Treatment of Car Sickness in Infants
For infants with car sickness, the primary treatment approach should be non-pharmacological interventions including proper positioning, timing of travel, and environmental modifications, as medications are generally not recommended for infants due to safety concerns.
Understanding Car Sickness in Infants
Car sickness is a form of motion sickness that occurs when there is conflict between the vestibular, visual, and proprioceptive systems. In infants, this can manifest as:
- Fussiness or irritability during car rides
- Vomiting
- Excessive drooling
- Pallor
- Crying that resolves when the car stops
Non-Pharmacological Management
Positioning Strategies
- Avoid semi-reclined positions like car seats for purposes other than travel - Research shows that placing an infant in a car seat or other semi-supine positions exacerbates gastroesophageal reflux and should be avoided except when necessary for travel safety 1
- Ensure the infant can see out the window if possible
- Position the infant in the middle back seat where motion is less pronounced
- Make sure the car seat is properly installed at the correct angle
Timing and Feeding Considerations
- Feed the infant 30-60 minutes before travel - not immediately before
- For longer trips:
- Plan frequent stops (every 1-2 hours)
- Take infant out of car seat during stops
- Schedule travel during infant's normal sleep times when possible
Environmental Modifications
- Ensure adequate ventilation in the vehicle
- Maintain a cool temperature in the car
- Reduce strong odors (perfumes, air fresheners)
- Provide visual distraction appropriate for infant's age
- Use white noise or gentle music
Additional Strategies
- For breastfed infants, maintain exclusive breastfeeding when possible as it has been shown to decrease frequency of gastroesophageal reflux compared to formula feeding 1
- If bottle feeding, avoid overfeeding before car trips
- Ensure adequate burping after feeding and before placing in car seat
Pharmacological Management
Medications are generally not recommended for infants with car sickness due to safety concerns and lack of FDA approval for this age group.
While dimenhydrinate (Dramamine) is indicated for prevention and treatment of motion sickness 2, it is not approved for use in infants and carries significant risks including sedation, paradoxical excitation, and anticholinergic effects.
The American Academy of Pediatrics does not recommend pharmacologic intervention for symptoms related to normal physiologic gastroesophageal reflux in infants 3, which can be exacerbated by car travel.
When to Seek Medical Attention
Parents should consult a healthcare provider if:
- Car sickness symptoms are severe and persistent
- Vomiting is projectile or contains blood
- Infant shows signs of dehydration
- Symptoms occur even when not traveling
- Infant demonstrates respiratory distress during travel
Common Pitfalls to Avoid
- Using car seats outside of travel - Car seats and semi-reclined positions can worsen reflux symptoms 3
- Overfeeding before travel
- Mistaking symptoms of other conditions (such as gastroesophageal reflux disease or ear infections) for car sickness
- Using adult motion sickness medications in infants without medical supervision
By implementing these non-pharmacological strategies, most cases of infant car sickness can be managed effectively while ensuring the infant's safety during necessary travel.