Medical Conditions

Baby Ear Pain During Flights and Altitude Changes

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published AAP, AAP, NIH guidelines

Editorial policy

Last reviewed:

If your baby has been diagnosed with or you suspect baby ear pain during flights and altitude changes, here is what the evidence says.

The short answer

Ear pain during flights and altitude changes is caused by pressure differences between the middle ear and the outside environment. Babies and toddlers are more affected because their Eustachian tubes are smaller and less efficient at equalizing pressure. The most pain occurs during descent (landing). To help: breastfeed, bottle-feed, or offer a pacifier during takeoff and landing (swallowing helps equalize pressure), use saline nasal drops before the flight if your child is congested, and avoid flying if your child has an active ear infection. Older toddlers can try sipping water or eating a snack during ascent and descent.

Key takeaways

  • Ear pain during flights and altitude changes is caused by pressure differences between the middle ear and the outside environment. Babies and toddlers are more affected because their Eustachian tubes are smaller and less efficient at equalizing pressure. The most pain occurs during descent (landing). To help: breastfeed, bottle-feed, or offer a pacifier during takeoff and landing (swallowing helps equalize pressure), use saline nasal drops before the flight if your child is congested, and avoid flying if your child has an active ear infection. Older toddlers can try sipping water or eating a snack during ascent and descent.
  • Usually normal when: Mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground
  • Call your doctor if: Severe, persistent ear pain after a flight that does not resolve
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

This is one of the most common questions parents ask. Searching for answers means you care.

What Parents Should Know

According to AAP, NIH guidelines, ear pain during flights and altitude changes is caused by pressure differences between the middle ear and the outside environment. Babies and toddlers are more affected because their Eustachian tubes are smaller and less efficient at equalizing pressure. The most pain occurs during descent (landing). To help: breastfeed, bottle-feed, or offer a pacifier during takeoff and landing (swallowing helps equalize pressure), use saline nasal drops before the flight if your child is congested, and avoid flying if your child has an active ear infection. Older toddlers can try sipping water or eating a snack during ascent and descent. At 0-12 months, babies cannot consciously pop their ears, so they rely on swallowing and sucking to equalize ear pressure. During takeoff and especially landing, offer a breast, bottle, or pacifier to encourage swallowing. If your baby is asleep during the flight, there is no need to wake them - most babies equalize pressure naturally during sleep. If your baby has a cold, nasal congestion can make pressure equalization harder. Use saline drops and a nasal aspirator before the flight. Ask your pediatrician about infant-dose acetaminophen before the flight if ear pain is expected. Avoid flying with a baby who has an active ear infection if possible. It is generally considered normal when mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground. However, you should contact your pediatrician promptly if severe, persistent ear pain after a flight that does not resolve.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground
Severe, persistent ear pain after a flight that does not resolve
Your child rubbing or pulling at their ears during altitude changes
Hearing loss after a flight (rare but possible from barotrauma)
A brief period of crying during descent that resolves after landing
Blood or clear fluid from the ear after altitude changes

When to Seek Immediate Care

  • Severe, persistent ear pain after a flight that does not resolve
  • Hearing loss after a flight (rare but possible from barotrauma)
  • Blood or clear fluid from the ear after altitude changes
  • Signs of a ruptured eardrum: sudden relief from pain followed by drainage

By Age

What to expect by age

0-12 months

Babies cannot consciously pop their ears, so they rely on swallowing and sucking to equalize ear pressure. During takeoff and especially landing, offer a breast, bottle, or pacifier to encourage swallowing. If your baby is asleep during the flight, there is no need to wake them - most babies equalize pressure naturally during sleep. If your baby has a cold, nasal congestion can make pressure equalization harder. Use saline drops and a nasal aspirator before the flight. Ask your pediatrician about infant-dose acetaminophen before the flight if ear pain is expected. Avoid flying with a baby who has an active ear infection if possible.

1-3 years

Toddlers may cry and pull at their ears during altitude changes. Help equalize pressure by offering a sippy cup of water, a snack that requires chewing, a lollipop (if age-appropriate), or by encouraging them to yawn. Avoid giving a toddler a pacifier if they have outgrown it just for the flight. If your toddler is congested, discuss using an age-appropriate decongestant with your pediatrician before flying. Distraction with toys, books, or screens during takeoff and landing can also help. For car travel in mountains, offer water or a snack during altitude changes.

What to Tell Your Pediatrician

  • Describe when you first noticed baby ear pain during flights and altitude changes and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if ear pain that persists for hours after a flight.
  • Mention if your child has an ear infection and you need to fly.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground
  • Your child rubbing or pulling at their ears during altitude changes
  • A brief period of crying during descent that resolves after landing
Mention at your next visit when...
  • Ear pain that persists for hours after a flight
  • Your child has an ear infection and you need to fly
  • Your child consistently has severe ear pain during flights
  • Fluid or blood draining from the ear after a flight
Act now when...
  • Severe, persistent ear pain after a flight that does not resolve
  • Hearing loss after a flight (rare but possible from barotrauma)
  • Blood or clear fluid from the ear after altitude changes
  • Signs of a ruptured eardrum: sudden relief from pain followed by drainage

What You Can Do at Home

  • Keep track of when you notice baby ear pain during flights and altitude changes — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground — this is generally within the range of normal.
  • At 0-12 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if severe, persistent ear pain after a flight that does not resolve.

ear infection

Baby Pulling or Tugging at Ears

Baby ear pulling is one of the most common concerns parents bring up, but it is rarely a sign of an ear infection on its own. Babies discover their ears around 4-6 months and often pull, rub, or tug at them out of curiosity, self-soothing, teething discomfort, or tiredness. Ear pulling is concerning for infection mainly when accompanied by fever, fussiness, disrupted sleep, or cold symptoms. Without other symptoms, ear pulling is almost always harmless exploration.

Baby Always Congested (Stuffy Nose)

Babies are naturally noisy breathers because their nasal passages are very small. Many parents worry their baby is "always congested" when the sounds they hear are actually normal newborn breathing. True chronic congestion can be caused by frequent colds, dry air, or irritants. Saline drops and gentle suctioning are the safest and most effective treatments for infant congestion.

Ear Infection vs. Teething - How to Tell the Difference

Ear pulling is one of the most commonly confused symptoms in babies - it can indicate either teething or an ear infection, and telling the difference can be tricky. Teething causes referred pain to the ear area (especially when molars are coming in), leading babies to pull or rub their ears. An ear infection typically follows a cold and is associated with fever, disrupted sleep, and increased fussiness. The key differences: teething ear pulling is usually without fever and is accompanied by drooling and gum swelling, while ear infections typically cause fever, follow a cold, and may cause more intense pain when lying down.

Triage

Excessive Crying Triage

Determine whether crying patterns need medical attention.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is baby ear pain during flights and altitude changes normal?
Ear pain during flights and altitude changes is caused by pressure differences between the middle ear and the outside environment. Babies and toddlers are more affected because their Eustachian tubes are smaller and less efficient at equalizing pressure. The most pain occurs during descent (landing). To help: breastfeed, bottle-feed, or offer a pacifier during takeoff and landing (swallowing helps equalize pressure), use saline nasal drops before the flight if your child is congested, and avoid flying if your child has an active ear infection. Older toddlers can try sipping water or eating a snack during ascent and descent.
When should I call the doctor about baby ear pain during flights and altitude changes?
Severe, persistent ear pain after a flight that does not resolve Hearing loss after a flight (rare but possible from barotrauma) Blood or clear fluid from the ear after altitude changes
When is baby ear pain during flights and altitude changes normal?
Mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground Your child rubbing or pulling at their ears during altitude changes A brief period of crying during descent that resolves after landing
What causes baby ear pain during flights and altitude changes?
Ear pain during flights and altitude changes is caused by pressure differences between the middle ear and the outside environment. Babies and toddlers are more affected because their Eustachian tubes are smaller and less efficient at equalizing pressure. The most pain occurs during descent (landing). To help: breastfeed, bottle-feed, or offer a pacifier during takeoff and landing (swallowing helps equalize pressure), use saline nasal drops before the flight if your child is congested, and avoid flying if your child has an active ear infection. Older toddlers can try sipping water or eating a snack during ascent and descent. Common explanations include: Mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground. Your child rubbing or pulling at their ears during altitude changes.
What should I mention to my pediatrician about baby ear pain during flights and altitude changes?
You should mention baby ear pain during flights and altitude changes at your next visit if: Ear pain that persists for hours after a flight. Your child has an ear infection and you need to fly. Your child consistently has severe ear pain during flights.
Is baby ear pain during flights and altitude changes normal at 0-12 months?
Babies cannot consciously pop their ears, so they rely on swallowing and sucking to equalize ear pressure. During takeoff and especially landing, offer a breast, bottle, or pacifier to encourage swallowing. If your baby is asleep during the flight, there is no need to wake them - most babies equalize pressure naturally during sleep. If your baby has a cold, nasal congestion can make pressure equalization harder. Use saline drops and a nasal aspirator before the flight. Ask your pediatrician about infant-dose acetaminophen before the flight if ear pain is expected. Avoid flying with a baby who has an active ear infection if possible.
Is baby ear pain during flights and altitude changes normal at 1-3 years?
Toddlers may cry and pull at their ears during altitude changes. Help equalize pressure by offering a sippy cup of water, a snack that requires chewing, a lollipop (if age-appropriate), or by encouraging them to yawn. Avoid giving a toddler a pacifier if they have outgrown it just for the flight. If your toddler is congested, discuss using an age-appropriate decongestant with your pediatrician before flying. Distraction with toys, books, or screens during takeoff and landing can also help. For car travel in mountains, offer water or a snack during altitude changes.
Should I go to the ER for baby ear pain during flights and altitude changes?
Seek emergency care if severe, persistent ear pain after a flight that does not resolve, or if hearing loss after a flight (rare but possible from barotrauma). When in doubt, call your pediatrician's after-hours line for guidance.
Does baby ear pain during flights and altitude changes go away on its own?
In many cases, baby ear pain during flights and altitude changes resolves on its own, especially when mild fussiness during takeoff and landing that resolves once at cruising altitude or on the ground.
AAPAAPNIH

References

  1. [1]American Academy of Pediatrics. Flying With Baby. HealthyChildren.org. AAP
  2. [2]American Academy of Pediatrics. Travel Safety Tips. HealthyChildren.org. AAP
  3. [3]National Library of Medicine. Barotitis Media in Children. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Baby Ear Pain During Flights and Altitude Changes.

Things to mention

  • Describe when you first noticed baby ear pain during flights and altitude changes and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if ear pain that persists for hours after a flight.
  • Mention if your child has an ear infection and you need to fly.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Ear pain that persists for hours after a flight
  • Your child has an ear infection and you need to fly
  • Your child consistently has severe ear pain during flights

Urgent signs to report immediately

  • Severe, persistent ear pain after a flight that does not resolve
  • Hearing loss after a flight (rare but possible from barotrauma)
  • Blood or clear fluid from the ear after altitude changes

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Crying TriageEar Infection TriageWell-Baby Visit PrepMedicine Dosage CalculatorEmergency ContactsBaby Tracker

Bottom line

Most cases of baby ear pain during flights and altitude changes are normal. Talk to your pediatrician if severe, persistent ear pain after a flight that does not resolve.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Baby Pulling or Tugging at Ears

Baby ear pulling is one of the most common concerns parents bring up, but it is rarely a sign of an ear infection on its own. Babies discover their ears around 4-6 months and often pull, rub, or tug at them out of curiosity, self-soothing, teething discomfort, or tiredness. Ear pulling is concerning for infection mainly when accompanied by fever, fussiness, disrupted sleep, or cold symptoms. Without other symptoms, ear pulling is almost always harmless exploration.

Baby Always Congested (Stuffy Nose)

Babies are naturally noisy breathers because their nasal passages are very small. Many parents worry their baby is "always congested" when the sounds they hear are actually normal newborn breathing. True chronic congestion can be caused by frequent colds, dry air, or irritants. Saline drops and gentle suctioning are the safest and most effective treatments for infant congestion.

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Ear pulling is one of the most commonly confused symptoms in babies - it can indicate either teething or an ear infection, and telling the difference can be tricky. Teething causes referred pain to the ear area (especially when molars are coming in), leading babies to pull or rub their ears. An ear infection typically follows a cold and is associated with fever, disrupted sleep, and increased fussiness. The key differences: teething ear pulling is usually without fever and is accompanied by drooling and gum swelling, while ear infections typically cause fever, follow a cold, and may cause more intense pain when lying down.

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