air travel with newborn baby

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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)

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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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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 flight with 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

Most airlines allow families 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.

Was this article helpful?

The ultimate packing list for traveling with a baby

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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]

Delta. 2023. Children and Infant Travel. https://www.delta.com/us/en/children-infant-travel/overview Opens a new window [Accessed January 2024]

Federal Aviation Administration. 2023. Flying with Children. https://www.faa.gov/travelers/fly_children Opens a new window [Accessed January 2024]

Federal Aviation Administration. Undated. Frequently Asked Questions. https://www.faa.gov/faq?combine=children&field_faq_category_target_id=1481 Opens a new window [Accessed January 2024]

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]

United. Undated. Traveling With Children. https://www.united.com/en/us/fly/travel/accessibility-and-assistance/traveling-with-children.html Opens a new window [Accessed January 2024]

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

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

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?)

Charlie Hobbs

Maya Silver

CNT Editors

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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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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• 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

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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.

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Liquid Formula, Breast Milk, Toddler Drinks, and Baby/Toddler food (to include puree pouches)

Formula, breast milk, toddler drinks and baby/toddler food (to include puree pouches) in quantities greater than 3.4 ounces or 100 milliliters are allowed in carry-on baggage and do not need to fit within a quart-sized bag. Formula, breast milk, toddler drinks and baby/toddler food (to include puree pouches) are considered medically necessary liquids. This also applies to breast milk and formula cooling accessories, such as ice packs, freezer packs and gel packs (regardless of presence of breast milk). Your child or infant does not need to be present or traveling with you to bring breast milk, formula and/or related supplies.

Inform the TSA officer at the beginning of the screening process that you are carrying formula, breast milk, toddler drinks and baby/toddler food (to include puree pouches) in excess of 3.4 ounces. Remove these items from your carry-on bag to be screened separately from your other belongings. TSA officers may need to test the liquids for explosives or concealed prohibited items.

It’s helpful to the officers when formula and breast milk are in clear, translucent bottles and not plastic bags or pouches. Liquids in plastic bags or pouches may not be able to be screened by Bottle Liquid Scanners, and you may be asked to open them (if feasible) for alternate screening such as Explosive Trace Detection and Vapor Analysis for the presence of liquid explosives. Screening will never include placing anything into the medically necessary liquid.

TSA X-ray machines are not harmful to food or medicines. However, if you do not want the formula, breast milk, toddler drinks, and baby/toddler food (to include puree pouches) to be X-rayed or opened, please inform the TSA officer. Additional steps will be taken to resolve alarms. You or the traveling guardian will undergo additional screening procedures, to include Advanced Imaging Technology screening and additional/enhanced screening of other carry-on property.

Ice packs, freezer packs, frozen gel packs and other accessories required to cool formula, breast milk, toddler drinks and baby/toddler food (to include puree pouches) – regardless of the presence of breast milk – are also allowed in carry-ons, along with liquid-filled teethers. If these items are partially frozen or slushy, they are subject to the same screening as described above.

Passengers requiring special accommodations or concerned about the security screening process at the airport may request assistance by contacting  TSA Cares  or by phone at (855) 787-2227.

Screening of Children’s Items

• Place all carry-on baggage such as children's toys, bags and blankets on the X-ray belt for screening.
• Strollers, umbrella-strollers, baby carriers, car and booster seats and backpacks must be screened by X-ray.
• Place items in the stroller pockets or baskets, in a carry-on bag or on the X-ray belt for screening.
• Equipment that does not fit through the X-ray machine will undergo a visual/physical inspection by TSA officers.

Screening Technology

Walk-Through Metal Detector

Children able to walk through the metal detector without assistance may do so separately from their parent or guardian. If they alarm, children are allowed multiple passes through screening technologies and may undergo other procedures to resolve the alarm to reduce the need for a pat-down. Infants and small children may be carried through the metal detector. Should the alarm sound, additional screening is required.

Advanced Imaging Technology

If your child is able to remain standing in the required position for 5 seconds, he or she may be screened through the advanced imaging technology. If a child 12 and under goes through the machine and alarms, they have an opportunity to go through again or the TSA officer may use other procedures to resolve the alarm to reduce the need for a pat-down.

You may not be screened by this technology when carrying an infant or child.

Screening your Child

• Children 12 and under can leave their shoes, light jackets and headwear on during screening. For AIT screening, light jackets must be removed and placed on the X-ray belt.
• Children will not be separated from their parent/guardian.
• Remove infants and children from strollers and car seats and carry them in arms through the walk-through metal detector.
• Infants may be carried in a sling/carrier (to include lap baby) through the walk-through metal detector or when being screened in a wheelchair, but may be subject to additional screening
• Modified screening procedures are in place to reduce the likelihood of a pat-down.

Traveling With My Newborn: What It Was Like On My First Flight With a Baby

"I was always the person who dreaded seeing children get on a flight."

d3sign / Getty Images

We’re dedicating our  March features  to family travel. Read on for insightful guides to the best road trips for different ages , the best hotels with amenities for children , and the changing face of family trip planning , as well as inspiring stories of traveling with a newborn, family travel post-divorce , the lowdown on family campground culture , and more. Giving birth abroad and traveling around the world with my child at such an early stage in his life was never in my five year plan. But, as life would have it, my newborn son was destined to become a frequent flyer. From his first plane ride from Germany at just six weeks old, he had covered four continents and a multitude of countries and states before he could even walk. 

I gave birth in Szczecin, Poland, just two hours outside of Berlin, where my husband had been coaching a professional football team. Shortly after, his contract was cut short, and we suddenly found ourselves packing up all of our things quicker than expected. The thought of flying with my newborn for multiple hours had me on pins and needles; I was always the person who dreaded seeing children get on a flight. As we prepared for our flight home, I thought of all the ways I could possibly keep my son subdued throughout the experience. My panic was sending me into a tailspin before we even boarded the plane.

Things didn't begin smoothly. The first rookie mistake I would make was not practicing separating the European-style pram we had been gifted from our Polish friends. It was a bit fancy—not one of those one-click type of strollers. As we checked in, my husband huddled with an airline employee trying to figure out how to separate the thing so we could get on the plane. Talk about stress through the roof! Thankfully, after a few trial and error clicks and hits, we were able to get the top and bottom separated and check it onto the flight. 

My panic was sending me into a tailspin before we even boarded the plane.

But that wasn't all. I would soon find that I would be making my next rookie mistake, which was checking our stroller at the check-in counter versus at the gate. As a new parent, it didn’t cross my mind that we could take the stroller through security and directly up to the gate where the airline would tag the stroller and check it for us. This left my husband and I having to trudge through Berlin’s Brandenburg Airport with a bulky carseat, a baby bag, two carry-ons, and a personal item. We had inconvenienced ourselves twice before even having the opportunity for people to snare at us for having a screaming baby on the flight. 

Once we finally boarded the flight, we hustled straight to the back. I always booked our seats in the very front or very back of the aircraft to be closer to bathrooms and to either get off quickly or be able to take my time when needed. On this flight, we shared a row with a woman who gleefully looked at us and let us know that if there were any empty seats, she would happily move to give us more room for my son. She wasn't at all disappointed that she had been placed next to a family with a newborn; it immediately eased all of the tension I had in my body. In my years traveling with my son, I will never forget the passengers who have openly given me grace—those who would show empathy by offering me an entire row or giving my son little gifts, toys, or candy to help lessen the stress.

Thankfully, the flight wasn’t full, which gave us an additional seat in our row. I had read somewhere that it’s good to feed your child during takeoff and landing to alleviate any air pressure they might feel, which often causes babies to cry. If they fall asleep, the advice had said, it was best to let them rest. Because my son had been awake and I breastfed, I allowed him to nestle during takeoff which put him to sleep. Once we were stable in the air, I laid him in the middle seat for the rest of the flight. Prayerfully, he did not cry—he slept for hours.

Throughout the flight, I focused on my son's food and snacks, entertainment, and clothing. Having food and snacks that I knew he liked was vital for the flight. For longer flying times, I learned, airplane food may not settle well, or your child may just may flat out refuse to eat it, which will stress them out. As my son grew older, I learned to bring along a tablet with pre-downloaded episodes of shows he would enjoy. When he was a newborn it was never needed, but once he reached the one-to-two year mark, having his own headphones with pre-downloaded shows kept him subdued. Just as adults want to be comfortable on flights, so do children.

She wasn't at all disappointed that she had been placed next to a family with a newborn; it immediately eased all of the tension I had in my body.

When my son was a baby, we always boarded a flight with a fresh diaper and I always had extras in my carry-on to keep him clean and comfortable. I’d take off his shoes, have a blanket in case the flight was cold, and have alternative outfits like a hoodie, pants, and socks, or tank top and shorts depending on whether he needed to be warmer or cooler. Those few moments of getting settled and making sure I had everything ready for him were essential; it's why airline policies that allow people traveling with children to board first are so appreciated.

My son is now five years old and travels like a complete pro. It takes a village to raise a child, and my first experiences traveling with a newborn certainly felt scary. But the years I spent traveling with my son as a baby taught me lessons about both parenting and traveling that have been endlessly valuable.

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9 Tips for Flying with a Baby | Fool-Proof Guide to an EASY Flight

F lying with a baby can be a daunting experience. The mere thought of your baby crying nonstop on an airplane probably sends you into an instant flustered state. However, with a little extra planning and a few tips for flying with a baby, air travel with your infant can be very manageable. 

We have never been proponents of sacrificing travel after having a child. In fact, we recommend flying as much as possible during the infant years, while your baby still flies free!  Although there are a few more things to take into account when flying during the newborn stage , air travel with a baby or a toddler doesn’t have to be a stressful experience.

Whether you’re a first-time parent or a seasoned traveler looking to make your next flight with your little one a little smoother, here are a few easy tips for flying with a baby that we’ve found to be most beneficial.

Advice and Tips for Flying with a baby

You often hear parents say that babies don’t come with an instruction manual or guide book. The same goes for traveling with them. Each baby is different, so there is no exact science to figure out what works best for soothing and calming your child during a flight. 

Flying with a baby is trial and error. But these 9 tips for traveling with a baby on an airplane will hopefully help make life easier – at least from takeoff to landing.

Wear your baby in a baby carrier

If you have a baby or toddler, the best way to travel throughout an airport is to wear them in a baby carrier. 

Whether you use the ErgoBaby 360 Carrier , like we do, or another type of baby carrier for travel , babywearing makes flying with a baby so much easier. 

Keeping your little one close to your body is calming for your baby and keeps you hands-free to pull a rolling suitcase, or juggle passports, boarding passes, or other children. 

One of the best parts about wearing your baby through the airport is that you typically do not have to take them off to go through security. Airport security will do some additional testing after you go through the metal detector, like wiping your hands to test for gunpowder residue. 

Wearing your baby in a baby carrier is also much easier than lugging a stroller around for your entire vacation. If you absolutely must bring a stroller, I’d recommend gate-checking it so you can use it while in the airport terminal.

READ OUR FULL POST ON THE BEST BABY CARRIERS FOR TRAVEL .

Nurse or bottle feed during take off and landing 

The most challenging part of your first flight with your baby will likely be the departure or landing. As the aircraft gains or reduces altitude, changes in air pressure can cause discomfort in a baby’s ears, leading to fussiness, crying, and potential ear pain.

The sucking motion associated with nursing or bottle feeding is not only soothing for babies, but it helps regulate the pressure in their ears. Adults can open their jaws to relieve the pressure that can build up as a plane makes an elevation change, but a baby cannot. 

If you nurse or give your baby a bottle or sippy cup during the ascent and descent, your baby won’t even notice the pressure change. Happy baby, happy parent, happy plane-full of passengers.

Feeding your little one may also make your baby fall asleep, which is every parent’s dream on a flight.

NOT COMFORTABLE BREASTFEEDING ON A PLANE? HERE IS EVERYTHING YOU NEED TO KNOW ABOUT FLYING WITH EXPRESSED BREASTMILK OR FORMULA .

Book flights around your baby’s sleep schedule, if possible

If you want to ensure your baby sleeps on the plane, try to book your flights around your baby’s sleep schedule, if possible. This may also help prevent baby jet lag .

If your child takes an afternoon nap, and you’re planning a short domestic trip, we recommend searching for flights around that time frame. 

If you are lucky, your child will fall asleep once the plane is wheels up – especially if you nurse or bottle feed them. Then you can enjoy a mid-flight cocktail or a nap yourself.

A few minutes of shut eye on a flight is a rarity for parents. So, take it when you can get it. Having a baby is no joke, and parents live in a constant state of sleep deprivation!

Also, your fellow passengers will thank you.

Buy a new toy for your baby and give it to them on the plane

Sometimes you can plan your trip around your baby’s sleep schedule, feed your little one during take off, and yet your pint sized co-passenger remains wide awake. Babies can easily get overstimulated in new environments and an airplane is certainly a new place for your tiny traveler.

In this scenario, a new toy is going to come in very handy. 

Prior to each flight with my baby, I would buy a new toy. The new toy doesn’t have to be expensive, but it must be new to your baby.

When my daughter was an infant, I would not show her the toy or let her play with it until we were on the plane. That way it was a new and therefore exciting, object to occupy her time for the duration of the flight. 

This is one of those tips for flying with a baby you won’t find many other places, but it has saved me on at least a few flights when my baby was on the edge of a boredom meltdown.

Once your little one is curiously distracted by their new toy, you can breathe a sigh of relief (along with all the passengers sitting directly adjacent to you – eying you nervously preparing for the screaming to start.) 

We often still do this even though our daughter is older. It worked when traveling with a toddler , and even works when traveling with her as a grade-schooler.

Pack your carry-on bag for a baby emergency

Hungry? I’ve got snacks. Bored? I’ve got toys, games and downloaded children’s shows on a fully charged tablet. 

A diaper blowout clear up to the neck? No problem, I have, not one, but two complete changes or clothes. Plus disinfectant wipes and a wet bag to store the dirty clothes. Can’t function without their beloved lovey or stuffed animal? Mom to the rescue. Let me just reach into my carry-on.

My carry-on bag is essentially an arsenal kit for attacking any baby emergency. 

Whether you’re traveling as a family or flying alone with an infant , the moment you sense a baby crisis on the verge of occurring, you need to be ready to break out your baby’s carry on essentials .

Our carry on is absolutely essential for air travel, long layovers , or road trips with a baby . Every. Parent. Must. Have. One. 

While there are certain travel essentials for babies that can go in your checked luggage, your baby carry-on bag should have enough diapers and formula (if formula fed) and baby food for the duration of your travel day plus one additional day. 

You should also have an extra change of clothing for a leaky diaper accident or a spill. And a medicine kit.

Planes can easily make babies congested and gassy, so having a medicine kit handy is a must when flying with a baby.

FIND OUT WHAT TO PACK IN YOUR CARRY ON BAG WHEN FLYING WITH A BABY HERE .

Use a backpack style diaper bag for your baby’s carry-on bag

Speaking of your baby’s carry-on bag, one of the best tips for flying with a baby is to invest in a backpack style diaper bag rather than one that has a shoulder strap. This just frees up a hand and makes walking through the narrow airplane aisles easier when you have your little one in tow.

While any backpack might work, we recommend one with a fold out changing pad and different compartments to make things easily accessible from underneath the seat.

When your baby gets fussy on the plane, you want to make sure you can quickly get whatever you need to soothe your upset travel companion.

Upgrade to the bulkhead

This is another one of the travel tips for flying with babies that we don’t see or hear often, but one that has personally been beneficial for us – particularly on long haul flights. 

There are both pros and cons to booking the bulkhead seat on a plane , but for parents traveling with a baby, there are mostly pros! Who would have thought a few extra inches would make such a big difference?

Having the bulkhead allows your child room to stand, stretch, or even sit on the floor in front of you and play for a few minutes. (You will want to do a quick check under the seat and around the area for anything a baby or toddler might try to grab or put in her mouth.) 

If flying long distances, you can often request a bassinet from the airline for your baby to sleep in if you are in the bulkhead. The bassinets attach to the wall in the bulkhead seat, and therefore can only be used by passengers flying in this particular row.

Things to bring with you for baby’s first flight

If this is your baby’s first flight, there are a few things you will need to bring with you.

Identification for your baby

We always recommend bringing some sort of identification for your baby. For a domestic flight, a copy of your baby’s birth certificate will suffice.

If flying internationally with a baby, your child will need a passport. Don’t worry! We have tips for taking your baby’s passport photo here .

You will want to consider your method of transportation once you arrive at your destination. If you will be driving, or traveling by car, you will either want to bring your baby’s car seat or rent one at your destination. 

In the United States, you can check your car seat for free if flying with a lap infant.

If you have purchased an extra seat for your baby, you can also bring your car seat on the plane, which may help your little one sleep better, particularly if they sleep well in a car seat during road trips or car rides.

If it isn’t cost prohibitive, we recommend buying an extra seat for your baby for long haul or international flights. This will make you and your little one a bit more comfortable during the flight.

FAQs about Flying with a Baby

If you’re planning your first flight with a baby, there are naturally a few questions you may have. In order to calm your anxiety, we’re including some of the most frequently asked questions along with our best tips for flying with a baby.

How do I protect my baby’s ears when flying?

The change in air pressure during take off and landing can be uncomfortable for babies. Aside from breastfeeding or bottle feeding, you can also offer a pacifier to encourage sucking, which can help equalize the pressure in the ears. Older toddlers can also be given a sippy cup.

Should I bring my baby’s car seat on the plane?

If you purchase a seat for your baby, it may make sense to bring their car seat on the plane. This can provide an extra layer of protection for your child in the event of turbulence and also bring added comfort and familiarity during the flight.

However, some airlines do not allow car seats that are not FAA approved or will require you to take your baby out of the car seat and use a child restraint that attaches to the regular seat belt during take off and landing. 

On a personal note, this only happened to us when flying a European regional airline, and our baby hated it and screamed the whole time. So, yeah, that was fun. 

What is the hardest age to fly with a baby?

For us, the hardest age began around the time our baby started becoming mobile and lasted until about 2 years old.

So, the most challenging age was between 9 months old and 18 months old, when our little one found it challenging to sit still for an extended period of time. 

This age presents unique challenges during air travel, and parents often need to be prepared with appropriate strategies and supplies to manage these challenges effectively – hence why we compiled this list of tips for flying with a baby.

What identification documents do I need for my baby for air travel?

The required identification documents for a baby may vary depending on the airline and the destination.

Domestic flights often do not require any documentation or identification for babies. However, we recommend bringing a copy of your baby’s birth certificate in case there is any question about the baby’s age or familial relation. 

Your baby will need a passport if you are traveling internationally. 

Additionally, if you are traveling alone with your child or without the other parent, some countries may require a notarized travel consent letter from the absent parent. 

Where do I change my baby’s diaper on a plane?

Most commercial aircraft are equipped with changing tables in the lavatories that fold down over the toilet. So, while the lavatories may be small, they are still the best place to change your baby.

This ensures the most hygienic experience for you and for other passengers, and gives you a proper place to dispose of the soiled diapers.

One Final Tip for Flying with a Baby

During air travel, sometimes you have to throw out all the tips for flying with a baby and just wing it. Give yourself grace. Traveling with little ones is hard. 

Be sure to give yourself extra time at the airport. If you are rushed, you will inevitably be more stressed out. Your baby will be able to sense your stress and mirror the same. 

Flying with a baby is already stressful enough, so having more time will give you one less thing to worry about.

Finally, try to relax, and repeat after me: “YOU GOT THIS!”

Do you have a comment or question about any of these flying with baby tips? We’d love to hear from you. Leave your thoughts in the comments below.

Like it? Pin this list of travel tips for flying with a baby!

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• Special assistance

Traveling with children

Traveling with children and infants.

We are committed to caring for people on life’s journey and want you and your children to have a safe and positive travel experience. To allow enough time for check-in, arrive early and be sure to have any required travel documents. You may have to present proof of age like a birth certificate for any children under the age of 18.

• Families with children under 2 years old can ask to board early at the gate.
• Only 1 carry-on diaper bag per child is allowed.

You can travel with a breast pump and small, soft-sided cooler of breast milk in addition to your carry-on or personal item. These items don’t have to be checked and are allowed even when you’re not traveling with a child. Also, most airports have nursing rooms and stations available for your convenience.

If you’re a family traveling with children under 15, we want to help make sure you’re seated together on your flight. Here are some tips for when you book:

• Be sure to book everyone in the same reservation.
• The farther in advance you book, the better. (Seats become limited closer to the day of travel.)
• On the seat map, choose seats for your entire family or skip seats for that flight.
• It’s better to skip seats than to choose just a few seats or seats scattered throughout the cabin. Our gate agents can try to reseat you but getting seats together the day of travel is difficult.

If you skip seats

If you’re unable to choose seats, don’t want to pay for seats, or chose a Basic Economy fare, our system will detect that you’re a family traveling. The system will search for seats together automatically before the day of departure. We’ll try our best to keep you together, but if seats are limited, we’ll assign seats so children under 15 are next to at least 1 adult.

Children and adults traveling in separate reservations

If you and your children are traveling together but have separate reservations, call Reservations so we can note it in each reservation.

Contact Reservations

Children 2 or older are required to have their own seat, a ticketed adult fare. Children under 5 can’t travel alone under any circumstances.

If you don't choose seats in Main Cabin or Basic Economy, we’ll assign seats a few days after you buy your tickets so children under 15 are next to at least 1 adult they’re traveling with.

We welcome infants as young as 2 days old, but infants under 7 days old must have a doctor's letter stating that they are medically cleared to travel.

Keep in mind:

• Only 1 infant may be seated in the lap of each ticketed accompanying adult and the infant must be included in the reservation.
• Additional infants under 2 years old must be ticketed and occupy an infant safety seat or in a separate aircraft seat.
• The infant must be under 2 years of age for the duration of the trip. If they turn 2 during a trip, they will need their own seat for the remainder of the trip.

Adding an infant to your trip

If you’re traveling within the U.S., including Puerto Rico, you can add an infant to your trip when you book on aa.com, or later once it is ticketed. You only need to contact Reservations if you’re traveling with an infant who is under 7 days old; or if you’re traveling outside of the U.S. (taxes and a percentage of the adult fare may apply on international trips).

Book a new trip

• Book your trip on aa.com
• Enter your information on the ‘Passenger details’ page
• Select ‘add infant in lap’

Book a trip

Update an existing trip

• Find your trip on aa.com
• Scroll to the ‘Passengers’ section

Find your trip

Call Reservations if:

• You’re traveling with an infant who is less than 7 days old
• You’re not traveling within the U.S., and Puerto Rico

Reserved seat

If your infant will travel in their own seat, you must buy a ticket. The infant must either travel in a safety seat approved by the Federal Aviation Administration (FAA) or be able to sit upright in their seat without assistance and have their seatbelt securely fastened during taxi, takeoff, landing and whenever the 'fasten seatbelt' sign is on.

Bassinets and changing tables

• Changing tables are available in the lavatories of all wide-body aircraft.
• Bassinets are available on a first come, first serve basis at the gate for travel only on 777-200, 777-300 and 787 aircraft.*
• Bassinets are not available in First / Business cabins.

*Infants using bassinets must be younger than 2 years old and weigh no more than 20lbs (9kg)

Acceptable safety seats

Most safety seats that are approved for use in motor vehicles are acceptable for use in aircraft. The seat must have a solid back and seat, restraint straps installed to securely hold the child and a label indicating approval for use on an aircraft.

The label may include:

• These notes: 'This child restraint system conforms to all Federal Motor Vehicle Safety Standards' and 'this restraint is certified for use in motor vehicles and aircrafts' or 'this restraint is certified for use in motor vehicles and aircraft.'
• Approval of a foreign government or a label showing that the seat was manufactured under the standards of the United Nations.
• The safety seat can't be used in an exit row or in the rows on either side of an exit row; window seats are preferred.
• Install the seat in the direction appropriate for the size of the child and according to the instructions on the label.
• The child must remain in the safety seat with the harness fastened during taxi, takeoff, landing and whenever the 'fasten seatbelt' sign is on.
• To carry on a safety seat, you must have bought a seat for the child, or a seat must be available next to you. If an unoccupied, adjoining seat is not available, the gate agent will check the safety seat to your final destination.

Review seat dimensions before your trip.

Safety seats are not allowed in First or Business on select planes due to the seat angles.

Airbus 321T

• Boeing 777-200
• Boeing 777-300
• Boeing 787-800
• Boeing 787-900
• Any device without an approval label
• Booster seats with no approval label or shoulder harness
• Vest and/or harness-type devices, except Aviation Child Safety Devices (ACSD) showing the FAA aircraft approval label
• Belt extensions that attach to the parent or the parent's restraint
• Any device that positions a child on the lap or chest of an adult

Carry-on and checked bags

If you’re flying internationally with an infant on your lap, we’ll issue the infant a ticket. You may check 1 bag for the infant at the same rate as the adult’s first checked bag.

• Each ticketed customer is allowed 1 stroller and 1 car seat to be checked free of charge
• Strollers over 20 lbs / 9 kgs must be checked at the ticket counter
• All other strollers should be checked at the gate before boarding
• If you have a stroller and a car seat only 1 can be checked at the gate
• Breast pumps and a small, soft-sided cooler of breast milk don’t count as your carry-on or personal item
• Play pens, wagons, cribs and 'pack and play' count as regular bags
• If any of these exceed carry-on limits they’ll be checked and incur regular fees

International documents

Children or infants traveling outside the U.S. are required to have the same documentation as an adult. If anyone under 18 is traveling internationally without both parents, they may be required to present a Letter of Consent.

International travel

Traveling during pregnancy

If your due date is within 4 weeks of your flight, you must provide a doctor’s certificate stating that you’ve been recently examined and you’re fit to fly.

Special assistance throughout your trip

For domestic flights under 5 hours, you won’t be permitted to travel within 7 days (before and after) your delivery date. If you need to travel within this time frame:

• Approval from your physician and a special assistance coordinator is required.
• Your physician will be required to fill out a passenger medical form before your flight. A special assistance coordinator will send the form directly to your physician.

Clearance from a special assistance coordinator is required for international travel or travel over water:

• Within 4 weeks of your due date (travel also requires a physician's note stating that you’ve been examined within the past 48 hours and you’re fit to fly)
• 7 days before or after your delivery (travel also requires a passenger medical form to be completed by your physician)

Flying on a partner airline?

Find helpful information if your trip includes 1 or more flights with our partner airlines.

• British Airways
• Japan Airlines
• Qatar Airways

What to Pack When Traveling With Baby

Fact-checking standards, latest update:, when can you travel with your baby, read this next, what to pack for your baby in a carry-on bag, what to pack in your baby's suitcase.

Happy travels!

What to Expect the First Year , 3rd edition, Heidi Murkoff. WhatToExpect.com, Flying With a Baby? Here's What to Know Before You Go , September 2021. WhatToExpect.com, Do Babies Need Passports? , October 2021. WhatToExpect.com, Best Travel Toys for Babies , February 2021. WhatToExpect.com, Baby Products You Can Take on a Plane , September 2020. American Academy of Pediatrics, Flying with Baby: Parent FAQs , November 2019. American Academy of Pediatrics, Is It Safe for Families to Travel Now? , August 2021. American Academy of Pediatrics, Travel Safety Tips , August 2018.  American Academy of Pediatrics, Is It Safe for My Baby to Travel in a Car Seat a Few Hours at a Time? , August 2021. Transportation Security Administration, Traveling with Children . Federal Aviation Administration, Flying with Children , March 2021. Mayo Clinic, Is Air Travel Safe for an Infant? , October 2019.

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Air travel safe for healthy newborns when parents take precautions

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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 to pack — and prepare — for travel with a baby

About to take your first trip with a new baby ? Or maybe this isn't your first time traveling with your little one , but you'd like to pack more efficiently this time around.

It can be hard to know how to prepare and pack when you have a baby in tow. Babies often change so quickly that anticipating their needs can be complicated — especially if you're planning a longer trip.

In addition to typical packing concerns, such as the weather in your destination or luggage size restrictions, it's not always clear what you can carry on or must check when it comes to your infant. Here's our advice to help you prepare, pack and travel better with your baby.

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Choose accommodations wisely (and pack accordingly)

If you're traveling by car, you can easily pack a travel crib and other larger baby items.

However, if you're flying, choosing the right accommodation is the key to packing lighter, which is the goal. Toting around an infant is strain enough — staying somewhere that provides baby items means you can leave the extras at home.

Check with your hotel to see if it offers cribs or other baby items, as well as if it provides laundry services or facilities where you can do your own. Some hotels will even provide an extra fridge for milk storage upon request.

Often, a home rental might be a better choice than a hotel, assuming you pick the right one. Airbnb allows you to filter properties by items such as "crib" and "high chair." You can also message hosts to see if they have any other baby-friendly items available.

For example, I recently filtered an Airbnb search in Punta Cana in the Dominican Republic to show only rentals that included a crib, high chair, washer and dryer. I ended up picking a rental that included not only the aforementioned items, but also a bottle sterilizer, bottle warmer and a few other infant-friendly items, which allowed me to pack less.

Some rentals I've stayed in even provided baby toys, books and cutlery. The key is communication. Don't hesitate to message and confirm the equipment again with hosts as you pack. You can also request or confirm that everything will be set up and ready for the baby upon your arrival.

Access to a washer and dryer is important since babies tend to have accidents or leaky diapers. Being able to do laundry also lets you pack fewer clothes. Also, if your rental is not a stand-alone house or a unit on the first floor, check that there is an elevator. A five-floor walk-up in a multi-unit building can be difficult with a stroller, shopping bags and baby in your arms.

Call your airline to understand the regulations

Depending on your airline, fare class and destination, you may have to adhere to different rules when it comes to traveling with an infant.

Those regulations can also vary depending on whether you've purchased a lap ticket versus a separate seat for your baby. In almost all cases, airlines allow travelers with an infant to gate-check a stroller or buggy, and some may also allow a car seat. Check with your airline ahead of time to understand baggage rules for your little one to avoid getting caught off guard at the airport or paying extra, especially when flying low-cost carriers like Ryanair or Spirit .

Flying with an infant in a car seat and hoping to bring it on the plane? Make sure it's approved for air travel. You may also want to request a bassinet for your baby, if the aircraft you're flying offers one (check the weight limits, however). Ask for an aisle seat, as it makes standing up with your baby much easier.

Invest in travel-friendly baby items

Having a dedicated (foldable) travel stroller will be useful beyond air travel. It's the perfect item to have when exploring a new city. Other key travel baby items to consider taking along are:

• Travel diaper backpack.
• Portable changing pad.
• Travel car seat.
• A bag for a car seat or stroller so these items aren't damaged if checked.
• Portable baby monitor.
• Baby carrier or wrap.
• Swaddle or baby blankets.
• Inflatable bathtub .
• Pack 'n Play or travel crib.
• Travel neck pillow (use it while feeding your baby).
• Baby chair strap.
• Disposable bottle liners.
• Disposable bibs.
• Portable blackout shades for travel cribs or strollers.

Purchase (or preorder) diapers, formula and more at your destination

Depending on how long your trip is and where you're headed, calculate (and it's always best to over-calculate) how many diapers you'll need for the trip.

If your baby uses a specific formula or baby food, make sure you know where to buy it at your destination. Amazon and other delivery services can be useful for ordering these items -- and remember, these services are available internationally, too. You can also compare ingredients to see if you can get a similar formula or food at your destination, so you won't have to load up your suitcase with diapers or formula.

Don't worry if you forget baby socks or another basic item. Babies live all over the world, so you'll likely find many basic items available for purchase wherever you are. If your baby requires something specific, though, pack it just in case.

There are also companies that rent baby gear in many destinations around the world. Research ahead of time to find out exactly where and how to obtain these necessary items, especially when traveling abroad .

Carry on the essentials (and extras)

Always pack your baby's key essentials in your carry-on . This includes comfort items like their favorite toy or pacifier, and extra clothes for both your baby and you (in case their wardrobe disaster becomes yours, as well). You should also pack enough food, diapers and other key items to last you through the trip, plus more for any possible delays and/or cancelations.

Here's a list of items you may want to keep in your carry-on bag :

• Extra clothing for you and your baby.
• Layers of clothing or blankets (plane temperatures are often extreme).
• Pacifier and clip (and backup).
• Comfort toy(s) or blanket.
• Extra diapers.
• Breast pump.
• Snacks (for you and your baby).
• Baby wipes.
• Sanitizing wipes.
• Extra bibs.
• Ziploc bags for stowing soiled clothing (or a reusable, waterproof bag).
• Baby Tylenol or any infant medications.
• A basic first aid kit.
• Small toy(s).

The rest of your baby's items, like additional clothing, blankets and more, can go in your checked bag. If you're checking more than one bag, split your baby's items among different checked suitcases. That way you'll be covered if the airline loses one of your suitcases.

Know the security regulations and have a backup plan

On a recent call to Iberia Airlines , I was told I could bring "reasonable quantities" of formula and breast milk through security. However, the representative also told me that in some cases during security checks, certain agents might not allow me to pass these items through security at the Madrid-Barajas Airport (MAD) . What?

Not all security checks, Transportation Security Administration agents or customs agents are alike, and each country, airport or airline may have specific regulations. Call ahead of time and prepare for things to not go as planned. If you do use formula, take your bottles already mixed, but also bring extra powder in case you need to prepare new bottles on board.

If you're pumping, it might also be a good idea to bring both a hand pump and an electric pump in case you have limited access to electricity or encounter issues with electrical outlets or voltage when traveling internationally.

Arriving at the airport early is always a good idea, because you may not breeze through security as you might have in your pre-baby days. Everything takes longer with an infant, so having that extra time can ensure a low stress travel experience. Take advantage and board the airplane first to give you extra time to get settled. If your airport has a family security line, use it.

Make sure you understand any remaining COVID-19 regulations

As mask rules and COVID-19 testing, entry and vaccine regulations continue to evolve in countries around the world, stay on top of exactly what you need to know and bring for your baby to get to your destination (and back home again). It's important to understand whether you'll need masks for your 2-year-old or need to show proof of a negative COVID-19 tests upon arrival at your destination or re-entry into the U.S. when traveling abroad.

Remember that airline staff members also struggle to keep track of ever-changing rules, so if you know something has recently changed or a rule seems specific, make sure to bring along proof of this information and whatever documentation you need in case you have trouble when boarding.

Photocopy important documents and always have extras. I loathe having to take paper documents along when traveling. However, having them may mean the difference between getting through customs, being able to board or being stranded at the airport. This is especially true if your phone battery dies or you're left without service for any reason. While being denied boarding is always dramatic, it's even worse with a baby in tow.

Download the right apps

Mobile phone apps can help you anticipate what you need, as well as keep your baby (and yourself) comfortable during travel.

A white noise app is key for better sleep for your baby — and therefore better sleep for parents — and allows you to leave a white noise machine home. Nightlight apps are also helpful during travel.

You can also connect most modern baby monitors to your phone and use an app to access the video of your baby so you won't need a separate viewing device.

Parents may find an app to track sleeping and feeding especially helpful during travel, particularly when switching time zones. A general packing app could help you keep track of what you need to bring for your infant, as well as the entire family. Make sure these apps are accessible offline if you need them while flying.

Don't forget their passport

This one is obvious, but you'd be surprised. Don't forget your baby's passport when traveling.

Look into identity and consent documents, as each country has its own requirements, especially if your partner isn't with you. If you have any older children, make sure to check that their passports are valid, as children's U.S. passports expire in just five years.

Traveling with a baby might seem like a lot. However, once you get the hang of it, packing, prepping and traveling with your infant becomes second nature. Ask for help when you need it and accept help when offered.

And when things don't go quite right, stay relaxed (remember, baby can feel your moods) — you'll figure it out. While it may seem tragic in the moment (like that major diaper blowout on board a plane), it will be an epic story to share one day.

Bottom line

When in doubt, bring enough baby supplies for a few extra days or a flight delay, but don't overpack. Make sure to be clear on any and all regulations that will cover your travel, from having the right documents to understanding what baby items you can bring through airport security . With these tips, packing and traveling will be a more enjoyable experience for the entire family .

Flying Solo With Baby: A Step-By-Step Guide

By: Author Leslie Harvey

Posted on Published: June 19, 2014

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Flying with a baby or small child involves a lot of logistics.  And when you are traveling solo as a single parent with one (or more than one) baby or young child, the logistics can seem that much more overwhelming.  How are you going to get a baby, stroller, gear, and yourself through TSA lines without an extra set of adult hands?  How are you going to get a bathroom break in-flight with no one to hold your child?  These and a million other questions are probably racing through your mind.

To help in planning for your next solo trip with your little ones, here’s my checklist.  This list walks you through all the logistical considerations of single parent pre-flight planning, navigating the airport by yourself, the in-flight solo parent experience, and more.

1) The Week Before Your Flight

• Make a comprehensive packing list for you and baby.
• Evaluate your luggage options before you pack.  Can you carry, push, or pull everything you will be bringing by yourself?  I often find that the following combination of items works well when traveling as a solo parent with a baby: umbrella stroller + good roller suitcase (to check) + backpack to serve as both carry-on and diaper bag.  You might also be able to handle a backpack and a separate diaper bag if you can hang one or more items from your stroller.
• Consider shipping baby items ahead that you need at your destination – diapers, wipes, formula, etc.  Alternatively, investigate whether there are stores convenient to your destination to buy what you need.
• Call the airline or check your reservation online to make sure you still have your original seat assignments and have not been separated from your child, if you’ve bought a seat for your baby.
• If you are traveling internationally and your baby is small enough to fly in the bassinet, call to confirm that your request for a bassinet and your corresponding bulkhead seat reservation is still on-file.

2) Getting to the Airport

• Consider having someone drop you off curbside with your bags.  Driving yourself and carrying the baby and your luggage on parking lot shuttles is hard.  Alternatively, you can take a taxi, but remember to book a car service that will have a car seat for your child.
• If you have to drive yourself, consider paying a bit more to park in a closer parking lot where you can easily walk to your terminal (often hourly/daily lots are only a few dollars more per day than the economy lot).

3) Checking In & Checking Bags

• Try to check-in online at home if possible.  You can often skip the long lines at the airport by bypassing check-in entirely.  If you have checked bags to drop, there is often a “bag drop” kiosk or separate line that is shorter than the full check-in line for your airline.
• If you are flying with a lap child, inquire at check-in about how full the flight looks.  Often, the agent can block an empty seat next to you if there is extra space (note that the gate agent may have more power to do this than the check-in agent, but it never hurts to ask at this stage in the process too).

4) Getting Through Security

• Look for the TSA family lane , which is now available in most airports.  Those lines are almost always shorter.
• Remember that all liquids and gels need to be in a separate zip-top bag and placed into a bin.  If you are traveling with an infant or small child, the TSA liquid limits do not apply to you .  You may, however, be required to go through special screening as a result.
• Keep the baby in a stroller or carrier until you get all of your personal items (including your shoes) into bins and onto the conveyor belt.  As the last step, take your child out of his stroller (you may also be required to take the baby out of a carrier).  Put the stroller through the x-ray machine last.
• Walk through the metal detectors.  With a baby or small child, you will not be asked to go through the more advanced scanning machines.
• Once you are through the metal detectors, put the baby in your carrier or stroller before gathering up all of your other belongings.  Don’t be afraid to take your time or pull to the side to get yourself organized.

5) Getting to Your Gate

• Depending on the size and layout of your airport, you will either walk or ride a shuttle or train to your gate.  Be prepared to take a little extra time to wait for elevators if you have a stroller.  Airports are rarely all on one level!
• Now is the time for bathroom and food stops, assuming you have enough time.  If you are traveling with a formula-fed infant, buy bottled water to use to mix powdered formula.  Also, consider taking a bathroom break to change your baby into a fresh diaper and to go yourself where the bathrooms are bigger and logistics are easier.

6) At the Gate & Airline Boarding

• If you plan to gate check a stroller and/or car seat, check in with the gate agent as soon as you get to your gate.  The agent will give you a claim check and will “tag” your gear.  If you plan to put the stroller or car seat in a protective bag, make sure to tag the bag itself.
• If you are traveling with a lap child, enlist the gate agent’s help to block off an extra seat next to you if there is empty space on the flight.
• Be aware that many airlines no longer offer preboarding with children , so you may not be able to board early.  If you are traveling by yourself with a child (especially if you are using a car seat or stroller that require extra juggling), this can be stressful as you are thrown in with the masses hurrying to board.  Relax and take your time.
• After walking down the jetway, you will fold up your stroller and leave it with the other bags to be gate checked.  I like to put my stroller and car seat in protective bags to prevent them from getting wet or dirty, but this is an extra step that takes time and is hard to do with a baby or toddler in arms.  You might need to put baby in a carrier to make this doable.
• Walk aboard and smile at the friendly flight attendant.  You might need her help or sympathy later.

7) In Flight

• If you are using a car seat, strap your baby in right away so you can free up your hands.
• As soon as you get on board, get your luggage stowed so you can access what you need in-flight.  I like to leave my full diaper bag under the seat in front of me so I can access all of the baby gear I might need without opening an overhead bin.  If you are taller and need the legroom, stash the essentials in your seat back pocket and put your other items in the overhead bin.
• Do what you can to entertain and contain your little one until takeoff.  Often watching other passengers board is ample entertainment.
• As the flight takes off, consider feeding the baby or letting him or her use a pacifier to help with ear pressure changes (do the same on landing, when the pressure equalization is more difficult to handle).  Important rule of thumb – don’t ever wake a sleeping baby to do this!  If they sleep through takeoff or landing, their ears will adjust.
• During the flight, do whatever you need to do to keep your baby happy – walk the aisles, feed & play with him, etc.  Lap babies of a certain age can get squirmy being cooped up so long, so be prepared with lots of in-seat toys and entertainment.  Get up as often as you can to mix things up.  And try your best to get the little one to sleep, especially on red-eyes.  A familiar blanket or stuffed animal may help.
• In-flight bathroom breaks involve the toughest logistics as a solo parent.  Often it is easiest to keep the baby in the carrier or balance him on your knee.  Sometimes on longer international flights, there might be a friendly flight attendant who will hold your little one for a moment.  But don’t count on it, and don’t do it if your baby is going through a stranger anxiety stage.

8) At Your Destination

• Touchdown at your destination – congratulations!  But the logistics aren’t quite over.
• Get your baby off of the plane and wait for your gate checked items on the jet bridge.  Strap the little one into stroller and be on your way.
• Now do everything in reverse – navigate through the airport (and if you are traveling internationally, you will have to clear immigration and customs) and claim your luggage.
• If you are visiting family or friends, it is easiest to have someone pick you up at the airport with a car seat waiting.  Your other choices are taxis (again, a car seat is needed), public transit (very hard to do with a baby and luggage, even in the easiest of cities), or a rental car (can be challenging getting on and off rental car shuttles, but the driver will help you).
• Enjoy your trip!

The inspiration for this post came from a friend who is planning to take a transatlantic flight with a toddler in her lap… by herself.  Brave mom!  If you have a trip coming up and have questions, I love to share my thoughts and experience.  Email me at [email protected] with your specific situation and I’m happy to help.  Sometimes the questions turn into great blog posts.

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Friday 17th of June 2022

Thank you! My anxiety is ramping up for flying solo with my 7 month old this weekend and I needed someone to walk me through this even though I’ve flown with help before.

Williams Forrest

Tuesday 28th of July 2020

Hi! Thank you so much for this article. Great advice. I was wondering if you could help with telling the best stroller for dogs. I am going to a picnic with my brother and my dog. We have a medium tall dog. I want to get a stroller for my dog as we can ride anywhere we want. I don’t want to spend too much. So, cheap price will do better. Any advice??? Thanks in advance! Take love.

Tuesday 6th of October 2015

Thanks ...this artical is a great help

mommytravels

Saturday 9th of August 2014

The first 10 times my son flew it was just me and him. Sometimes it went great and sometimes it was a complete disaster. Motherhood is a humbling experience!

Why I Blog: The Goals & Purposes of Trips With Tykes | Trips with Tykes

Monday 14th of July 2014

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