefore, more air per passenger;

• flying early in the day when aircraft are cleaner;

• changing seats when a nearby passenger coughs and sneezes;

• washing hands frequently ; and

• bringing one’s own pillow or headrest cover.

Aircraft are cleaned thoroughly only before the first flight of the day. Presumably, the air in the morning is cleaner. On most airlines, pillows and headrests are replaced only at the time of that cleaning. Lately, many major airlines exchange pillows and blankets only when they are visibly soiled — sometimes once every several weeks.

Dr. Neumann is a member of the AAP Section on International Child Health.

Article reprinted with permission from the section newsletter.

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How Old Does a Baby Have to Be to Fly?

Although babies can fly soon after birth, parents should consider various health and safety concerns first.

The truth is that flying with an infant can be a breeze—if your baby sleeps or coos happily the whole way. But the experience can also be closer to a nightmare if your baby ends up crying the entire time, turbulence makes holding them a challenge, or they have a diaper blowout mid-flight. And you might not know which way it will go until you're 30,000 feet up in the air.

But having a newborn doesn't necessarily need to hinder your travel plans. Whether you're visiting grandma or going on vacation, there are some factors to consider before bringing a baby on an airplane. Here's how old a baby needs to be to fly, with tips for making the plane ride go smoothly.

How Old Does a Baby Need to Be to Fly?

Most pediatricians believe that a 4- to 6-week-old baby can handle airplane flights. But this guidance only refers to babies with no health complications who get the go-ahead from a pediatrician. Premature infants, as well as those with respiratory or other health issues, may fare better on the ground. (What's more, doctors may recommend a longer rest period for new parents who had delivery complications or C-sections ).

It's also smart to check your airline's policies on newborn travel. They might have a minimum age requirement, ranging from 2 days old to 2 weeks old . In some cases, newborns won't be granted permission to fly without a doctor's note. You might also need proof of your baby's age. (If official government paperwork hasn't arrived, you could possibly use vaccination or hospital forms.) International travel isn't possible until your baby receives an official passport.

If you're feeling queasy about the idea of spending a whole lot of money on an airline ticket for a baby, ask your airline for a discounted fare. Many airlines offer discounts of up to 50% for children under age 2. Also, if there's an open seat on the plane at the time of boarding, you may be able to use it for your baby.

Considerations for Newborn Air Travel

Although air travel is generally safe for newborns, the American Academy of Pediatrics (AAP) recommends that parents consider the following factors before booking their flight.

Germs and illness

While some older planes use recirculated air, which means that if one person has a cold, their germs are broadcast throughout the plane by the ventilation system, most commercial aircraft use sophisticated methods to refresh the air. Advanced airflow management techniques, including air filtration, ventilation, controlling the movement of the air downwards (rather than side-to-side), and drawing in fresh air from outside, all contribute to reducing the transmission of airborne illnesses between passengers.

In fact, in a 2021 letter published in Travel Medicine and Infectious Disease the authors wrote that "the air quality within modern commercial aircraft is enhanced by frequent air changes, with a complete air change every 2 to 4 minutes." The consensus among the authors was that there is a low risk of getting sick from other passengers, particularly those sitting more than a few rows away.

Other research has also found a low risk of transmission of airborne illnesses (specifically COVID-19) on airplanes: "Altogether, high airflow and use of HEPA filters onboard planes make it unlikely to catch the virus from someone who is not in the immediate vicinity."

However, if someone sitting nearby is sick, your baby could be exposed. That's not typically a problem for healthy adults, whose mature immune systems can more easily fight off germs. But an infant's immune system is no match for some of the viruses and bacteria that may be floating around on airplanes and in airports. If you do fly, make sure to wash your hands regularly, and avoid sitting near sick passengers.

Air pressure and ears

Ordinary cabin pressurization can cause intense pain in infants' ears. This can be helped, somewhat, by having the baby suck or drink during ascent and descent, says Dr. Berger. Offer your baby your breast, a bottle, or pacifier during take off and landing to help.

Breathing problems

Since airplanes have lower air pressure, some babies may have trouble breathing—especially if they were born premature or have heart, lung, or respiratory issues. If your baby fits the bill, talk to your doctor for more information about when it's safe for them to fly.

Fussy behavior

The unfamiliar setting of an airplane with its smells, sounds, and lights, as well as painful ear pressure, may lead to screaming, crying, and general fussiness . Make sure you're prepared to handle the worst.

Changing diapers

Most commercial airplanes have changing tables in at least one of their restrooms. However, not all do, such as smaller planes for shorter flights. Either way, you can't always get up to change your baby's diaper when needed, particularly during takeoff, landing, and times of turbulence.

And as new parents know, you can't always predict when you'll need to change a baby's diaper. So, be sure to change them right before boarding. And bring extra diapers and changes of clothes—you just might need them.

Where Should My Baby Sit?

According to the Federal Aviation Administration (FAA) , it's ideal to opt for window seats for babies. Aisle and middle seats put them at greater risk of items falling on them from the baggage compartments above, getting knocked into by people or carts rolling through the aisle, or hot drinks spilling on them (that are passed over them to people sitting closer to the window).

Sometimes, people purchase a separate seat for their baby or end up with an extra seat they can use, but often parents have their baby in their arms, sitting on their lap, or in a baby carrier (nevertheless, airlines do require your child be added to your ticket even if they will be in your lap for the entire flight). This option makes sense because it can save you money—and provides comfort to your baby during the flight. Also, holding them provides easy access for breastfeeding (yes, you can breastfeed on a plane ) or bottle-feeding.

However, there are some safety concerns about holding a baby on your lap while you fly. While the expense is a big consideration, if possible, it's recommended for your baby to sit in their own seat in a car seat approved for air travel.

Do they need their own seat?

Airlines allow babies and young children to ride on a parent's lap for no fee, but that's not the safest place for them if the plane hits turbulence, has to make an emergency landing, or if you're trying to sleep. The FAA strongly recommends that parents secure children in an appropriate restraint, if possible. Most car seats fit the bill (though not all are approved for use during air travel).

Before you fly, check your car seat for a label that identifies it as certified for use in planes. If there is no label, look at the seat's instructions or contact the manufacturer. A car seat should fit into most airplane seats if the car seat is no wider than 16 inches. If you have questions about whether your car seat will fit, call the airline and ask or check their website.

The risks of holding a baby on your lap in-flight

While in-flight deaths in healthy children are exceedingly rare, a 2014 study found a pattern among children who died during air travel during the study period. The study tracked recorded incidents of thousands of medical emergencies on airlines from 2010 to 2013. During that period, there were 10 pediatric deaths. Several were healthy children under the age of 2 who were sitting in an adult's lap during a commercial airline flight.

While this study is the first of its kind, research suggests that lap infants were at a greater risk of dying than those in their own seat, possibly due to in-flight environmental factors, such as sharing a seat with an adult and potentially dangerous co-sleeping arrangements, says Alexandre Rotta, M.D. , lead researcher on the study, a pediatrician, and professor of pediatrics at Duke University School of Medicine in Durham, North Carolina.

More research is needed to explain these deaths but it is possible that lower oxygen levels on planes could harm infants' immature respiratory systems. "What was unexpected was the number of healthy lap infants who ended up dead. It's a rare event but this is clearly a pattern," says Dr. Rotta. The study authors also noted that there could be another factor that is causing these deaths that has yet to be identified.

The Bottom Line

Once your baby is cleared for air travel by their pediatrician, it is relatively safe to fly with them. Often, flights with little ones go better than expected. That said, many a baby put their parents through the wringer while they fly. But even if your baby cries, spits up, or badly needs a diaper change or a bath, know that many people on board are sending you positive vibes. Just about every other parent has been there. So, you got this—and soon enough, you'll get where you're going and be back on land.

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Home / Parenting, Kids & Teens / Air travel with an infant

Air travel with an infant

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Your first flight with your child will likely be a lot different from your previous flights. Instead of worrying about whether you have enough reading material, you may now be worried about entertaining your baby or toddler. While there’s no telling how your baby will react to his or her first time on an airplane, careful planning can go a long way toward calming you and your child’s nerves.

Identification

  For domestic travel, consider bringing a copy of your child’s birth certificate with you. If leaving the country, your child will need a passport. If you know you’ll be traveling outside of the country with your child in the future, consider applying as soon as possible. The application process can typically be expedited for a fee.

Seat safety

  Although airlines typically allow infants to ride on a caregiver’s lap during flight, the Federal Aviation Administration recommends that infants ride in properly secured safety seats. Most infant car seats are certified for air travel.

  In order for your little one to travel in a car seat on the plane, your child will need his or her own seat. Though airlines typically will let you use an empty seat if available, the only way to guarantee a seat for your child is to purchase a ticket. When booking your flights, check if there are any discounts for infant children.

Keep in mind that car seats must be secured in a window seat so other passengers will be able to exit the row. If you purchase a seat for your child, FAA strongly encourages that your child remains in the seat with the seatbelt firmly fastened during the duration of the flight. This can be a challenge if your child is crying and you want to hold him or her, especially during takeoff and landing. Airlines typically allow a child under 2 to be held on your lap, but the policy varies by airline.

If you don’t bring a car seat for your child on the plane, ask the flight attendant for instructions on how to hold your child during takeoff and landing. If you sit in an aisle seat with your child, be sure to protect your child’s head, hands and feet from getting bumped by service carts or other passengers.

Many traveling families seek out the bulkhead of the plane, which offers extra space. Others prefer the back of the plane, which is typically noisy enough to drown out crying and may even lull a baby to sleep. Do what makes the most sense to you.

Getting through the airport

If you plan to bring a car seat on the plane, a stroller that allows you to attach the car seat to it is a smart investment. You’ll be able to wheel your child in his or her car seat until you board the plane, at which point you can collapse the stroller base and check it at the gate. You will, however, have to take your child out of a car seat and carry him or her through security while the stroller is screened.

While the Transportation Security Administration limits the amount of fluids you can bring on a plane, exceptions are made for baby-related items, such as medications, formula, baby food and breast milk. Be sure to notify security officials about what you’re carrying and expect it to be inspected. Also, let security officials know if your child is using or has any special medical devices.

Many airlines offer families priority boarding. However, some families prefer to board last to minimize the amount of time spent on the plane.

Keeping baby happy

Dress your child in comfortable, easy-to-remove layers. This will help you keep him or her warm or cool enough and make diaper and clothing changes easy.  Bring extra clothing in a plastic, sealable bag for accidents that might occur or if your child becomes sick and vomits on the plane. Consider bringing an extra change of clothing accessible for yourself, too, in case you’re part of the accident.

Nursing or sucking on a pacifier or bottle might ease discomfort during takeoff and landing, since babies can’t intentionally “pop” their ears by swallowing or yawning to relieve ear pain caused by air pressure changes. Having extra pacifiers on hand will be helpful in case the pacifiers fall or get lost. A sippy cup of water can help a toddler with the same issue.

If your child is restless, consider taking an occasional break to walk up and down the aisle — as long as the crew approves moving throughout the cabin.

If your child is old enough to snack, have different types of snacks available and bring them out at different times during the flight. Also, consider bringing several little toys to keep your child occupied, introducing a new toy as your baby’s interest in the current toy wanes.

Although parents often joke about giving a child a sedating over-the-counter medication to induce sleep during the flight, this isn’t recommended. In some cases, the medication could end up producing the opposite effect and make your child agitated.

If your child does cry during the flight, do your best to figure out what’s wrong — just as you would at home — and try to stay calm. Chances are that many passengers on the plane have been in your situation before and likely sympathize.

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Flying with a baby: 15 tips for an easier trip

Planning on flying with a baby? Here's everything you need to know, including whether your baby can fly for free and tips for managing the flight.

How old does a baby need to be to fly?

Do babies fly free, what do babies need to fly, 15 tips for flying with a baby.

Flying with a baby adds a layer of complication and planning – but that doesn't mean you can't make it work. To help the trip go as smoothly as possible, book a seat for your baby, plan for the security screening, and pack wisely for you and your little one. For everything even the most seasoned travelers need to know about air travel with a baby , read on.

Planning a flight with a newborn? There isn't an official age requirement for air travel , but airlines have varying policies. Some (such as Alaskan Airlines) have no minimum age to fly; others (American Airlines, JetBlue) say babies can fly as young as two or three days old; and still others (Delta, United, Spirit, Frontier) allow babies on board after the first week of life.

Less commonly, airlines will require infants to be slightly older. Southwest, for example, says children must be at least 14 days old for an international flight. Check with your airline to confirm their policy before booking a ticket for your little one.

However, the American Academy of Pediatrics Opens a new window (AAP) discourages parents from flying with a baby too soon after birth. With their delicate immune systems, newborns have a heightened risk of contracting an infectious disease on a plane. That's especially true if your baby was born prematurely or has a condition such as a chronic heart problem that makes them more vulnerable.

Always discuss your travel plans with your pediatrician and ask what they recommend. Depending on your baby's age and your destination, they might suggest an extra dose of certain vaccines .

Babies and toddlers under 2 years old aren't legally required to occupy an airplane seat and can instead travel as a "lap infant" on their parent's ticket. Lap infants are generally free of charge, although you may pay a percentage of the full fare if you're traveling internationally .

Even though you don't officially need to purchase a ticket for your under-2-year-old, leading experts agree that it's much safer to buy an airplane seat for your baby. That's because a baby held in your arms is nowhere near as secure as they'd be buckled into an approved child restraint system should the plane encounter turbulence.

Unrestrained children are the leading cause of pediatric injuries on an airplane, and lap infants have tragically been killed during even moderate turbulence. Although it can be upsetting to think about, human arms are simply not strong enough to hold a child in these events. That's why the American Academy of Pediatrics (AAP), the Federal Aviation Administration (FAA) Opens a new window , and the  National Transportation Safety Board (NTSB) Opens a new window all strongly urge parents to purchase an airplane seat for young children.

If you book a seat for your baby or toddler, bring an FAA-approved child restraint on board to strap them in safely. You can use a car seat on a plane (make sure it's approved for both motor vehicles and aircraft) or AmSafe's Child Aviation Restraint System (CARES) device Opens a new window .

Although it can be tough to swallow the additional cost, a baby or toddler in their own seat has other benefits in addition to safety: They're more comfortable during the flight, easier to manage, and more likely to fall asleep, many parents find.

This depends a little on your child's age, the airline you're flying, and whether you're traveling within the United States or internationally.

For domestic travel, the Transportation Security Administration (TSA) Opens a new window doesn't require children under 18 to provide identification. However, it's still smart to check your airline's identification requirements. Some (JetBlue, Alaska Airlines) may ask for an infant's proof of age for domestic flights, which could be a birth certificate, passport, or immunization record.

Other airlines, such as Southwest, might not ask for proof of age but may require you to have a boarding verification document printed for your infant from the ticket counter even if they aren't occupying their own seat. When in doubt, it doesn't hurt to have some extra documentation for your baby just in case.

If you're flying internationally, your baby will need a passport regardless of their age. And if your baby is flying internationally with just one parent, you might be asked to show a letter of consent.

1. Check in with your airline

Regardless of whether you're flying with a lap infant or purchasing a seat for your baby, it's worth connecting with the airline ahead of time to discuss your seating options. A few things to consider bringing up with the agent:

If you're going the lap infant route : Ask the airline if there's an option to reserve a seat in a row with a skycot. These onboard bassinets are designed for babies 6 months and younger and provide a place for your baby to lie down flat during the flight (though you will need to pick them up whenever the seatbelt sign is on, as well as during takeoff and landing). Also confirm whether there are any rules about how many lap infants are permitted per row or section. Alaska Airlines, for example, has a policy Opens a new window stipulating where lap infants can sit on certain aircrafts.

If you're booking your baby their own seat and bringing a car seat : Some airlines require that car seats be placed next to a window so they don't block other passengers. A bulkhead row can also be nice to request when traveling with a car seat since it provides extra legroom. Just keep in mind that in the bulkhead row, it's sometimes trickier to access bags that might contain diapers, milk, and anything else you might need. Because there's no seat in front of you to stash your personal item under, you'll likely be asked to place it in the overhead compartment.

2. Ask whether your child is eligible to earn points

When booking a seat for your child, look into the airline's loyalty program. Some, though not all, will allow children to earn points that you can use towards future travel. Take  JetBlue Opens a new window , which lets parents enroll children 13 and younger in their TrueBlue account. You can then combine points earned within the family through the airline's Points Pooling program.

3. Confirm that your car seat is FAA-approved

If you've bought an airplane seat for your baby, bring an FAA-approved car seat for your child. This is the safest way for babies to fly, plus it ensures you'll have a car seat for your baby at your destination. It's likely that your child's existing car seat is approved for airline travel, but check the product manual or look for a label that says "This restraint is certified for use in motor vehicles and aircraft" to make sure.

If you didn't buy a ticket for your baby, you might get lucky and be able to use the car seat if there are empty seats on board, but there are no guarantees with this approach.

4. Consider your stroller strategy

If you're traveling with a baby or toddler, chances are good that you'll be bringing your stroller along, too. Families have three options when flying with a stroller:

Check it at the ticket counter: If you want a stroller at your destination but don't need it in the airport, you can check it along with your baggage when you arrive. (Note that some airlines always require you to check a stroller at the ticket counter if it weighs over a certain amount.) A stroller usually doesn't count towards your checked baggage, and many airlines allow families to check one stroller and one car seat per child for no extra cost. If you do check a stroller when you arrive at the airport, you may want to use a baby carrier to get your baby to your gate.

Gate-check your full-size stroller: The benefit of gate-checking a stroller is that you have it with you while navigating the airport, which many families find helpful. Waiting in a long security line or racing to the gate with a small child in tow is often much easier with the support of a stroller. Plus, you can use the stroller's storage basket to stash some of your stuff. The downside is that you'll have to wait for your stroller to be unloaded once you arrive, which can slightly prolong the process of getting out of the airport.

Bring along a stroller that will fit in the overhead bin: If you'd prefer not to gate-check your stroller, consider investing in a lightweight travel stroller. Some are compact enough to fit in most overhead compartments when collapsed (though you can check your airline's carry-on bag size guidelines to be sure). Their smaller size can be convenient for travel, and it's also nice not to have to wait for a gate-checked stroller to be brought back up when you land.

5. Look into your baggage options

Airlines have different baggage policies, but call ahead of time to understand exactly what you can bring on board. For example, while lap infants are generally not entitled to their own carry-on bags, many airlines allow families traveling with a child to bring a diaper bag, a breast pump , a cooler bag for milk or formula, an FAA-approved car seat, and a compact stroller onboard in addition to the regular carry-on and personal item allowance.

6. Pack smart

Packing for a baby is an art form: You need to have access to all the essentials, but you also don't want to overpack and have to rummage through a big bag to find something you need.

Consider what you'll want to have access to during the flight and pack your bags accordingly. For example, it's helpful to have a bag with diapers, wipes, disposable changing mats, disposable diaper bags, and a change of clothes at easy reach. For more ideas, check out our suggested packing list for traveling with a baby .

Definitely pack more spare clothes for your baby than you'll think you'll need – and include a fresh shirt for yourself. Nothing is worse than a blowout on an airplane! (Here's how to handle a blowout or change a diaper on a plane .)

7. Be ready for flight delays and cancellations

When you're traveling with your little one, the last thing you want to deal with is getting stuck at the airport. But it happens, so be prepared. Bring more than enough diapers, formula, and snacks in your carry-on bags, as well as a few changes of clothes for your baby (and perhaps a change of clothes for you, too). Flight delays and cancellations can make it difficult to get your checked luggage, so you want to have the essentials with you. 

In the same vein, consider gate checking your car seat and stroller (rather than checking them at the ticket counter) so you can easily get them back if needed.

8. Plan ahead to bring formula, breast milk, and bottles

Thankfully, not all the TSA rules about traveling with liquids apply to you. Parents are permitted to bring greater volumes of breast milk or formula through security.

Review your airline's policies for bringing formula or  breast milk on board and hand it to security officers when you go through screening. You don't need to put bottles into the standard quart-size zip-top bag.

To speed up the process, TSA recommends storing either breast milk or formula in clear, translucent bottles rather than plastic bags or pouches, which may be subject to additional screening. And if you pack all the bottles in a cooler bag, know that most airlines won't count it towards your personal item allowance.

Breast pumps are often considered medically necessary, and ice packs, freezer packs, and other cooling accessories are allowed in your carry-on bags. You can bring all of these items on board even if your child isn't traveling with you.

9. Pack formula safely …

When traveling with baby formula, keep these safe storage tips in mind:

Ready-to-feed formula: Bring an unopened container and clean, empty bottles on board. When your baby is ready for feeding, pour the formula into the bottle and serve it right away.

Powdered formula: Fill bottle(s) with clean water, and bring a small container of powdered formula and a scoop with you on the plane. You can measure, shake, and serve a bottle to your baby when they're ready for a feeding.

Premade bottles: You can also bring premade bottles through security if you prefer, using a cooler to keep them cold. Just keep in mind that if the cooler doesn't keep bottles at 35 to 40 degrees, you'll need to use or refrigerate them within two hours.

10. … and breast milk, too

A cooler will be essential if you're bringing breast milk on a plane. You can pack breast milk in bottles or pre-sterilized, sealable storage bags in a cooler bag, then offer them to your baby on the plane.

Breast milk will stay fresh for 24 hours in a cooler with frozen ice packs. At room temperature, breast milk is good for four hours; in the refrigerator, for four days; and frozen, for up to 12 months, according to the Centers for Disease Control and Prevention (CDC) Opens a new window . 

11. Bring plenty of snacks

If your little one has started solids , pack baby-friendly foods for your flight. Containers with pre-chopped fruit, steamed veggies, tofu, and crackers are all easy choices. Know that you're also allowed to bring puree pouches through security, as the TSA considers them medically necessary liquids. And make sure to include snacks for yourself, too!

12. Consider whether you want to board early

Some family-friendly airlines allow you to pre-board. But there are two schools of thought on how to approach boarding with kids: Some families relish the chance to locate their seats early and settle in, while others find it difficult to entertain young children on an airplane that's not moving as other passengers also try to get settled.

If you're traveling with your partner or a loved one, you might decide to split up, with one adult boarding early with the bags while the other lets the kids run around a bit longer by the gate.

13. Bring entertainment for older babies

Younger infants may be mostly content to sleep, eat, and snuggle their parents, but older babies and toddlers can be trickier to keep occupied on an airplane. At this stage, kids are learning how to pull up to a stand and walk , or else have recently mastered these skills and are eager to explore an exciting new environment.

While you don't need to pack tons of toys, a few new items can help hold their attention. Some ideas: a slinky, painter's tape, small board books, coloring books and crayons, and stickers. You can also try classic car games like "I Spy" and "Rock, Paper, Scissors."

14. Take steps to fight jet lag

If you're crossing time zones, try shifting your baby's sleep schedule over a few days leading up to your departure and exposing them to sunlight once you reach your destination. Or, you may want to keep the same schedule in the new time zone if that works best for you. Here are more tips for handling time changes with a baby .

15. Prepare for pressure changes

If your baby's ears seem to hurt from air pressure changes during takeoff and landing, encourage them to breastfeed or suck on a bottle, pacifier , or sippy cup. If your baby's strapped into a car seat, give them something to suck on while in their seat rather than taking them out to breastfeed. It's safest for both of you to be securely buckled in.

Not all babies experience ear pain when flying, so use your judgment. If your baby's sleeping soundly, leave them be and they might get through the takeoff or landing without any trouble.

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

Alaska Airlines. Undated. Traveling with infants and children. https://www.alaskaair.com/content/travel-info/policies/strollers-car-seats Opens a new window [Accessed January 2024]

American Academy of Pediatrics. 2023. Flying with Baby: Parent FAQs. https://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Flying-with-Baby.aspx Opens a new window [Accessed January 2024]

American Airlines. Undated. Traveling with children and infants. https://www.aa.com/i18n/travel-info/special-assistance/traveling-children.jsp Opens a new window [Accessed January 2024]

Centers for Disease Control and Prevention. 2022. Proper Storage and Preparation of Breast Milk. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm Opens a new window [Accessed January 2024]

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National Transportation Safety Board. 2015. Child Passenger Safety on Aircraft. https://www.ntsb.gov/Advocacy/safety-alerts/Documents/SA-015.pdf Opens a new window [Accessed January 2024]

Southwest Airlines. Undated. Traveling with an infant. https://www.southwest.com/help/flying-with-children/flying-with-infants Opens a new window [Accessed January 2024]

Transportation Security Administration. Undated. Traveling with Children. https://www.tsa.gov/travel/special-procedures/traveling-children Opens a new window [Accessed January 2024]

Transportation Security Administration. Undated. Identification. https://www.tsa.gov/travel/security-screening/identification Opens a new window [Accessed January 2024]

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Kathleen Felton is a freelance writer and editor. She was previously the executive editor of editorial strategy and growth at BabyCenter, the world's number one parenting resource. She is originally from Farmington, Connecticut, and now lives in Sydney, Australia, with her husband and two sons.

Where to go next

Everything You Need to Know Before Flying With a Baby or Young Kids

By Laura Dannen Redman and Noah Kaufman

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Your baby’s first flight can be as momentous as their first steps, first solid food, or first drop off at daycare. And like all those milestones, parents can feel understandably freaked out beforehand. No one, not even your baby themself, knows how a child will react to being on an airplane for the first time. And no matter what happens, one thing's for sure: you'll be stuck in a cabin full of strangers for at least a couple hours while you find out. 

But dread not—your child may love air travel, for starters—and even if they don't, you will get through it. With a little planning, the right gear, and a willingness to make many lists, flying with a baby or young kids can be easier than you think. Here are our best tips for arriving in your destination with energy to spare, from seasoned parents. 

All products featured on Condé Nast Traveler are independently selected by our editors. If you buy something through our retail links, we may earn an affiliate commission.

How to prepare 

Right after you purchase your tickets, download Flying With Baby by Meg Collins, the blogger behind new mom survival guide Lucie’s List . Collins claims, accurately, to be the voice of reason about everything: “ticketing, check-in, car seats, feeding, napping and all the other stuff that makes your brain explode.” 

There's no surefire way to prepare a baby ahead of time, but if you're traveling with a toddler or an elementary school-aged child, you may need to do a little incepting—i.e., plant the idea that flying is fun! and make a game of it at home beforehand. Traveler contributor Debbie Dubrow gave Traveler some excellent tips a few years ago that still hold true:

• Talk about your trip and your flight ahead of time, focusing on the aspects that are new to your child or might cause them concern.
• Read stories about flying, like Airplanes by Byron Barton for toddlers, and Richard Scarry's A Day at the Airport for older kids. If you’re headed to a new destination, make a trip to the library to pick up a few books set in that place.
• Line up some dining chairs to make airplane seats, and act out how you should sit down and buckle up on a plane. Build a security checkpoint using a doorway as the metal detector and a cardboard box and towel as the conveyor belt and X-ray. Practice putting your child’s stuffed animal or blanket through the X-ray and getting it back on the other side.
• Let your children help pack their carry-on bags (but secret away a few new toys in your own). That way they’ll get to choose which items they just can’t live without, and you’ll get to set expectations about which toys are okay on the plane (leave the harmonica at home, please!).

What to pack

If this is your first time flying with a baby, you'll be bringing significantly more items than you've flown with before. To keep track of everything, make an itemized list of the major items (i.e., the car seat, stroller); the bags you’re checking; and the bags you’re carrying on. Do a count of your bags like they’re children on a field trip when you get to the airport, get through security, and get off the plane. (If it sounds like overkill, think about what your trip might be like if you forget the one bag with your baby's favorite stuffed toy. Yeah.)

As for what to bring? Everyone has their go-to items, but there are a few items we love most.

The Doona Infant Car Seat/Stroller (for infants up to 35 pounds) combines two of the most cumbersome items you have to bring on a trip. With the Doona you just gate check the stroller, and get to leave the car seat at home. 

The Dohm sound machine helps little ones fall asleep and stay asleep in new and strange places. “I bring my son’s Dohm everywhere with us," says director of strategic projects Lauren DeCarlo . "Hotels, my parents house. It’s essential.” You can also download white noise apps on your phone.

The Líllé Baby Carrier is a comfortable and functional carrier that adjusts into six different positions, so you can keep your (hopefully) sleeping baby against your chest during flight and prop them on your hip while you're waiting to board.

A well-stocked diaper bag with enough wipes, diapers, and formula/breast milk/food to get you through the flight and an hours-long delay, minimum, is a must. Frequent flier, Skift aviation reporter, and father Brian Sumers recommends three days' worth of food for the baby to account for any mishaps. Make sure you also have basics like hand-sanitizer, scented diaper trash bags, a pacifier clip ("this will save you the horror of watching a pacifier drop to the airplane floor," says Traveler contributor and mom of three Juliana Shallcross ), and one new baby toy. "I still swear by the one-new-toy trick," Shallcross says. "Buy the baby one new toy specifically to open on the airplane. It will keep their attention for a little bit longer than if you brought an older toy. However, for young babies, you don't need much. All they really need is their bottle, maybe a pacifier, and a nice seatmate who makes funny faces."

The WayB Pico Car Seat is great pickup for kids that have outgrown the Doona. It weighs a barely noticeable eight pounds and folds up into a convenient carrying case. Note that this is a forward-facing car seat, so your child will have to be physically ready for that.

The Cares Airplane Safety Harness is the only FAA-approved harness for kids over the age of one, when they're big enough for their own seat but too small for the seatbelt to do any good.

A different outfit —for you—is a gift. "A change of clothes is a no-brainer for the baby who may have a diaper situation at some point during the flight," says Shallcross, "but if you can manage it, pack a T-shirt or leggings for yourself in your carry-on." You don't want to be stuck wearing a formula-stained shirt (or worse) for the rest of the flight.

As for what to leave at home? Anything you can get where you’re going: jars of baby food, diapers, wipes. Just make a beeline for a local grocery store once you arrive. It can also be fun seeing how other cultures and countries do the basics. (Fun fact: French diapers aren’t quite as absorbent as American ones. Who knew?)

Harrison Pierce

Alex Erdekian

Charlie Hobbs

Uber drivers always get out of the car to open the trunk, assuming the stroller will need to go in the back—and are always amazed when you collapse the Doona and slide it into the backseat instead.

Do babies need an I.D.?

Babies from the U.S. don’t need an ID when flying domestically, says the TSA . This is actually true of anyone under the age of 18. But they will need a passport to fly internationally. 

To apply for a passport for your infant, both parents need to be there in person—“there” may be a USPS post office or a passport agency near you; if you’re the sole custodian of a child, you need to bring proof of that as well . You will also need the child’s birth certificate (original and a copy), your passports and U.S. drivers’ licenses (and a copy), a completed DS-11 form , money for the fees (credit is not accepted for the $80 standard fee and $35 acceptance fee—bring cash or your checkbook), and—the best part—two identical 2x2 inch passport photos of your baby. There are websites dedicated to getting your infant to sit upright and still against a plain white backdrop for long enough to get a photo. Some, like epassport.com, will prepare your photos with a guarantee that your baby's photo won't be rejected (check your passport application location's policy on this, as some don't allow third parties to send in photos). 

Here’s the full list of what you need to get the baby’s passport.

What about their own ticket?

It depends. On most airlines, babies under the age of two can sit in your lap on a flight, sometimes with a special lap belt that you attach to your seatbelt. You may have to pay a fee—primarily on international airlines—which may come with a special boarding pass. It helps to call the airline before booking to confirm. Once the child turns two, they are required to have their own ticket. 

Still, if you can swing it, we suggest purchasing your baby their own seat from the get-go. It will be more pleasant to have the extra space (and a buffer from other passengers) and, as Sumers says, it's safer: “You wouldn't hold your baby in your lap in a car, even if you were only going a mile away at 10 mph. So why would you hold your baby on an airplane racing on a runway at 150 mph? In severe turbulence, or in a survivable crash, you may not be not able to hold onto your baby.” 

At the airport

When flying with kids, arrive early to the airport, so you have extra time to check in, get through security, and board the plane. 

Going through security

If you have TSA PreCheck , children 12 and under can get in line with you and breeze on through. But if you have Global Entry , the baby needs it, too. Here’s what it takes to apply.

When it comes to getting your stuff through, TSA checkpoints are “wildly inconsistent” across different airports in the U.S., says Shallcross. "If you're traveling with breast milk or formula, note that you can carry-on [in excess of the 3.4 oz liquid rule] , but you will most likely be on the receiving end of a pat-down." Having TSA PreCheck makes the process go a bit faster, and sometimes, in lieu of a screening, TSA will test to-go bottles of formula instead. International checkpoints also vary widely, but, often, jars of food and bottles get checked.

As for the stroller you plan to gate check, know that it will have to go on the belt through the x-ray machine, like the rest of your bags. It may be pulled aside and tested or swabbed by a TSA agent. 

Getting to the gate

Speaking of gate-checking: "As soon as you make it through security, head to your gate and get the gate tags for your stroller," says Shallcross. "If you wait until you board, the gate attendants may ask you to step aside and wait until they finish boarding the group, before they give you the tags."

And then there's the age-old question: Should you board in the first wave with your baby and toddlers? Most gate agents give you the option of early boarding—and with a newborn or infant, that's the way to go so you can get settled with bags stowed and essentials out for takeoff. But with an active toddler? That means you're on the plane for an extra 30 to 45 minutes, trying to contain their wild energy in a small space. No thanks. 

If you're traveling with another adult, super traveler Sam Brown recommends dividing and conquering. One of you boards early with the bags; the other stays behind with the kids, letting them burn off energy at the gate until the last possible minute you can board.

Nursing and pumping

If you need a quiet space to breastfeed before boarding, look for a Mamava Pod . They're designed to allow moms to nurse babies in private, they're free to use, and there's even room for another small child to hang out inside. 

The flight itself

The easiest way to keep a baby from crying during the flight is to give them milk or formula on takeoff and landing—the go-to move of parents for decades, as it helps babies adjust to the change in cabin pressure. Admittedly, if the baby is going to be strapped in, nursing will be hard, so consider a bottle. (When it comes to tips for getting your toddler to sleep on a plane , we've got those too.)

If you have a bassinet or plan to have the baby in a Bjorn for most of the flight, they'll need to come out and be strapped into their seat or held on your lap during takeoff and landing. Become friendly with your flight attendants, because you may need their help (and patience) more than usual from here on out (that said, they're often happy to help with things like warm water for a bottle).

This also brings us to our favorite controversy: Should you apologize in advance to your fellow seatmates? Sumers says, emphatically, that “there's no reason parents should bring treats for other passengers, or apologize for their baby's behavior." Everyone knows it's hard to control any situation on an airplane, and that you're doing the best you can, Sumers says. People pleasers may feel the need to do otherwise; ultimately, it's about whichever move creates an on-plane environment that's most comfortable for you. 

Does my baby need to wear a mask?

Though pandemic-era regulations require adult passengers to wear face masks , rules vary for children. For children under two, the answer is no. But once your child is old enough to need their own seat, they also need to wear a mask, per an update to federal law in February 2021. If you know that will be an issue for your two year old, you'll want to hold off on flying—airlines reserve the right to remove anyone refusing to wear a face mask from the plane. 

What if your kid is a seat kicker?

Try changing up your seating chart. Travel journalist Sam Brown and her husband would book seats in two separate rows, one right in front of the next, and each sit with one of their twins. If one of the kids got fussy—or kicked the seat in front of them—at least it would be a family member they were harassing.

Upon arrival

Many parents worry about the impact of jet lag on children when flying long distances. If you're taking a transatlantic flight (say, New York to Paris), the red-eye is a godsend and the easiest way to ward off jet lag . To start: Your baby will be more inclined to sleep through the flight. Once you land, consider not getting on local time. Yes, you'll all sleep in later and start your day later, but you can keep the baby out later, rather than having to commit to your hotel room by 6:30 p.m. every night, and the re-entry back home goes a bit smoother because you never really got off your schedule. There's also something special about being able to take your baby to the Louvre at 8 p.m. on a Friday.

This article was originally published in 2018. It has been updated with new information.

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When is it safe to fly with my baby?

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Where to go next

When is it Safe to Travel with a Newborn Baby by Car or Plane? 13 BEST Tips from a Well-Traveled Mom of 4

• Last Updated: March 2, 2023

By Sarah Peerless

Inside: traveling with a newborn by car or by plane may feel a little daunting. find out when it’s safe to do so here, plus the best newborn travel tips for air and car travel..

You may not be itching to travel with your newborn in the first few weeks after delivery, but needs must, right?  Going to visit friends and family may leave you asking when is it safe to travel with a newborn by car or can newborns go on long car rides.

I wasn’t exactly keen to leave the comfort of the sofa in the early days but we had long-haul flights to take with both my first two babies before the age of 6 weeks.  So the question of when is it safe to travel with a newborn by plane came up pretty early for us.

Whether you’re traveling with a newborn by car locally, further afield or by plane, first off you need to know when is it safe to travel and how to do so.  What about during a pandemic?  Is it safe to travel with kids?

Find out when you can travel with a baby and how soon after birth can they travel by car and plane right here. 

This post contains affiliate links.  If you click on one and make a purchase, I may receive a commission at no extra cost to you.

Table of Contents

How soon can you travel with a newborn after birth?

You may be wondering when you can travel with a baby because you need to get home from the hospital with your newborn soon after birth.  The likelihood is you need to travel some distance.  

You may specifically need to know how soon after birth can a baby travel by car.  Even if you don’t have your own car or you live very close to the hospital, you’ll probably make this journey by taxi or bus. Or maybe a friend or family member will drop you home.

This is absolutely fine. In this respect, you can travel as soon as you need to after birth, as long as you have the go ahead from your doctor to leave the hospital .

However, for longer distances and non-essential travel, ideally you want to wait until it’s deemed ‘safe’ to travel with a newborn.

When is it safe to travel with a newborn baby?

Most doctors advise to wait until your baby’s immune system has fully developed.  Or is, at least, better developed before traveling.  That means different ages for different babies. 

When is a baby’s immune system fully developed?

In this article , Dr. Sabella explains, “An infant’s immune system doesn’t mature until around 2 to 3 months old.”   That is for babies who are born full-term and have no other health conditions. 

To be safe, if you want to travel with your baby any significant distance it’s best to hold off until at least 3 months, but at the minimum wait until baby is 2 months old.

Like I said first up, we took long-haul plane journeys with our first two babies earlier than this, because it was unavoidable.  However, the advice is to wait until the 3-month mark.

Remember that if your baby is premature, they’re developmentally behind so it’ll take longer for their immune system to reach the maturity of a 3-month-old. 

If your baby was a month early, expect development around a month behind.  In which case you should wait until baby reaches 4 months before traveling.

When is it safe to travel with a newborn by car?

When it comes to traveling with a newborn by car, short distances such as to local doctor’s appointments and errands around town will be safe from birth as long as your newborn has no complicated medical issues.  

For longer car journeys of an hour or more, stick to the guideline of waiting until maturity of the immune system.  So, to be safe, 3 months or older.

Here are some common queries for traveling with a newborn safely.  Take note of these.

Is holding a baby in a car illegal?

In the United States, it is illegal for your child to be held in any car, including cabs. They need to be in an approved car seat that is manufactured for their age and size.

If you are traveling in and around the UK, the only time a child is allowed to ride without a car seat is in a taxi or minicab, a minibus, coach or van, in emergency situations and when there is no room for another car seat.  You can read more about the laws in the UK here . 

In Mexico, it depends on the state. In the State of Mexico and in Yucatan children must be in the back seat in a car seat. But in other states including Baja California, Chihuahua, and up to 18 other states there is no rule stating children must ride in a car seat. 

So definitely check the law in your home country and any you’re visiting ahead of time. 

Is holding a baby in a car safe?

Never mind what’s legal and in what country, at the end of the day it’s all about safety. Depending on the circumstance you find yourself in, you’re going to have to make the call.  

The best and safest practice is for your baby to always ride in an approved car seat and to never take your baby out while your vehicle is in motion.  

You may be tempted to breastfeed while in the car for convenience or to keep your baby calm, but this would put your newborn at risk, should you have an accident. 

Don’t be swayed by comments from parents or grandparents, determined to remain stuck in the past.  Ignore comments like this: “In my day, baby car seats weren’t even a thing”.  (Thanks Dad.)  

Roads are busier, cars faster, accidents and fatalities more common.  Car seats weren’t just invented to make more money from parents.  Although with the hefty price tag you might think so!   Use them.

If you need to breastfeed or your baby is crying, it is best to take a rest stop, let everyone get out and stretch their legs and tend to your newborn. 

What kind of car seat do I need for a traveling with a newborn?

When traveling with a newborn by car, you’ll need a car seat that has a five-point restraint system or harness and that faces to the rear.  Rear-facing has long been recommended by the AAP and in some states in the US and in many countries, this is a legal requirement. 

This is because the majority of car accidents involve frontal collisions, meaning everyone in the car is thrown forwards.  This is dangerous for a newborn with little muscular strength.  Traveling rear-facing will spread the force of the impact across the whole back.

You can choose between an infant seat or an infant to toddler convertible car seat.

Infant car seats

These go down to the smallest weight, usually around 4 or 5 lbs, so if your baby is early or measures small, an infant car seat will probably be your best bet.  For tiny babies and prematures, the seat may still seem enormous and you may need a newborn insert to help pad it out.

They typically have an upper weight limit of 30-35 lbs which usually means baby will be around 8 to 18 months old by the time they’re ready for the next seat up. 

Most infant car seats come out of the car easily, clipping on and off a car seat base that stays in the car.  This is convenient for getting baby ready and all strapped in while still in the house. 

Some can be used as part of a “baby travel system”, clipping onto the top of a push chair or buggy.

A convertible car seat

A convertible car seat is another option when traveling with a newborn by car. These start off as rear-facing car seats then, when your baby is ready to move to forward-facing, you simply switch the car seat around.  It effectively grows with them.

While some convertible car seats go down to 4 or 5 lbs, others will not be suitable until baby reaches at least 10lbs.  Even with convertible car seats that are rated for small babies, the car seat may seem enormous around a newborn.   

Either option will work, but most parents opt for an infant car seat for at least for the first 6 or 9 months as they’re a better fit and more convenient. 

How soon can a newborn travel long distances by car?

If you are taking a long-distance trip, again, it’s advised to wait until baby’s immune system has fully developed at around two to three months old. 

From a practical side, babies who are 3+ months old and have longer periods of happy wakefulness are easier to travel with as things are a bit more predictable.

Younger babies eat more frequently and are slower to feed, and may not yet be on any kind of feeding schedule . So traveling with a newborn is a little trickier.

How long can a newborn stay in a car seat on a long drive?

If you’re wondering how soon can a newborn travel long distance by car, you may be a little disappointed by the answer.

Car seat manufacturers recommend that babies don’t stay in a car seat for more than two hours in a 24 hour period.   Doesn’t get you very far does it?!  Again these are just guidelines; use your common sense and do what you need to do. 

Guidelines on length of trip when traveling with a newborn by car

30 minutes for newborns 0-4 weeks old.

As a general rule, babies that are under four weeks old do not have the neck strength to hold their heads upright. Some babies may be a little stronger a little earlier, but this is the guideline to follow. 

So in the first few weeks, when in the car seat, your newborn’s head can fall forward and risk restricting their airway. Clearly this is dangerous.

Restrict car journeys to 30 minutes and only using a car seat when traveling with a newborn by car, rather than using it around the house, for example. This is the best way to keep your baby safe. 

Even if your baby is asleep when they arrive at your destination, take baby out of the car seat. The safest place for a baby to sleep is on a firm, flat surface. 

2 Hour Rule

The two-hour rule is based on manufacturers’ recommendations that babies should not be in a car seat for longer than 2 hours in a 24-hour span.  This is a day-to-day recommendation. Occasional long-term travel can be done but with lots of breaks, at least every 2 hours.

15-30 Minute Breaks

How do you drive long-distance with a baby?  In this case 15-30 minute breaks are an absolute must.

If you’re in the car for an extended period of time, take a rest stop at least every two hours . Get baby out of the car seat for 15-30 minutes, longer if possible.

During this break, feed baby and allow her a little kick about on her back or put her on her front for some tummy time.  Anything to give those limbs some freedom of movement, having been restrained in the car seat.

What about a 4 hour car journey with a newborn?

For a 4 hour car journey with a newborn, the best plan would be to split the journey into two.  Do the first 2 hours in the morning. Then take a few hours break, then do the remaining 2 hours.  Or if you can split it into multiple shorter sessions even better.

Likewise, try to split longer journeys into smaller portions and spread them across the day as much as possible.

This is the best way for a 4 hour journey or longer distances with a newborn baby.  The rest stops will make it easier on all of you and will be healthier for your baby.   

Traveling with a 2 week old baby by car

It’s common to wonder about traveling with a 2 week old baby.  Your partner may have been off those first 2 weeks , the visits from family and friends may have dwindled and you’re at home alone.

You need to get out!

As long as you’ve recovered from birth sufficiently and had the go ahead from your doctor, it’s a good idea to get out the house with your newborn a little. It’s one of my top newborn hacks to get through those early weeks.

However, a 2 week olds immune system will not be sufficiently developed to go very far.  In addition, they won’t have much neck strength to adequately support their head while in a semi-upright position in the car seat. So you’ll need to stick with the 30 minutes for 4 week olds rule outlined above.

Ideally stick close to home.  You don’t even need to go in the car to get out.

To give yourself some fresh air and a change of scene, wrap your baby up well and pop them in the buggy or carry them in a baby wrap or sling.  As long as you keep them warm and safe and limit exposure to excessive germs they’ll be just fine. 

That means, avoiding strangers and curious kids leaning in and breathing all over them! Which is why a wrap or sling is preferable.  (Also best for keeping those tiny hands warm .)

Limit traveling with a 2 week old baby by car to short, essential journeys less than 30 minutes where possible.  And of course, if you’re in any doubt, check with your pediatrician first.  

Traveling with 2 month old baby by car

At 2 months old your newborn will be a lot bigger and stronger. They’ll be physically stronger and should be able to hold their head up unsupported, which means they should be able to go the full 2 hours in a car seat safely.

A 2 month olds immune system will be almost, if not entirely, fully developed. This means going to new places will pose far less of a risk of infection.

So you’ll be much less restricted when traveling with a 2 month old by car.  Simply stick to the 2 hour rule with 15-30 minute breaks, as outlined above.

When is it safe to travel with a newborn by plane?

The guideline to wait to travel long distances until your newborn’s immune system has fully developed is possibly even more important when it comes to air travel.  Several hours confined in the small space of an aircraft with the AC pumping will expose your little one to a very unfamiliar variety of germs.

However, life goes on and this is not legally enforced…  

How old does a baby need to be to fly?

Regulations differ by airline, but all of them will allow a baby to travel long before the 2-3 month mark, some as early as 1 week old.  Some airlines will allow a younger baby to fly with a note from their doctor. 

However, if you can wait longer, so much the better.

Do I need to get documentation to travel with a newborn by plane?

At a minimum airlines require a birth certificate or passport to fly.  You may also need a doctor’s note. If you don’t have your baby’s birth certificate yet, you need to take other medical documentation stating when the baby was born like a crib sheet, hospital discharge papers, and other medical paperwork.  

Of course, this differs by airline, so check these details out before booking a flight.

Does my newborn need a passport?

If you are traveling with a newborn by plane and crossing an international border, you’ll need to get baby a passport.  This involves a heap of paperwork as well as the challenge of getting a good passport photo where baby’s eyes are open (which is often tricky with a sleepy newborn).

You can find the full rules for getting a US passport here at U.S Dept of State .  In brief, you’ll need: 

• Form DS-11 filled out by both parents or guardians
• Birth Certificate or if your baby was born abroad, you need a Consular Report of Birth Abroad 
• If you are divorced or have an adopted baby you will also need to produce legal documents like an adoption decree or a divorce decree
• Parents need to have an approved ID as well (bring the actual ID and photocopies of front and back of each ID) 
• Both parents need to be present or if not present you can find a list of workarounds at the   Dept of State Website   
• Provide a photo of the child (but some places will take the photo for you)  The best way to do this for a baby is to lay them on a white sheet or blanket on the floor. No one else (even a helping hand of someone) can be in the photo. 

Even if you don’t plan on traveling with your baby out of the country anywhere soon, getting a passport for your baby is a good idea.

What do I need to know about air travel with a newborn?  

Having lived in Africa the last 8 years with family back in the UK, we’ve more than our fair share of air travel.  This started when they were just 6 weeks old, before the recommended age of 3 months. 

So I reckon we’ve learnt a thing or two about traveling with a newborn by plane!  Here are some need-to-knows and after you’ll find tips and must-haves for traveling with a newborn baby by plane.

It’s going to be tough and a little stressful, but hopefully the reason for your journey will make it worthwhile 

I’m not going to sugar coat it, traveling anywhere with a newborn, baby or toddler for that matter, will come with a certain level of stress and discomfort. Traveling with a newborn by plane is probably the most difficult of the lot. 

Other than being prepared, both mentally and physically, there’s not much way around it!  

You’ll probably need to have your newborn on your lap with an infant seatbelt

This is not a legal requirement but enforced on an airline by airline basis. 

The first few flights we went on, I always used the infant seat belt, but after that, if it was optional, I never used it.  Apart from the fact that they are such a faff to put on, I saw little point. 

Your firm hold will give your baby the maximum safety, far more than the seatbelt.  There’s no harm in putting it on but I cannot see how it would really add anything in the event of turbulence or an accident.

For long-haul flights, bassinets are normally available but need booking

When traveling with a newborn by plane, bassinets are normally available on long-haul flights but there aren’t many of them and you probably need to book ahead.  Don’t forget as these will make your life a lot simpler.

Even if baby doesn’t sleep in it, the bassinets are in the extra leg-room seats so you’ll have much more space and the bassinet itself can be very useful to hold all baby’s bits and pieces.

If baby will sleep in the bassinet , this will mean you can get some proper rest, but beware – as soon as the seat belt signs come on, you will be required to take your newborn out, hold her and/or put the infant seat belt on.

Many airlines will let you take your stroller to the aircraft door – ask at check-in

When traveling with a newborn by plane, you may be asked to check your stroller into the hold of the aircraft with your luggage at check-in.  However,  often airlines will allow you to take it all the way to the aircraft door.

Having the stroller with you while you’re in the airport after check-in and going through security etc will make life so much simpler, not only to put your newborn in but also to help carry all your hand luggage/burp clothes, bottles and all the other baby gear you’ll need close at hand.

Picking up your stroller after disembarking varies by airline as well as airport

Only a handful of times has our stroller been waiting at the aircraft door after disembarking.  More often than not it’ll be taken to the luggage hall to the oversized/awkward bag section, which is often tricky to find.

If you’re going to be traveling with your newborn by plane regularly and this’ll continue into the baby and toddler years, this travel stroller Babyzen Yoyo would be a worthwhile investment. It packs so small it’ll fit into the overhead lockers of the aircraft.  Otherwise, I’d advise a small umbrella stroller.

It’s pricey but you can you really put a price on baby gadgets that’ll make travel so much easier? I think not!

Different countries may have varying rules on the liquids that can be taken aboard 

I’d always advise checking with the airport you’re flying out of, but bottled breastmilk and formula should be fine to take in your carry on luggage.  This is certainly true in the US and UK.  (Check the TSA’s 3-1-1 rule here, which doesn’t apply to pumped breastmilk, formula or juice in a toddler cup.)

A wrap or sling is essential to carry baby easily and safely without the stroller

A baby carrier or sling will make navigating the airport a lot easier for the times when you don’t have your stroller.  Or if your stroller never appears at the luggage hall. 

(This only happened to us once and it did land us with quite a useful tiny travel stroller, but it was a big hassle reporting and claiming for ours and made for a delayed journey and very grouchy, tired baby .  And mommy for that matter…)

Recommended baby carriers/slings:

For tiny newborns, a wrap or sling is the way to go. This Sleepy Wrap Carrier is the one I’m wearing in the photo above.

When baby is a bit bigger, this All Seasons baby carrier from LILLEbaby is a great all-rounder, allowing you to hold baby in 6 different positions.  Great for at home and when traveling with your newborn.

You probably won’t be able to move your newborn to a different seat

The crew will ensure there’s an infant life vest and oxygen mask at the seat you’re booked into, so won’t allow you to move seats or for your newborn to be passed to your partner in another seat mid-flight.

This can be really frustrating!

If you need to take a break, you’re going to have to switch seats with your partner so your newborn remains in the same seat.

Take off and landing can give a newborn earache – nursing or a paci can help

Just like adults, baby’s ears may be susceptible to the change in air pressure at take-off and landing.  Sucking can help. So feeding your baby or offering a pacifier on landing and take-off can help.

Flight attendants should happily provide you with boiling water for a bottle – ask if you need

Don’t be afraid to ask for this and anything else you may need.

Tips for traveling with a newborn by air

#1 the baby change facilities in the aircraft toilets are often very difficult to use – avoid using  .

Avoid using them if you can by checking and changing diapers before boarding.  In addition, if baby has a wet rather than a dirty diaper and you can be discreet (if you have a window seat and your partner is next to you) do a quick stealth diaper change at your seat.  

#2 Aircraft air conditioning can dehydrate – offer baby more milk 

Because of the recycled air, planes are notorious for leaving people feeling dehydrated. But this is even more true for small babies so offer your baby an extra feed/more milk than normal. 

If you’re nursing, you’ll also need to ensure you keep up with fluid intake which may mean asking for or buying extra water when on board.

#3 Some passengers will tut and look disapproving, others will be super helpful and sympathetic – just do your best!

Whatever state you or your baby are in, just concentrate on the task in hand.

My super fussy reflux baby actually spat up into someone’s shoes the one time – highly embarrassing – but we’ve laughed about this many times since.

#4 Pack as little hand luggage as possible when traveling with a newborn by plane

This is really hard and I rarely managed without a huge bag of baby gear accompanying us into the cabin.  But the less you carry, the easier it’ll be.  

#5 Swap your normal diaper change bag for an airplane carry on, either with wheels or backpack style

You either want to be hands-free (ie go for a backpack) or at not have to carry the weight of a bag (go for a wheeled bag).  First prize – a bag that has wheels and can be carried like a backpack, like this one – pictured in the photo above.

#6 If you’re flying in the evening or overnight, try to carry out as much of baby’s bedtime routine as normal before boarding

I’ve followed this newborn schedule with all of my 4, which includes a bath and bedtime routine in the evening and wind-down routine in the day before naps. 

For overnight flights, try to do as many of these elements as possible. Take baby to a baby changing cubicle, give her a sponge bath or wipe down, a little massage or apply some lotion etc, change the diaper and dress in her normal sleepwear . Just do all the things you’d normally do for bedtime at home. 

All these tasks will be quite a challenge on the plane, but while at the airport you’ll have the time and space to do this at your own pace.

If this routine is familiar to her, it’ll help settle her and get her body and mind in the zone for sleep. Then once you’ve boarded, all you need to do is give her that last feed before settling her to sleep.

#7 If you have some kind of sleep nest, take it! (Or consider buying one)

Not only can baby sleep in it when away, rather than a strange cot, these are soooo handy at the airport and on the plane, any journey in fact. 

It means you can put your newborn down on the floor safely, whenever you need to.  So if there are no spare seats or you want some hands free time.  I even used it on the plane, instead of the bassinet, which was handy to put other things in.  It easily squished into my hand luggage.

Try this sleep lounger/nest from Cosy Nation .

#8 Accept help and ask for it if you need

Most flight attendants will offer to help – take it!  You’ll probably find other passengers will also be jumping in to offer to help carry things, pass you things or even hold your newborn .

Likewise, if there’s something you need help with, ask.  

General tips for traveling with a newborn by plane or by car

These tips are relevant for any travel away from home.

#9 Try to recreate baby’s home sleep environment as much as possible when traveling 

Ensuring your newborn is in as familiar a sleep environment as possible will really help you all get a good night’s sleep when away from home. 

As well as all your newborn’s sleepwear, if you can take their bassinet or co-sleeper with you so much the better.  A travel bassinet may be a worthy investment if you go away a lot. 

If the bassinet they’re going to sleep in when away will be unfamiliar, take the bassinet sheet with you.  Ideally, clean but with a day or two’s use. 

Newborns are very comforted by familiar smells , including their own smell.  A sheet and their swaddle or sleep sack with some use will make them feel more at home.

#10 Take portable black out blinds

Darkness really helps newborns sleep well – it was pitch black in the womb.  They help prevent early morning wakings and short naps .  Hopefully your baby’s home sleep environement is pitch black. I.e. so dark you cannot see your hand in front of you when hold it out in front of you. 

This is one of my top recommended sleep strategies to help newborns sleep long stretches.

So I’d absolutely recommend these portable black out blinds which stick on to any window. I don’t go anywhere without 2 of these! You never know quite how many windows you’re going to need to cover when you’re away from home.

For solutions to black out the nursery, check out: 18 Best Blackout Shades/Curtains For Baby’s Nursery in 2023

#11 Try to stick to any routine you’re normally in at home 

Likewise, take your normal white noise machine or lullabies that you use at home.  Carry out the same bedtime routine while away and use the same baby products. Again, anything to replicate the steps you take at home to settle baby .

When it comes to traveling with a newborn by car, if you’re following a newborn schedule , try to plan the journey around naps and normal feed times.

#12 If you do buy anything specifically for your trip, use it at home first

For your newborn, this further helps with the familiarity of anything you want to use while away.  For example, if you have travel cot, get baby sleeping in it at home for a few weeks before going away

For you, it means you’ll also become accustomed with how to use any new contraptions and devices.  Some travel cots/Pack n Plays can be particularly challenging to put up and the last thing you want to do is have a battle late at night after a long journey…

#13 Understand, that despite your best efforts, your newborn will likely be a little unsettled while away

Expect your newborn to take longer to settle to sleep, perhaps more night wakings and/or a little clinginess.

Is it risky to travel with children during a pandemic, like Covid-19?

With more and more people getting vaccinated and more countries opening up to visitors, travel is on the rise again.  But is it safe to travel with children during a pandemic like COVID-19? 

The Washington Post released this article , where they spoke to Sahera Dirajlal-Fargo who specializes in pediatric infectious diseases and travel medicine in Cleveland. 

Dirajlal-Fargo said that we know more this summer than last summer and we can make safe choices when it comes to flying.  Shorter plane rides are better than long ones.

Parents should try and ensure their children are socially distancing, keeping masks on if old enough, washing hands or using hand sanitizer frequently and always before eating, drinking or touching their face.  

However, families with children who have complicated medical issues and deemed high risk are advised to stay home during a pandemic.

Conclusion: Minimize traveling with a newborn while baby is small

If you do find yourself needing to travel and wondering when is it safe to travel with a newborn by plane, the recommendation is to hold off until baby’s immune system is more mature. This reduces the risk of illness and infection.  

If you’re wondering when can you travel with a baby and how soon you can travel with your baby locally by car, then as long as your baby has a well-fitted and approved infant car seat it’s safe from birth. 

However, stick to the 30 minutes for 4 weeks guidance and minimize travel to essential journeys.

When it comes to h ow soon a newborn can travel long distance by car the recommendation is the same as air travel: when the immune system is better developed, at 2-3  months old.

At this age, 2 hours is recommended as the maximum for travel in the car in a 24 hour period.  If a longer car ride with your newborn is unavoidable, make sure you take plenty of breaks.  And remember, no holding your baby in the car – that’s illegal.

Hopefully, you’re a lot more clued up about traveling with a newborn by car and I hope the tips on traveling with a newborn by plane will be useful.

Happy travels! 

____________________________________________

For more tips for the early weeks with a newborn, these posts may be helpful:

• How to keep baby warm at night without a swaddle
• First night home with your newborn baby; what to expect & tips to survive it
• 6 newborn baby cues you need to know: understanding baby cues (printable chart!)
• How to help a newborn poop instantly! 11 tried & tested ways to relieve poopy struggles
• Is it OK to put baby to sleep without burping? (Yes, if you learn how to burp a sleeping baby)

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Want to dig a little deeper? Check out these other related posts:

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When is it safe to fly with my baby?

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Does my baby need a passport?

Parents' tips: travelling with a baby

Travelling with a newborn to eight-month-old

Buying a travel cot

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Infant Air Travel

We’re here to take you and your family wherever you need to go.  Infants or children under 2 years of age can travel on the lap of an adult for free (within the United States) or at a reduced fare (for international travel). You also may purchase a ticket and use the child’s own seat on the aircraft as long as it meets the FAA-approved child safety seat specifications or use a CARES harness. Our step-by-step guide explains how to easily add a lap-held infant (Infant-in-Arms) to your ticket yourself.

Due to FAA safety requirements, 1 adult passenger may only carry 1 lap-held infant. If an adult passenger is traveling with 2 infants, a seat must be purchased for the additional infant. Infants occupying a seat on domestic flights require a ticket and pay the applicable fare.

Pregnant Passengers

Child & infant age restrictions, infant-in-arms or child in safety seat, you will need to purchase a ticket for your child if you:.

• Have a child that is 2 years old or older
• Have a child that turns 2 during the trip
• Prefer the child sit in a seat with an FAA-approved child safety seat
• Already have a child that will be sitting in your lap, regardless of age
• Want your child to earn miles for their SkyMiles account
• Will be traveling between countries, regardless of whether or not the child occupies a seat

Child Safety Seat Guidelines

If you decide to use a child safety seat aboard the airplane and purchase a ticket for your child, there are a few restrictions and guidelines you'll need to follow.

The window seat is the preferred location for an approved child safety seat (child restraint system or car seat). Other locations may be acceptable provided the seat is not installed between other passengers and the aisle. An accompanying adult must sit next to the child. More than one car seat may be in use in the same row and section of seats. Per FAA regulations, children under 2 years of age are not allowed to sit in a seat equipped with an airbag seat belt.

When using a child safety seat, don’t select seats in the following areas: 

• Aisle seats
• Emergency exit rows
• Bulkhead seats when the safety seat is a combination car seat and stroller
• Flatbed seats in the Delta One ™ area of the following aircraft: Airbus A330-200 or A330-300 aircraft *

* Child Safety Seats are not permitted in this area since the airbag seat belt cannot be deactivated .

An adult (18 years or older) may hold an infant (Infant-in-Arms) or place the infant in a FAA-approved child restraint in their seat during takeoff and landing. Booster-type car seats are not permitted for use during taxi, takeoff and landing.

Delta flight attendants will check with accompanying adults to ensure that children are properly secured in their safety seats and in the aircraft seat. The accompanying adult, however, has the following responsibilities when using a child restraint during takeoff and landing:

• Ensure that the child restraint seat meets FAA guidelines , Go to footer note
• Ensure that the child restraint seat functions properly and is free of obvious defects
• Secure the child according to the manufacturer's instructions
• Ensure the child does not exceed the restraint's weight limit
• Ensure the child restraint is secured to the aircraft seat using the aircraft seat's safety belt

All child safety seats or restraints include labeling that indicates their compliance with safety requirements. Restraints that meet the qualifications and labeling are approved for use on Delta flights.

Restraints manufactured within the U.S. after 2/25/85 with the following labels:

• Conforms to all applicable federal motor vehicle standards
• Is certified for use in motor vehicles and aircraft

Restraints manufactured within the U.S. between 1/1/81 and 2/25/85 with the following label:

Restraints manufactured outside the U.S. with the following labels:

• Has the approval of a foreign government
• Was manufactured under standards of the United Nations

Restraints that are not permitted:

• Booster seats, even if they bear labels indicating they meet U.S., UN or foreign government standards
• Vest and harness-type child restraint devices other than the FAA approved CARES restraint device

Bassinets or SkyCots

For some of our smallest passengers on some international flights, we offer onboard baby bassinets. They’re ideal for babies weighing up to 20 lbs. (9 kg) and up to 26 inches (66 cm) long.

• Onboard bassinets, also known as SkyCots, are available free of charge for passengers in select seats on equipped aircraft for some international flights
• SkyCots can be requested by contacting Reservations before arriving at the airport and then speaking with the gate agent at the boarding gate, but cannot be guaranteed due to a limit of two SkyCots per aircraft and weight restrictions
• Please note that all infants must be held during takeoff, landing and whenever the seat belt light is on

Additional Infant Travel Information

For children under the age of two, we recommend you purchase a seat on the aircraft and use an approved child safety seat. Here are some other helpful tips for traveling with your infant or toddler:

Breastfeeding

Delta fully supports a woman’s right to breastfeed on board Delta and Delta Connection aircraft and in Delta facilities. Breast pumps are allowed on board. At the airport and if you prefer, many airports do offer private lactation rooms or spaces. Ask a Delta associate if you need assistance locating one at an airport.

Booking Your Trip

When traveling with an infant or toddler, you may find it helpful to allow a little extra time between flights to take rest or bathroom breaks along the way. Our Airport maps can help you plan your layovers before you even reach the airport.

International Flights

If your travel destination requires a passport and/or travel visas, you will need a passport for your child, and possibly extra documentation. To review required documentation in each country you’re visiting or stopping over in, visit the U.S. Department of State’s Special Requirements for Children .

Infant Baggage

Review our Infant & Children's Items guidelines for specific details on carry-on items, including child restraint seats, strollers and diaper bags. During security check in, the TSA will usually make a special provision for items like medications, breast milk and baby formula. Check out the Traveling with Kids section of the TSA website for information and helpful videos about travel with infants and carry-on baggage restrictions.

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When Is It Safe to Travel with a Newborn? By Train, Car, & Plane

• When Is It Safe to…

Do you think you are ready to travel with your newborn? While post-delivery long-haul flights can exhaust you, they can be even more tiring for your little one. Additionally, you want to make sure your newborn is safe and healthy, whether you are traveling by plane, car, or train.

Use the table of contents below to find what you’re looking for

Table of Contents

When Is It Safe to Travel with a Newborn?

Medical experts suggest waiting until the baby is at least two to three months until their immune system has fully developed. However, remember that development takes place differently in newborns. Your baby may develop a strong immunity in a month, or it may take around three or four months. Generally, babies have a fully developed immune system by four months .

Traveling with a newborn is not as complicated as it may sound. Many people who travel with newborns report a relatively smooth experience, contrasting with the misconceptions and myths. You should follow some basic medical recommendations to ensure your baby’s safety and health.

When Is It Safe to Fly with a Newborn by Plane?

As mentioned, you should wait until your baby is three months old to ensure their immune system has fully developed. You do not want your infant to contract an infection after all. This practice helps ensure your baby’s health.

Regarding health concerns, premature babies and those with heart and lung diseases often suffer from breathing difficulties. The low air pressure on the flight can significantly influence your baby’s health. Therefore, discussing your concerns with your pediatrician before flying with your baby is wise.

You also want to check your airline’s policies regarding flying with an infant. Different airlines have different requirements. According to Delta’s policies , the minimum age requirement for infants is typically a week old. If your infant is younger and you have to travel, you may need a written letter you’re your pediatrician.

Tips for Traveling with a Newborn on a Plane

Flying with a newborn can be pretty intimidating, especially if you have never traveled with kids. Besides the procedures becoming more complicated, the trip can get uncomfortable if you are unprepared. So, how can you ensure a smooth and comfortable flight with your new travel partner?

Here are some helpful tips to maximize comfort during your infant’s first flight.

1. Plan the Trip

Planning your trip and making all the necessary arrangements can mean the difference between a hectic vacation and a fun experience. Therefore, take your time to plan all the little things before boarding.

Starting with the basics, more and more air passengers have started opting for online bookings. While it is a convenient route, calling the airline reservation desk can help eliminate any future problems that may show up later to ruin your experience. In doing so, you can ensure that you provide and receive all the necessary information.

Here are some critical considerations:

• Provide the agent with all the passengers’ ages, including your newborn child. This is also an excellent time to ask about any age limitations or specific regulations for traveling with an infant. For example, some airlines do not allow infants less than two weeks on the board. Similarly, some other airlines may charge an excess fee for baggage, like strollers and car seats .
• Decide if you’re going to use car seat or flying the infant on your lap .
• Ask the airline reservation for a bassinet and front row (bulkhead) seat. However, you want to avoid bulkheads if your baby is a few months old. It is especially advisable for parents carrying a considerable amount of baby supplies.
• Avoid booking a flight during a time that clashes with your baby’s naptime. You do not want to deal with a cranky baby, after all. Furthermore, ensure your flight is not at the same time as your child’s “witching hours”- a particular time during the day when babies act annoyed and irritated.
• Be sure to aware of the airline’s rule regarding baby stuffs you bring, for example if you fly Delta you should know Delta’s car seat policy , if you fly AA you should know American Airlines’ stroller policy , and so on.

2. Pack Smartly

It can be tempting to pack everything that comes to your mind. You want to make the trip as stress-free as possible, after all. However, packing smartly instead of heavily is the key to ensuring that your first flight with your newborn is smooth.

On that note, picking suitable travel bags also makes a huge difference. For instance, the right carry-on bag for all your baby’s essentials can be a lifesaver during a long-haul flight. Your bags should be easy to lift and roll while they fit with the luggage weight limitations set by the airline.

Let us look at some essential supplies that will ensure you are well-prepared for an unexpected delay or layover.

• Extra change of clothes
• Diaper changing pad
• Baby Blanket
• Empty plastic bags
• Ample of baby food (formula milk, baby food, etc.)
• Extra baby bottle
• Premeasured formula milk in separate containers or bags
• Waterless hand cleanser
• Hand sanitizer
• Toys (non-noisy ones to not disturb fellow passengers)
• Any prescription medication

3. Prepare for the Long Day at the Airport

No matter the age of your child, parents should always reach the airport early. Traveling with a baby is stressful enough, so do anything to avoid unnecessary hassle. If you want a good start, arrive at the airport a few hours before boarding the flight.

Local Flight: Arrive at least thirty minutes before the boarding time

International flight: Arrive at least three hours before the boarding time

This way, you can go through the security and other necessary procedures without causing stress to you and your baby. You will not need to stand in long queues or rush through checkpoints. Here are some other helpful tips for your time at the airport.

• Inform your attendant that you are traveling with a newborn as soon as you check-in. Tell them you have brought a car seat or stroller for the flight.
• Consider gate checking your stroller so you can use it while waiting at the airport.
• Try to check all your luggage to avoid paying additional money for carrying extra carry-on bags.
• Change your newborn’s diaper right before boarding the flight.
• It is best to avoid feeding your baby right before boarding, whether it is breast milk or formula. If your newborn is not too hungry, consider waiting until you have settled in your seat.

4. Be Alert during the Flight

Infants are incredibly unpredictable, especially on their first flight. Even the quietest and calmest of babies can act fussy on the plane. The strange surroundings can scare and make them uncomfortable, after all.

Besides dealing with a cranky child, you may also have to tolerate looks from fellow passengers. Whether you like it or not, not everyone is tolerant of crying babies, and you may even have to apologize to some. This can further add to the stress, making your flight more frustrating.

Here are some ways to help your baby stay calm.

• Take-off and landing are the most stressful experiences for infants flying for the first time. You can help your baby adjust to the changes in air pressure by encouraging swallowing. You can use a pacifier, bottle, or breastfeeding for this.
• During a flight, babies tend to get dehydrated more quickly than adults. Therefore, you want to make extra efforts to ensure your baby is well-hydrated.
• Changing a diaper on a flight can be extremely challenging. While some airplane bathrooms have changing tables, others are typically smaller with congested spaces. You may need to change your newborn’s diaper on the floor if your airplane bathroom does not have a diaper station.
• Storing baby food in the fridge is not possible on a flight. However, you can ask a flight attendant to warm the baby bottle. It is usually necessary, considering the temperature drops on flights.

When Is It Safe to Travel with a Newborn by Car?

The basics for traveling with a newborn by car are the same as traveling with a newborn by plane. Medical experts recommend waiting until a baby’s immune system has fully developed before taking them out for a trip. Your child is more vulnerable to colds and other infections when their immunity is not strong enough.

It typically takes around three months for newborns’ immune systems to mature. According to doctors, it is safe for babies a few weeks old to travel short distances. This includes traveling a few miles to the doctor’s office or taking your baby with you for groceries, given that your baby is healthy and is not suffering from any complicated health problems.

However, it is best to wait at least three months , until your newborn’s immune system matures, for longer car journeys. Ideally, you should avoid car travels that are longer than an hour. On the other hand, it is illegal to hold your infant in cars, including cabs. It is necessary to have an approved car seat according to the baby’s size and age.

The Car Journey vs. the Baby’s Age

Long car drives can be highly uncomfortable for adults but even more tiring for children.

Here are some basic guidelines when planning a car trip with your infant.

1. Avoid Traveling for More than 30 Minutes if Your Baby is Younger than Four Weeks

Infants under four weeks of age struggle with keeping their heads upright. While some babies may be stronger individuals at this age, most do not have enough neck strength to bear the weight of their heads.

In the first few weeks after birth, there is always a risk of your newborn’s head falling forward. It can restrict your child’s airway, presenting a serious health risk. The danger chances increase when you have seated your baby in a car seat.

Ideally, you should restrict your drives to thirty minutes long if your child is younger than four weeks.

2. Follow the 2-Hour Rule

According to car seat manufacturers, babies should not stay in a car seat for more than two hours a day. That said, an occasional longer than two hours journey is safe, given that you take a lot of breaks. Fifteen to thirty minutes breaks are ideal if you are on a long-distance car journey. You should make stops after every two hours and remove your baby from the car seat for at least fifteen minutes.

Tips for Traveling with a Newborn in a Car

As a parent of a newborn, you may hesitate to expose your newborn to the outside world. It is full of pollutants and germs that can risk your baby’s health. The prospect of a long drive can stress out even the calmest of parents and experienced travelers.

Planning can help make your road trip comfortable for you and your baby. Before diving into some practical tips, we want to emphasize the value of car seats. The best travel car seats help protect during traveling, reducing the probability and risk of fatal injuries in case of accidents.

Here are some things you want to keep in mind for your road trip with a newborn.

1. Take a Practice Trip (Or Two)

Do you know a family that embarked on a long car drive with their newborn but returned before finishing their trip?

Generally speaking, babies do not like a change of scenery and environment and are most comfortable with their routine life. For that reason, they become annoying and fussy outside of the house. You do not want your newborn to dissolve into hysterics, do you?

While a fair amount of crying is inevitable, you can avoid long spans of tantrums by getting your baby used to being in the car seat. Are you planning a long road trip soon? If so, taking your baby on a practice car drive will familiarize them with their car seat. Your baby will learn to adjust to the new setting, making future trips much more manageable.

Of course, the first trip will be challenging. Therefore, it is best to avoid overdoing it and increase the distance slowly. Start with a short first trip, which should be longer than your regular car travels to the doctor’s appointment, etc. Similarly, your second road trip can be a little longer to help your newborn get comfortable in the car seat.

Once things start getting better, you can take the long trip to your parents’ place that you have been preparing for. Incrementally increasing your baby’s time in a car seat reduces the chances of your baby throwing a tantrum and causing you to turn around for home. In summary, practice can make a road trip successful.

2. Schedule the Right Drive Time

Making sure that your baby is comfortable throughout the journey is the key to planning a smooth road trip. Generally, babies are much happier when they are well-rested. So, how can you ensure that your baby gets enough sleep during the journey?

It all comes down to scheduling your travel at the right time. Many people recommend driving at night. They claim that your baby will stay asleep and you will be close to your destination by the time they wake up. In that case, you can have a stress-free and crying-free road trip.

However, such a plan can have quite the opposite effect, with a high probability of things not working out in your favor; avoiding driving when your baby naps or during periods of sleep is the best and safest option when traveling with a newborn in a car.

How? Traveling during your baby’s sleeping time means talking away their comfort. A clashing schedule like this can disturb your newborn’s sleeping cycle. They will not receive restful sleep, which can cause them to become fussier.

You can save yourself the stress of entertaining your baby by scheduling the journey when your baby sleeps. But it typically comes at the cost of you and your baby feeling incredibly exhausted.

Instead, scheduling the drive according to your family’s natural sleeping patterns is best. Make sure you get enough sleep before starting the journey to prepare your body for the long day ahead. Similarly, you want your baby to rest well before settling in a car seat.

Keep the morning and evening rush hour traffic in mind when planning your travel.

3. Ensure Proper Car Seat Installation

The travel car seat is critical in keeping your baby safe and comfortable during a long car journey. But, the wrong car seat and improper installation can present health and safety risks.

Therefore, checking whether your infant’s car seat is installed correctly is vital before settling your newborn in it. While many parents tend to ignore it and go in their way, reading the manufacturer’s manual is essential. These manuals usually tell you about the right and wrong installation methods and the risks associated with doing a step the wrong way.

Make sure to follow the manufacturer’s instructions for installing the travel car seat in your car. Ideally, your car seat should be rear-facing when you install it at the correct angle. Not following the correct installation techniques and all the necessary steps increase the chances of your baby’s head slumping down in the seat. Being in the chin-to-chest position can gradually block their airway, and you may not realize it.

Besides installing the car seat at the right angle, you want to adjust the five-point harness correctly. Proper installation makes the car seats comfortable for babies, who may even sleep during the journey.

While car seats help protect babies in a car crash, they are also safe for napping babies. That said, picking the right car seat for your baby’s age and size is critical to benefit from the advantages.

4. Avoid Dressing Your Baby in Bulky Clothes

Dressing your baby in comfortable clothes is a simple, easy, and effective way to maximize comfort. Your baby is less likely to cry and get cranky when dressed in something that does not make them feel dressed .

Therefore, it is best to avoid dressing your newborn in bulky clothes. Bulky clothes, such as coats and jackets, also make car seat buckling difficult. The baby will also feel uncomfortable in the seat with heavy clothes. They may even feel heated in bulky apparel.

Additionally, the car seat’s buckles and straps may shift with the bulky clothes. Therefore, dressing your newborn in light layers is the safest and most convenient option. If you are worried about the cold temperature, consider warming your car in advance.

5. Simplify the Schedule

Do you have the travel itch? You may have become immune to long travel journeys over your years of traveling. However, you may have to lower your expectations from your first road with your newborn. Sticking to a strict schedule can be challenging, even unachievable, when traveling with an infant.

Of course, you want to reach your destination as soon as possible. The shorter the journey, the smoother it will be. However, it would help if you kept your offspring’s needs and your sanity in mind when making a car travel schedule.

Even the calmest and most experienced-in-traveling baby can only take as many hours in a moving vehicle. Therefore, it is essential to simplify your schedule to ensure your road trip is as hassle-free as possible.

Furthermore, you want to ensure you care for yourself and the rest of the family (spouse, other kids, etc.). While your newborn needs extra handling, forgetting about your sanity and health is not a good idea.

Make sure to schedule some rest time away from the wheel. Only when you are well yourself can you drive safely.

6. Take Regular Breaks

Having a successful road trip with a newborn is impossible if you do not plan regular breaks in your schedule. The sooner you accept this truth, the better your journey will be.

Planning stops at the trip’s onset reduces your chances of struggling with a crying baby. It will also keep you and the rest of the family from getting cranky. Therefore, add a few minutes of break every few hours to your itinerary. Make the stop regardless of whether you need to do something important during the break. Getting out of the car to stretch can help prevent restlessness and an aching back.

Ideally, you should stop every two or three hours during the day. You can reduce it to every four to six hours during the night. Remember that toddlers do not have the patience to stay in a closed space like a car. If your baby starts getting cranky, simply pulling over and stepping out can help them calm down.

Additionally, you want to break your long car ride into manageable segments for breastfeeding the baby or changing diapers. Feeding in a moving car can get messy, and it is also incredibly unsafe. You should only do so when your baby is starving and cannot pull over in the middle of the road. On the other hand, your baby may need a diaper change at the most inopportune time. Generally, you should not hesitate to pull over for comfort and safety. A milk spit-out fiasco? A diaper blowout? Anticipating hunger? Stop the car, and take care of the issue.

Ideally, you should plan your stops before hitting the road to ensure you still reach your destination on time. Learn about the rest stops and gas stations on the way so you do not struggle with an unexpected mechanical issue with the car. It is also wise to find baby-friendly hotels on your way in case you need a hotel stay.

7. Pack a Travel Bag

Whether you are a first-time parent, a travel bag is vital to ensure no hassle on your car journey with your newborn. While traveling with a baby can feel overwhelming initially, packing a travel bag with the right essentials can make it easier than you think.

Items to Keep in Front of the Car

Let us look at some essentials you want to keep in close reach (preferably at the front of the car).

Diapering Station

• Lots of diapers
• Diaper wipes
• Diaper changing pads
• Plastic bags (for dirty diapers or clothes)

Feeding Supplies and Essentials

• Breast pumps (if breastfeeding)
• Lots of burp rags
• Feeding bottles
• Powdered formula

Other Essentials

• Pacifiers (two or more)
• Portable sound machine (optional)
• Nasal bulb suctioner
• Change of clothes
• UVA-blocking sun shades for the windows
• Safety mirror (to see the baby) (or baby monitor to keep an eye on your newborn in the backseat)
• First aid kit
• Toys (for entertaining the baby)

Essentials for You

Other Items for the Road Trip

What and how much you pack depends on several factors. For instance, you may not need as many things for a short-distance car ride as you would for a long one. Additionally, you may have specific needs depending on your location, schedule, medical issues, etc. You want to carry the most convenient things for your car journey.

• Travel car seat
• Baby carrier
• Bouncer/ bassinet

Sleeping Essentials

• Swaddle (two in case one gets soiled by a diaper accident)
• Blankets (for everyone)
• Outfits (two to three changes of clothes for a day)
• Outerwear (sweaters, cardigans, etc.)
• Sun hat/ beanie
• Socks (two pairs for a day)

Medical & Hygiene &Diapering

• Baby shampoo
• Laundry detergent
• Hand wash (to clean your hands after diaper changes)
• Dish soap (to clean pacifiers and feeding bottles)
• Feeding bottle cleaning brush
• Thermometer
• Infant’s prescription medications
• Baby medications (for fever, cold, etc.)
• Nail clippers (for a long trip)
• Forks and spoons
• Plates and bowls
• Disposable nursing pads
• Breast pump

8. Pack/ Organize Your Car

Now that you know the travel bag essentials for traveling with a newborn by car, it is time to learn how to pack strategically.

How you fit all the items in your car can make a massive difference to the space in your car. Not forgetting, packing the right essentials is only useful when you can efficiently grab the needed things in time. Therefore, packing/strategically organizing your car is extremely important.

Packing your car a day or night before the day of the trip is excellent, as it will save you a lot of hassle on the day itself. You do not want to rush things or run late and end up in traffic. When organizing your car, it is a good idea to think about the items you will not need and can stow away.

In doing so, you can make space for the necessary items you will most likely need throughout the journey. When traveling with a newborn, you will need many things within arm’s reach.

Ideally, you want to keep your carry-on bags, suitcases, and other large items in the car’s trunk, like a travel crib. After all, you will probably not need access to these items at your road trip destination.

On the other hand, consider making a separate “necessity bag” for other items you will need and want en route. These include the essentials mentioned in the list of “items to keep in front of the car” above. Ideally, you should create separate feeding and diaper bags.

If your car is spacious enough, you can use the back of the vehicle for a makeshift diaper-changing table. You can especially do that if you have an SUV. These vehicles have a flat trunk and just the right height for changing a newborn’s diaper. Utilizing the extra space makes pit-stop diaper changes considerably easier and quicker.

Additionally, you want to designate a space in the car to throw your trash. While a trash bin is excellent, trash bags can work well too. You can install them around the headrest of the front car seat. If you want extra organization, consider using back-of-the-seat organizers for placing toys and other necessities.

Is It Safe to Travel with a Newborn by Train?

Traveling by train offers an incredible experience for adults. It is a safe, comfortable, and eco-friendly mode of transportation. You can relax in your seat and enjoy the beautiful views as you wait to reach your destination.

However, does the train offer the same comfort level for babies, particularly newborns? More importantly, you may wonder if a train journey is safe for a newborn. Generally, many people report that traveling by train is the best- most comfortable, and safest option for passengers with newborns.

While the train offers many advantages, what goes for traveling by plane or car goes for train travel. In other words, you must check in with your pediatrician if your baby is only a few weeks old. Ideally, you should wait until your newborn is three months old before planning their first trip in train . By this time, most children have developed their immune systems and are ready to see the world.

Tips for Traveling with a Newborn on a Train

While you may have heard that traveling by train is the safest option, doing so for the first time can feel overwhelming and challenging. Not only is your baby new to traveling, but you also probably have no experience caring for such a young child on a train.

However, traveling with a newborn on a train is not so complicated. You can ensure a successful train journey by learning about some practical tips. Here are the top tips to make your travel experience much smoother.

1. Wear Your Infant

Have you ever wondered why most people say traveling by train is a great time for young travelers, including infants and toddlers? Well, trains are incredibly comfortable – a sure-fire sleep-inducing method of transport.

Sleep will most likely not be a problem for your baby, and they will get restful sleep whenever they want. Not to mention, you can also sleep comfortably on the train. However, make sure to use a soft baby carrier. This way, you do not have to worry about your baby’s safety when taking a nap.

Baby carriers allow you to keep your baby close to you and move around naturally and comfortably. If you are purchasing one for your trip, trying both harness and sling carriers is excellent to find a comfortable one for you and your baby.

2. Reach The Station Early

Reaching your train station early has similar benefits to arriving at the airport a few hours before boarding the flight. Traveling with an infant is a new experience, so it is only natural you want to make it hassle-free. You want to avoid the stress of missing the train or not being able to find your seat, do you not? Arriving early is the only way to minimize unnecessary stress when traveling with a newborn on a train.

Reaching your train early before other passengers will allow you to learn about the train and its services. For example, some train cars are specifically for families. These have additional amenities, such as changing tables in the bathroom. You can find a seat in one of these train cars if you reach before it gets full.

3. Let the Staff Help

Trains traveling over long distances are usually fully-staffed. This allows them to be friendlier and more helpful to the passengers as the tasks are divided. While you may hesitate to trust them, letting your train’s staff members remove some of your stress is wise.

For instance, you may need to store the baby’s food (breastmilk or formula) in the refrigerator. Or, you may need to heat the feeding bottle before feeding your newborn. You can ask the train’s staff to do these tasks for you.

4. Pack Smartly

Packing for a train journey is similar to how you would do for air and road travel. Here are some things to remember when packing for train travel with your newborn.

Pack Baby’s Clothes Separately

Train journeys are usually long, meaning your baby will need diaper changes a few times before you reach your destination. Ideally, you should pack around four to five outfits for a day of traveling.

Keep the Baby’s Feeding Supplies within Reach

You want to make a separate bag for your newborn’s feeding supplies so that you do not have to open bigger bags frequently.

Bottom Line

Traveling with young children can be challenging. It is overwhelming, even scary, for parents who have never traveled with an infant.

If you have a newborn, you and your child may still be trying to adjust to many different things. Traveling can be especially tricky if your baby does not like being in new places. While a few crying tantrums are inevitable, your trip with your newborn should not be a huge struggle.

Ideally, newborn babies should not travel before three months. So if your child is younger, consider waiting until their immune system fully develops. Do not forget to refer to our tips for traveling with a newborn by plane, car, or train!

Related Articles

• 10 Best Practices On Flying with Infant on Lap
• American Airlines Stroller Policy – Flying With Small Child
• Travel With A Car Seat: Flying, Renting, Regulation, & More
• 12 Best Travel Car Seat: Cosco, Doona, Evenflo, and More
• 15 Proven Tips for Gate Checking A Stroller Easily

Author:  Olivia Moore

Olivia is a mother with two kids, 3 and 5. Between her activities as a writer and teacher, she plan and arrange all her family trips to both local and international destinations.

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Can You Fly with a Newborn? What the Experts Say

Not many parents wants to travel with a newborn, but sometimes it is a matter of necessity.

So you’re probably wondering how soon you can fly with a newborn and if it will be safe?

Depending on the airline you are flying with, you can fly with a newborn who is as young as 2-14 days old, though an approval letter from a physician may be required.

Table of Contents

• 1.1 By Airline
• 2 The Same Applies When Flying Internationally
• 3 Doctors Recommend Waiting
• 4 Even Newborns Need Passports
• 5 Sit in the Bulkhead or Back Row
• 6 It’s Generally Safe to Fly With a Newborn
• 7 What to Keep in Mind When Flying With a Newborn
• 8 How Soon Can You Travel With a Newborn By Car and Train?

How Soon Can You Travel With a Newborn By Plane?

Here are airline policies of the major air carriers in the U.S. if you want to fly with a newborn:

• Alaska Airlines: Alaska Airlines state that there is no minimum age requirement to fly, but you should “check with your doctor if you’re unsure your infant should be traveling via plane.”
• American Airlines: If flying with American Airlines, you can fly with a newborn who is young as 2 days old, but you must have a medical authorization form completed by a physician for newborns under 7 days old.
• Delta: Delta state that you can only fly with a baby under 7 days old if you have an approval letter from a physician.
• JetBlue : Newborns as young as 3 days old are allowed to fly with JetBlue, but if aged between 3 and 14 days, written approval from a doctor is necessary.
• Southwest : Southwest state that “a medical release for travel is required for any infant under 14 days old.”
• United : United state that newborns younger than 7 days old are not allowed to fly.
• Air Canada: Air Canada state that newborns as young as 7 days old are allowed to fly.

The Same Applies When Flying Internationally

Regardless if you’re flying domestically or internationally, airline policies appear to remain the same.

So, you can fly internationally with a newborn who is as young as 2-14 days, though an approval letter from a physician may be required the younger a newborn is.

While how soon you can fly with a newborn may vary in other countries according to airline policies, they will generally be similar – i.e. from 2 days and older.

Related: How Early Should You Get to the Airport For an International Flight?

Doctors Recommend Waiting

Doctors recommend waiting until your baby’s immune system is better developed until they can fly.

While this can be as soon as one month for full-term infants, most doctors recommend babies be between three months and six months old before flying.

Even Newborns Need Passports

When flying domestically in the U.S., newborns do not need any form of ID to fly.

In fact, anyone who is under 18 does not need ID as long as they are accompanied by an adult who has an acceptable form of ID.

When flying internationally, a passport is always necessary, regardless of age.

Related: What Do Kids Need to Fly?

Sit in the Bulkhead or Back Row

The best place to sit on a plane when flying with a newborn is a bulkhead row.

This is because the bulkhead:

• Leaves more room for a diaper bag
• It is easier to pass an infant between parents/caretakers
• You have better access to flight attendants
• You can get off the plane more quickly.

The back row of the plane can also be a great place to sit when flying with a newborn because:

• It is near the galley, making it easier to get up and walk around
• It is near the bathroom
• It offers more privacy
• The food cart starts from the back, so you won’t be stuck if you need to get up
• Seats are more likely to be empty at the back of the plane

However, keep in mind that the back of the plane can be louder and there will be a lot of movement as people come and go to the bathroom.

It’s Generally Safe to Fly With a Newborn

Generally, it is safe to fly with most, healthy, full-term infants.

However, the longer you wait to fly, the better, so an infant’s immune system can better develop, and they have had the time to complete their primary immunizations.

Infants who get stomach bugs or respiratory illness are more at risk than older babies, too.

Always consult your physician first to get the all clear from them.

What to Keep in Mind When Flying With a Newborn

• Check With the Airline: Many airlines will require a note from a healthcare provider before a newborn can be cleared to fly, depending on how soon after their birth you want to fly.
• Consider the Noise: Planes can be very loud, so it can be a good idea to use baby ear muffs .
• Use a Car Seat: Placing an infant in a car seat rather than carrying them on your lap is a better idea. The Federal Aviation Administration actually recommend this.
• Travel Light: Traveling light is recommended because it will ensure your full attention will be on your newborn and not your luggage.
• Board Last : Boarding the plane last means that you will avoid passengers climbing over you and walking past you and in your baby’s path.

How Soon Can You Travel With a Newborn By Car and Train?

While you can take short car trips with a newborn soon after birth, it’s recommended to wait until your baby is at least six weeks old for long-distance road trips.

Doctors recommend waiting until your baby’s immune system is better developed until they can travel by train.

So the same recommendations apply for train travel as they do air travel, which is to wait at least 3 months before traveling with a newborn on a train.

Related: The Easiest Way to Book a Flight for an Unborn Baby

Ella Dunham

Ella Dunham, a Freelance Travel Journalist and Marketing Manager, boasts an impressive career spanning eight years in the travel and tourism sectors.

Honored as one of "30 Under 30" by TTG Media (the world’s very first weekly travel trade newspaper), a "Tour Operator Travel Guru" and "Legend Award" winner, Ella is also a Fellow of the Institute of Travel, a Member of the Association of Women Travel Executives, has completed over 250 travel modules, and hosts travel-focused segments on national radio shows where she provides insights on travel regulations and destinations.

Ella has visited over 40 countries (with 10 more planned this year).

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Automatic Refunds and No More Hidden Fees: D.O.T. Sets New Rules for Airlines

The Transportation Department issued new requirements on refunds when flights are canceled or delayed and on revealing “junk” fees before booking. Here’s what passengers can expect.

By Christine Chung

The Transportation Department on Wednesday announced new rules taking aim at two of the most difficult and annoying issues in air travel: obtaining refunds and encountering surprise fees late in the booking process.

“Passengers deserve to know upfront what costs they are facing and should get their money back when an airline owes them — without having to ask,” said U.S. Transportation Secretary Pete Buttigieg in a statement, adding that the changes would not only save passengers “time and money,” but also prevent headaches.

The department’s new rules, Mr. Buttigieg said, will hold airlines to clear and consistent standards when they cancel, delay or substantially change flights, and require automatic refunds to be issued within weeks. They will also require them to reveal all fees before a ticket is purchased.

Airlines for America , a trade group representing the country’s largest air carriers, said in a statement that its airlines “abide by and frequently exceed” D.O.T. consumer protection regulations.

Passenger advocates welcomed the new steps.

Tomasz Pawliszyn, the chief executive of AirHelp, a Berlin-based company that assists passengers with airline claims, called it a “massive step forward and huge improvement in consumer rights and protection” that brings the United States closer to global standards in passenger rights.

Here’s what we know about the D.O.T.’s new rules, which will begin to go into effect in October.

There’s now one definition for a “significant” delay.

Until now, airlines have been allowed to set their own definition for a “significant” delay and compensation has varied by carrier . Now, according to the D.O.T., there will be one standard: when departure or arrival is delayed by three hours for domestic flights and six hours for international flights.

Passengers will get prompt refunds for cancellations or significant changes for flights and delayed bags, for any reason.

When things go wrong, getting compensation from an airline has often required establishing a cumbersome paper trail or spending untold hours on the phone. Under the new rules, refunds will be automatic, without passengers having to request them. Refunds will be made in full, excepting the value of any transportation already used. Airlines and ticket agents must provide refunds in the original form of payment, whether by cash, credit card or airline miles. Refunds are due within seven days for credit card purchases and within 20 days for other payments.

Passengers with other flight disruptions, such as being downgraded to a lower service class, are also entitled to refunds.

The list of significant changes for which passengers can get their money back also includes: departure or arrival from an airport different from the one booked; connections at different airports or flights on planes that are less accessible to a person with a disability; an increase in the number of scheduled connections. Also, passengers who pay for services like Wi-Fi or seat selection that are then unavailable will be refunded any fees.

Airlines must give travel vouchers or credits to ticketed passengers unable to fly because of government restrictions or a doctor’s orders.

The vouchers or credits will be transferable and can be used for at least five years after the date they were issued.

Fees for checked baggage and modifying a reservation must be disclosed upfront.

Airlines and ticket agents are now required to display any extra fees for things like checking bags or seat selection clearly and individually before a ticket purchase. They will also need to outline the airline’s policies on baggage, cancellations and changing flights before a customer purchases a ticket.

The rules, which apply to all flights on domestic airlines and flights to and from the United States operated by foreign airlines, have varying start dates.

For example, automatic refunds must be instituted by the airlines within six months. But carriers have a year before they’re required to issue travel vouchers and credits for passengers advised by a medical professional not to fly.

Follow New York Times Travel on Instagram and sign up for our weekly Travel Dispatch newsletter to get expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places to Go in 2024 .

Christine Chung is a Times reporter covering airlines and consumer travel. More about Christine Chung

Open Up Your World

Considering a trip, or just some armchair traveling here are some ideas..

52 Places:  Why do we travel? For food, culture, adventure, natural beauty? Our 2024 list has all those elements, and more .

Mumbai:  Spend 36 hours in this fast-changing Indian city  by exploring ancient caves, catching a concert in a former textile mill and feasting on mangoes.

Kyoto:  The Japanese city’s dry gardens offer spots for quiet contemplation  in an increasingly overtouristed destination.

Iceland:  The country markets itself as a destination to see the northern lights. But they can be elusive, as one writer recently found .

Texas:  Canoeing the Rio Grande near Big Bend National Park can be magical. But as the river dries, it’s getting harder to find where a boat will actually float .

The sad, stale state of in-flight vegetarian meals

Who ordered the limp cucumber sandwich.

Last month, a traveler posted a photo to Reddit of his girlfriend’s vegetarian meal for a 12-hour flight. It wasn’t pretty.

The sandwich featured two grim cucumber slices and wan tomatoes. On the top half of the dry roll, faint oval imprints of the filling resembled cupping therapy marks. If the flight attendants had tried to revive the meal, they failed.

As a vegan, I could relate. For travelers who don’t eat animal products, the special meal delivered to our seat is often a mystery: What will the ingredients be? How was it prepared? Will it be halfway palatable?

We know the usual suspects all too well, tomato-soupy ratatouille, salty rice the color of pale sunshine or an anemic salad. We squirrel away extra packets of Biscoff not because we are members of the cookie’s fan club; we’re just trying to survive the flight.

The pitiful cuke is the latest publicly shared slight to vegetarian and vegan travelers seeking sustenance on airplanes. In 2023, a Japan Airlines passenger received a solitary banana with chopsticks for his vegan business-class breakfast. In March, Donna Zeigfinger, founder of Green Earth Travel , ordered a quinoa plate on a United flight. The travel adviser’s plant-based meal came with a side of chicken strips.

“They’re not quite getting it,” said Zeigfinger, a longtime vegan. “They’re still not understanding.”

On a 12 hour flight and this was my gf’s veggie sandwich around 8hrs in. by u/pestopopcorn in mildlyinfuriating

Airlines are constantly investing in meal service , especially in the higher ticket categories. American Airlines recently unveiled its reimagined menu, which included such meat-free dishes as truffle ricotta ravioli and vegetable and garbanzo bean tagine with couscous. Yet, veg travelers are discovering a disconnect between what’s on the menu and what lands with a thud — or whimper — on their tray table.

“One word — disgusting,” said Nikki Dewan, a Vegetarian Society member who participated in a recent Facebook survey about airplane food . “Airlines don’t make an effort to bring good, delicious and wholesome food for the airline customers.”

In a Gallup poll conducted in July, 4 percent of Americans said they were vegetarians. So, why aren’t airlines doing better? And can they please cheer up that sad cucumber with a little dressing?

Missing meals force airlines to improvise

In general, a catering company or in-house culinary team plans the in-flight menus and prepares thousands of meals and snacks in an industrial kitchen on the airport grounds. The airlines assume that all of the passengers will eat the standard meals unless they are otherwise informed.

No different from a restaurant or wedding reception, it is the diner’s responsibility to inform the host (in this case, the airline) of dietary restrictions or meal preferences. Most carriers require passengers to submit their meal choices at least 24 to 48 hours before departure, so the chefs can fill the special orders. If you wait until you’re on the plane to share your requirements, you could end up with an improvised meal conjured in the galley.

“I was always amazed by the time it takes to put together a special meal, which is actually not that easy,” said Daniel Klein, executive chef for research and development at LSG Group, one of the world’s largest airline catering firms. “That’s why I can sometimes see why you might just get a banana, because it’s a last-minute request.”

However, reserving a meal is no guarantee that you will receive it. The flight attendant might not deliver the dish to its rightful owner because of a technical glitch, human error or passenger interference.

“It’s not just the quality of the food or the availability. It’s actually the service,” said Deirdra Barr, director of communications for the U.K.-based Vegetarian Society. “So many people’s vegetarian or vegan meals go missing or someone else gets them, and that means they’re left with nothing.”

Grace Philips, a Vegetarian Society member, knew exactly what happened to her veg meal on a recent flight: Another passenger didn’t “fancy the meat option” and asked for the vegetarian option instead. When the flight attendant reached her seat, all of the veg meals were gone. “I was hungry,” she shared on the group’s Facebook page.

In these instances, the flight attendants will often assemble an improvised plate of food for the neglected passenger. They will forage in the galley or pinch items from their own mini-coolers.

On a flight from New York to Scotland, Elyse Mercedes King said a flight attendant donated her two apples. Vanessa Winsor once survived a long-haul trip with three segments of a satsuma mandarin, six grapes and a bread roll.

When Zeigfinger flew United from Washington Dulles to Berlin, her preordered vegan meal never materialized. The flight attendant tried to correct the injustice with a slapdash meal, plus 700 frequent-flier points.

“The flight attendant was really angry,” Zeigfinger said. “She acknowledged that this was a serious thing.”

The best and worst airlines for vegetarians and vegans

In the 1990s, many travelers who identified as carnivores on the ground became temporary vegetarians when flying. The meatless meal seemed like the tastier and less enigmatic option.

“People who weren’t vegetarian were ordering the vegetarian meal because it was so much better than the chicken or beef they would serve on the plane,” said James Doran, director of business development, tourism and hospitality practice at SIS International Research.

As airlines chase after loyalty members and elite travelers, they are paying more attention to overall meal service, including the previously maligned proteins. Some carriers have teamed up with celebrity chefs, such as Delta’s partnerships with Michelle Bernstein, Michael Chiarello and Linton Hopkins. Air France works with Michelin-starred French chefs and award-winning pastry chefs.

Charles Platkin, founder and executive director of the Center for Food as Medicine , described vegan and vegetarian meals as an “afterthought” in this profit-driven market. Even so, the major airlines are still providing special meals, including several that go beyond the traditional veg diet. The subcategories include Asian vegetarian, vegetarian lacto-ovo, fruit platter and Jain , a vegetarian diet that eschews root vegetables.

Travelers note that airlines that cater to populations inclined toward vegetarianism, for cultural or religious reasons, often excel in this department. Doran fondly recalled a vegetarian Malay meal on Malaysian Airlines and an Indian-style vegetarian dish on Emirates. However, this rule doesn’t always apply.

“Very surprisingly Air India is terrible on the occasions I’ve flown with them,” Teresa Dawkes shared on the Vegetarian Society’s Facebook page. “Pretty inedible and they didn’t have any gin.”

Ashley Isaacs Ganz, the vegetarian founder of the luxury tour operator Artisans of Leisure , said she wishes carriers based in countries with strong vegetarian traditions would better showcase their culinary heritage. For example, she suggested Japan Airlines and All Nippon Airways incorporate Japanese temple cuisine into their menus.

“I always want to have the Japanese meal, but the different components of the meal are, for the most part, not vegetarian,” she said. “I would love for them to take it to the next level.”

In a Vegetarian Society Facebook post about airplane food, more airlines were panned than praised. Patricia Thompson called Irish carrier Aer Lingus “woeful” for serving dry veggie pasta for dinner and canapés with chicken bits that the flight attendants offered to pick off.

Not just pasta and salad anymore

To be fair, some airlines have been refining their palates.

Since 2009, Swiss has partnered with Hiltl , which claims to be the world’s oldest vegetarian restaurant (it was founded in Zurich in 1898). The airline celebrated its 10-year anniversary with a three-course meal that included spicy beetroot tabbouleh, penne with vegetarian bolognaise or massaman curry for the main course, and a vegan mango mousse for dessert.

In November, Australian carrier Qantas launched new vegan menu items in all of its classes. Economy passengers can dine on lemon herb pearl couscous with roasted carrots, baby beans and toasted almonds. Higher classes can sample such dishes as pumpkin and ginger soup with sourdough croutons; stir-fried shiitake mushrooms with tofu, chrysanthemum greens and jasmine rice; or plant-based orecchiette with sautéed mushrooms, spinach, cauliflower cream and pangrattato.

For its latest vegan and vegetarian menus, Air New Zealand introduced such dishes as cannellini bean smash with pan-fried tofu spinach and jackfruit with coconut red curry and black mustard seed steamed rice.

Klein recently developed a Western-themed vegan menu for Korean Air. For first class, he created a trio of amuse-bouches, including an onion puree flavored with passion fruit; smashed Yukon potatoes with fresh truffles and a chestnut puree; and a risotto with roasted vegetables. The airline said the menu is in the planning stage and is not on offer yet.

He said the biggest challenge in crafting innovative in-flight meals is not the altitude, which dulls the taste buds, but the cost of some products. He said alternative meats are too expensive to include on menus.

“They are still very pricey,” he said. “We’re not there yet, so we go with regular items, but we try to be creative.”

Platkin is not clamoring for fake proteins on flights. He advocates for clean, healthy ingredients, and said the airlines already rely too heavily on processed foods and easy carbs.

When asked to review new menu options on American Airlines, he said the dishes look tasty, but he was concerned about the heavy use of cheese and the fake meat.

As for the meal plan for international economy passengers, his critique was short and to the point: “It is all pasta.”

More on air travel

Leave flying to the pros: Think you could land a plane in an emergency? Experts say you’re wrong . Here’s what you should actually do if something goes awry during a flight .

Pet peeves: Why do “gate lice” line up early for a flight ? Psychologists explained for us. Another move that annoys airline workers: abusing the flight attendant call button . For more on how to behave on a flight, check out our 52 definitive rules of flying .

Plane mess: Stories about extremely disgusting airplanes have been grossing out travelers. The question of plane cleanups became the subject of a recent debate after a flight attendant allegedly told a pregnant passenger to pick up the popcorn spilled by her toddler.

Frequent flying: Airline status isn’t what it used to be, but at least there are some good movies and TV shows to watch in the air. And somewhere out there, experts are trying to make airline food taste good.

Airlines must cough up cancellation cash and can no longer hide fees under new federal rule

A federal rule announced Wednesday will require airlines to quickly give cash refunds — without lengthy arguments — to passengers whose flights have been canceled or seriously delayed, the Biden administration said.

“Passengers deserve to get their money back when an airline owes them — without headaches or haggling,” Transportation Secretary Pete Buttigieg said in a statement.

The rule from the Transportation Department says passengers who decline other reimbursement like travel credits are to get cash refunds.

It applies when a flight is canceled or has a “significant change,” the administration said.A “significant change” includes when departure or arrival times are three or more hours different from the scheduled times for domestic flights or six hours for international flights, and when the airport is changed or connections are added, it said.

Passengers are also to get refunds when their baggage is 12 hours late in delivery for domestic flights.

The new rule comes after promises to hold airlines accountable after major disruptions that made travel hell for passengers, including the 2022 Southwest Airlines meltdown , which resulted in almost 17,000 significantly delayed or canceled flights and a missing baggage nightmare.

The Transportation Department said that the new rule means refunds are automatic and that "airlines must automatically issue refunds without passengers having to explicitly request them or jump through hoops."

Also announced Wednesday was a rule requiring airlines to more clearly disclose so-called junk fees upfront, such as surprise baggage or other fees, the department said.

It said that rule is expected to save fliers around $500 million a year.

The surprise fees are used so tickets look cheaper than they really are, and then fliers get the unwelcome surprise of fees on checked bags, carry-on bags or reservation changes — or even discounts that are advertised but apply to only part of the ticket price, officials said.

Airlines will also have to tell fliers clearly that their seats are guaranteed and that they don't have to pay extra to ensure they have seats for flights, according to the Transportation Department.

Airlines for America, an industry trade group, said that its member airlines “offer transparency and vast choice to consumers from first search to touchdown” and that they do offer cash refunds.

The 11 largest U.S. airlines returned $10.9 billion in cash refunds last year, an increase over $7.5 billion in 2019 but slightly down from $11.2 billion in 2022, the group said.

“U.S. airlines are providing more options and better services while ticket prices, including ancillary revenues, are at historic lows,” Airlines for America said.

Left out of the federal changes announced Wednesday are those involving "family seating fees," but the Transportation Department said in a statement that "DOT is planning to propose a separate rule that bans airlines from charging these junk fees."

Travelers have complained to the Transportation Department that children weren’t seated next to accompanying adults, including in some cases young children, department officials said last year.

Fees on bags specifically have made up an increasing amount of airline revenues, the Transportation Department said Wednesday in announcing the new rules.

A Transportation Department analysis found that airline revenue from baggage fees increased 30% from 2018 to 2022, while operating revenue — which is from the flights themselves — increased by only half that amount, the department said.

Jay Blackman is an NBC News producer covering such areas as transportation, space, medical and consumer issues.

Phil Helsel is a reporter for NBC News.

A 101-year-old woman keeps getting mistaken for a baby on flights and says it's because American Airlines' booking system can't handle her age

• A 101-year-old woman says American Airlines keeps getting her age wrong.
• She says the computer can't process that she was born in 1922, not 2022.
• Airlines have increasingly adopted computerization across systems, but errors have caused serious disruption.

American Airlines cabin crew were expecting to look after a baby on board a flight from Chicago to Marquette, Michigan, this weekend.

But sitting in the seat designated for the infant, they instead found a 101-year-old woman, according to a BBC reporter who was also on the flight.

The centenarian, named Patricia, had booked the seat for an adult but laughed off the incident with the confused cabin crew.

Patricia, who didn't want her surname to be shared, told the BBC: "It was funny that they thought I was only a little child and I'm an old lady!"

But she said it wasn't the first time American Airlines had mistaken her for a baby.

Patricia, who flies every year to visit family, said the airline's booking system couldn't seem to process the fact that she was born in 1922 rather than 2022.

"My daughter made the reservation online for the ticket, and the computer at the airport thought my birth date was 2022 and not 1922," she said.

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During a previous trip, the BBC reported, the glitch meant that airport staff met Patricia after a flight without a pre-arranged wheelchair, thinking that they would just transport a baby through the terminal.

"The same thing happened last year, and they were also expecting a child and not me," Patricia said.

She had to wait on the plane until all other passengers had disembarked while they brought her a wheelchair, the BBC reported.

"I would like them to fix the computer as my poor daughter had to carry all our luggage and apparel almost a mile from one gate to the other," she said.

American Airlines didn't immediately respond to a request for comment from Business Insider.

Airlines are increasingly adopting automation across their systems to make operations more efficient, and passengers mostly embrace the convenience that technology brings to their travel experiences.

In the latest annual American Customer Satisfaction Index , app services, ease of making reservations, and airlines' websites were the factors that customers were most satisfied with when traveling with US airlines.

But while technology generally makes operations smoother and more efficient, glitches routinely pop up, often affecting more vulnerable passengers with special requirements.

Errors with technology have also caused serious disruption to global travel.

A glitch in the UK's national automatic flight-planning system last August left air traffic controllers processing flights by hand . The issue led to more than 1,500 flight cancellations across Europe.

In 2022, 12,000 American Airlines flights were left without pilots after a glitch allowed them to drop assignments. The airline had to offer pilots triple pay to cover the fallout.

Watch: A glitch in air traffic control left thousands of travelers stranded

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