A:
Many people get ear pain when they travel by airplane. This is from pressure building up behind the eardrum, a membrane between the outer ear (ear canal) and the middle ear. During takeoff and landing, there is a rapid change in air pressure inside the plane. The pressure in the outer ear becomes different from that in the middle ear. Pain is felt as the eardrum moves away from an area of higher pressure.
The Eustachian tube, a connection between the middle ear and the back of the nose and throat, normally acts to equalize pressure changes. For most adults, the pain they feel with takeoff or landing is brief. Its relieved when the ears pop as the Eustachian tube opens and eases the pressure. But in many children, the Eustachian tube does not function as well as in an adult. Plus, the tube can be temporarily blocked by colds, allergies or ear infections. This can result in mild to severe ear pain.
There are some simple things you can do during takeoff and landing to help open the Eustachian tube and relieve pressure. These include yawning, chewing and swallowing. Infants and young children can drink something or suck on a pacifier. Older children can chew sugarless gum.
If your child has an ear infection or a cold with nasal congestion, some parents have chosen to delay their flight, if possible. If you still want or need to fly, an over-the-counter pediatric nasal decongestant may make a difference. Talk with your childs doctor about it.
Henry H. Bernstein, D.O., is a senior lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and professor of pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston. 
