From the Guidelines
Managing motion sickness in a 21-month-old, 25-pound toddler primarily involves non-medication approaches, as most anti-motion sickness medications aren't recommended for children this young. The best approach to manage motion sickness in this age group is to use preventive measures that do not rely on medication, given the potential side effects and the lack of strong evidence supporting their use in toddlers 1.
Some key strategies include:
- Positioning the child in the middle of the back seat where they can see out the front window, helping their brain reconcile visual input with the sensation of movement.
- Planning travel during nap times when possible, as sleeping children don't experience motion sickness.
- Ensuring good ventilation in the vehicle and maintaining a cool temperature.
- Offering small, light snacks like crackers before and during travel, avoiding heavy, greasy, or spicy foods.
- Using distraction techniques such as singing songs or playing simple games, but avoiding activities that require looking down like books or screens, which can worsen symptoms.
- Taking frequent breaks during long trips to let the child get fresh air and reset their equilibrium.
If symptoms persist and travel is unavoidable, it's crucial to consult a pediatrician for personalized advice. They might recommend specific medications like children's Dramamine (dimenhydrinate) or Benadryl (diphenhydramine) in dosages tailored to the child's weight, though these are generally not first-line recommendations for children under 2 years due to the risk of side effects and the lack of robust evidence supporting their efficacy in this age group 1.
It's essential to understand that motion sickness occurs due to a mismatch between what the child sees and what their inner ear senses about motion, causing confusion in the brain that leads to nausea and discomfort. Therefore, non-pharmacological interventions that minimize this sensory conflict are preferred as the first line of management.
From the FDA Drug Label
Dimenhydrinate Injection, USP is indicated for the prevention and treatment of nausea, vomiting, or vertigo of motion sickness.
The FDA drug label does not answer the question.
From the Research
Managing Motion Sickness in a 21-Month-Old Toddler
To manage motion sickness in a 21-month-old, 25-pound toddler, several strategies can be employed:
- Behavioral Strategies:
- Medications:
- First-generation antihistamines, such as dimenhydrinate, are effective in preventing motion sickness, although they can be sedating 2, 3.
- Scopolamine is a first-line medication for prevention of motion sickness and should be administered transdermally several hours before the anticipated motion exposure 2.
- Ondansetron is not effective in preventing motion sickness 2, 4.
- Other Considerations:
Important Notes
It is essential to consult with a pediatrician before administering any medication to a child, especially if the child has any underlying medical conditions or is taking other medications. The pediatrician can provide guidance on the appropriate dosage and potential side effects of the medication.
Non-Pharmacological Interventions
Non-pharmacological interventions, such as behavioral strategies, can be effective in managing motion sickness in children. These interventions can be used in conjunction with medications or as a standalone treatment.
Limitations
While there is evidence to support the use of certain medications and behavioral strategies in managing motion sickness, more research is needed to determine the most effective approaches for young children, particularly those under the age of 2 4, 5.