The holidays are here. Someone just plopped thanksgiving in my to-do list. I like it. Celebrating with family and friends is one yummy thing in life even in the face of family dynamics-drama. I know it doesn’t feel yummy for everyone. I’m not trying to sound Pollyanna-ey. I’ve had the dark years of holidays, too. When the being together made me feel lonelier than truly connected. But, that’s not where I find myself now, fortunately. The people in my life who are less than 3 feet tall also decorate these times together and make it better and better. Who knew you could get so excited about a little, “gobble, gobble.”
The smallest in our family also make holidays more complicated though. It’s the over the river and through the woods part that can be really tough.
I get piles of questions around the holidays about traveling with kids. Between now and New Year’s I’m going to expand on a list of travel do’s and do not’s from my perspective. But I wanted to get one thing out there before I get those lists assembled. It being the busiest travel day of the year tomorrow and all, I thought you should know:
If it were my child, I would not use Benadryl on the airplane, car or train to knock my kid out. I never have and hopefully never will. Yes, I heard about the 2-year old getting kicked off the Southwest plane in October for being too loud. I hear you in not wanting to be the ditto on that story. I know how painful flying can be with a squirming, screaming infant or toddler and the surrounding public. With F (my first born), we took more than 10 commercial flights in his first year. I remain stunned at how rude the public can be when they feel inconvenienced by flying and sitting around children. Nonetheless, I still wouldn’t push the syringe full of Benadryl to make it better.
My rationale is part philosophical and part safety based. Benadryl is a medicine designed to help children with symptoms of allergies. It’s an anti-histamine (it works against histamines produced by cells in the body as a response to an allergic trigger). But when you give an oral medicine, it enters the blood stream and has effects all over the body. With Benadryl, those effects are often on the brain, gastrointestinal system and skin. One of the side effects from Benadryl is that it’s sedating, hence why people talk about using it for travel. Crash out, knock out, eyelid closed, tired in some kids. Trouble is the response to Benadryl is inconsistent between kids and can be dangerous. Children can get dry mouth, stomachache, nausea, vomiting or rarely an allergic response to the med, heart palpitations, rash or other neurologic changes. And, some kids go absolutely nutty. A paradoxical (opposite) response, some kids get totally wired and a little crazy on it, too. The crazy-hyper-nutty is not dangerous, but can be disastrous in a travel setting.
The last place you want to be with an unexpected or undesirable medication side effect is on the airplane at 35,000 feet.
Your pediatrician cannot predict what kind of response your child will have to a new medicine they have never tried. Period.
The bottom line is this: we work hard to avoid using medication in children unless they absolutely need it. Using a medicine for parental convenience is not an indication to medicate your child. I just can’t advise that you put medicine in your child’s mouth for ease of travel or convenience. Especially since we never know which child (and why) will have side effects. Side effects to medications represent a huge number of visits to pediatricians and emergency rooms, especially for kids under age 5, as it’s often their first-time exposure to a medication.
Some Points on using Benadryl in Children:
- Benadryl is an anti-histamine, designed to help children suffering from mild allergy symptoms (itchy nose, sneezing, itching of skin, hives).
- Never ever use Benadryl in a child under age 1. This sedating effect could be more sedating than you would want.
- Using a medication for your convenience is never an indication for medication in a child.
- Some children have a paradoxical effect (opposite from the desired effect) and get wired, hyper and a little nutty.
- Always talk with your pediatrician before giving any medicine (OTC or prescribed) in a child less than 2 years of age
- Some pediatricians may disagree with me and advise you to use Benadryl for travel. If you decide to use Benadryl for travel, try a dose at home first. Don’t attempt a new med at the airport or on the plane for the first time.
Thanks for this. I have never wanted to use Benadryl for the plane, but it is great to have this all articulated so clearly. I can think of a lot of parents who would love to read this. Hope you enjoy your over the river and through the woods!
Great blog post!
Chowderboy McGee says
I confess, we tried Benadryl on our kid en route to Hawaii last year… HUGE backfire… We had abut 20 minutes of sleep before the sound of the pilot on the PA system awoke him. This was followed by 6 hours of a woozy shrieking devil child who alternated between trying to disembowl the seat back in front of him and clawing at the unfortunate woman seated in front of us. Needless to say, should our travel plans call for babies in the future, we’ll be packing ear plugs for all and not the sedatives.
Karen Stern, M.D. says
As always, excellent advise from my favorite pediatrician:)
Thanks for posting this. I have often wanted to get a doctor’s informed perspective on the topic, but HEAVENS, I would never ask my own pediatrician for fear she’d “report me”! We do fly an awful lot, and I’ve had many well-meaning friends (and strangers, of course, usually plane-mates) suggest the B-therapy. There’s just a lot of conflicting info out there, you know?
Stephen H says
I too have been bitten by the Benadryl backfire on the plane. Lately we have been experimenting with booking our flights as red-eyes or either very early or very late so that our girls (who are 2 and 4 years old) are more naturally tired. That seems to work a little better. However…. I don’t sleep very well on the plane either! So we try not to set the same expectation on our girls.
Folks, it all gets better when they are teenagers and have their own mp3 players. Trust me. This summer we went to Europe with a 15 and 18 year old, and they were both fun. I actually have (blackmail!) photos of them playing on a playground. Actually, the best thing I found that worked when traveling was pre-planning surprises for the kids (not medication). Go to a toy store and buy teeny tiny presents that you give at certain portions of the trip. They could be tiny toys (it was Power Rangers when our kids were young), or little coloring books. It does not matter, just give tiny surprises to distract the young children. What is even better is to encourage your children to read, well by reading to your child! My daughter had been wonderful on airplanes from age seven on… but that is because she reads. She has also been a finalist on the Seattle Global Reading Challenge twice.
Tiffany@Mommy Goes Green says
I’m so glad to hear you “say” this! I’ve heard from numerous moms about using Benadryl but never felt inclined to try this myself. My daughter flew all over the country with us the first two years and we found that new (to her) toys and books plus a lot of snacks kept her happy.
I second the comment about bringing surprises. I flew 8 (yes 8) children from Cincinnati to Hawaii (and back) in 2006. They were ages 14 and down at the time. They flew first class and were the best behaved kids on the plane. We purchased new backpacks ( which they knew about) and loaded them with snacks ( not really needed in FC) and other things which they were able to take out something new each hour. Some things that were a big hit were those tiny containers of play doh. Fun – but not enough to do any real damage/mess. Among the youngest the most useful were sheets of small stickers and a spiral notebook to stick them in. Peeling little stickers takes ALOT of time and gets you easily thru an hour of your flight =) They did well on the first commuter flight since it was so short- so we ate a snack and did nothing else… saving the big guns for the long flight. I was able to spend lots of time just relaxing – and had time to be annoyed by some older kids who werent so well behaved ( actually thier mom wasnt even sitting near them – very telling).
I’m so glad you posted this. I’ve never given my 16 month old medications without a good reason and would not give her an antihistamine for a plane ride. My brother and his family visited for Thanksgiving and insisted on giving his kids (3 years and 18 months) bendryl before their flight home. For the life of my I can’t understand why people who buy all organic food and delay vaccinations because they don’t want the chemicals in their kids would decide to squirt a chemical down their throats just for a more peaceful plane ride.
Do you mean never use benedryl in an infant as a sedative? Or really NEVER use it? What should I do/use if my two month old seems to be having an allergic reaction to something?
I agree. Absolutely not. My fear is parents can get too comfortable with this and use it more regularly for sleep, etc.
As the spouse of an air sick prone wife, I can tell you that antihistamines work well for the nausea and dysequilibrium that go along with motion sickness. I frequently advocate being HUMANE and treat the kid for motion sickness. If they fly great and don’t fuss, great. However, as a pediatrician, I can tell you thet many “fussy, agitated” kids on airplanes feel miserable. I also advocate acetaminophen for ear/sinus pain on planes, as they can’t tell us their ears hurt.
First Last says
Try nursing on the way up and down! Or bottle with water, if they’ve nursed too recently to be hungry, anything to keep them sucking off and on during ascent/descent. I was on 35 flights with my first by the time she was 1.5 or 2 years old, often 2-3 consecutive flights, and it worked like a charm every time. Same with the second baby. I always want to tell parents with screaming babies this, but I’m afraid of sounding like I’m butting in.
I would never drug my child out of ease of my life. I had Americans suggest the use of Benadryl, when we traveled to Denmark (my home country) and I was very surprised. Yes, it’s a 12 hour flight with one lay-over but if I can’t manage that with my child, then I shouldn’t travel.
Let me preface my confession with this: My in-laws live in England…we do not. I have flown with them as infants and as toddler and have had perfectly pleasant (for everyone around me) flights. I am always a nervous wreck that they are going to kick the seat, play with the tray, talk to much and too loud, and get a nasty neighbor upset. Not too terrible you might say. But a red-eye to England with two toddlers over-stimulated on benadryl is a horrible, nightmare. I happened to be on a flight with people who had never had children or had developed that particular amnesia some empty-nesters have. i.e. “my children NEVER behaved that way. We wouldn’t ALLOW it!) As if my husband and I are swilling martinis and watching movies. Flying is difficult for small children. People are intolerant. When your kids get to the other side they have a horrible time adjusting to the time change.
Lest you believe it’s all about “convenience,” keep all that in mind. There are some who would suggest we not fly when they’re small. If we had done that my husband’s parents would never have met my kids before they died, and my children would have been denied loving grandparents.
However, there are better sedative medicines available and doctors should consider the blood pressure, anxiety, and consequences for the entire family when asked about mild sedatives for long flights. Nine hours is too long for most adults to sit still, let alone toddlers. It is a harrowing experience for some parents and I’ve learned the hard way not to judge others on parenting matters like this.
I may not need to clarify that I did NOT fly with my in-laws as infants and my kids would never have met their grandparents before the grandparents died. Proof read!
What do you think about the use of benadryl for babies and small children for the symptomatic treatment of colds? Thanks!
So this is not about Benedryl, but I have a travel question…with all the chatter about upcoming holiday travel from sources as disparate as community listservs to US Weekly…I am wondering about one little tip that is being thrown around. Does it really make a difference to put something like vaseline or Aquafor in your nasal passages to decrease the risk of infection by a new bacterium or virus?
Laura Marcial says
How can I (safely) test my identical twins (8yo now) for the paradoxical effect with benadryl when I think I might have witnessed it when they were toddlers?
Wendy Sue Swanson, MD, MBE says
My understanding of the paradoxical effect is that it’s not dangerous, just unpleasant. Instead of being drowsy, children get hyper.
The only way that I understand that you could check for the response is to give your child a dose of benadryl.
I suggest you check with their pediatrician or general doctor prior to doing so if you’re concerned about previous reactions.
Why would anyone in their right mind use Benadryl to sedate their child, SMH ???? That’s not what it’s for. It’s common knowledge that dramamine is for motion sickness and traveling. You can also use natural sedatives and relaxers like Melatonin, Chamomile, Gaba, etc. Do your research before you harm your child. Natural is always the best way to go.
Always teach your kids respect, manners and how to behave in public places. Discipline your child before someone else has to. Don’t be a lazy and irresponsible parent.
Anna Slong says
Well – we use Benny all the time and my 6mthbold and my 3 year old toddler love it. We tend to do dose them up at home first then hit them with another fix at the airport just prior to boarding. I have not heard a word from them on all 6 Long haul flights we have flown this year.
Jazz Biyi says
May I ask the dosage you use please? Thank you
bill brunett says
Diphenhydramine was NOT “designed to help children suffering from mild allergy symptoms” — rather it was discovered accidentally during research of muscle relaxers. To say that any use of the drug is more in line with its purpose than any other use is subjective, as the drug was stumbled upon by chance.
My kid is autistic. Flying is quite stressful for her. I use Benadryl for flights. Definitely agree with try at home first. Tend to agree w always ask pediatrician but my kid has frequently made people second guess themselves and black and white opinion led. If she could talk, I think she’d thank us for getting through the flights! We are in hundreds of hours of therapy to work on navigating life, and my goal is to work on flying not sedated some day. Quick note: dye free Benadryl only for her- dyes can make kids hyper!! Also, I’d rather give otc Benadryl every now and then for travel than some of the hard core prescription drugs that have been recommended to us!
Wendy Sue Swanson, MD, MBE says
Thank you for this. Every rule often has an exception and I appreciate hearing your experience and advice for others here.
Agree that benadryl is LESS hard core than some Rx that can be used for severe anxiety, etc.
I wrote this blog so long ago (over 9 years ago) and I think the copy/writing didn’t incorporate the variability and openness I intended and other uses and reasons for benadryl and for children, like the ones you point out with your child.