Toddlers are more prone to ear pain during flights than adults, but a few simple strategies during takeoff and landing can prevent most of the discomfort. The key is encouraging your child to swallow frequently during the two moments when cabin pressure changes most rapidly.
Why Toddlers Are More Vulnerable
Ear pain during flight comes down to a small channel called the eustachian tube, which connects the middle ear to the back of the throat. This tube opens briefly every time you swallow or yawn, letting a tiny puff of air in or out so that pressure on both sides of the eardrum stays equal. When cabin pressure drops during ascent or rises during descent, the tube needs to open repeatedly to keep up.
In toddlers, eustachian tubes are shorter, narrower, and more horizontal than in adults. That makes them less efficient at equalizing pressure and more likely to get blocked, especially if your child has any congestion. The result is a pressure imbalance that stretches the eardrum inward or outward, causing sharp pain. Because toddlers can’t follow instructions like “pop your ears,” they need help from you.
Keep Your Toddler Awake for Takeoff and Descent
This is the single most overlooked piece of advice. The American Academy of Pediatrics specifically recommends keeping children awake during both takeoff and descent. When your child is asleep, they swallow far less often, so pressure builds without relief. It’s tempting to let a sleeping toddler stay asleep, but they may wake up screaming from ear pain that’s harder to reverse once it sets in. If you can, time naps for the middle of the flight when cabin pressure stays relatively stable.
Encourage Swallowing During Pressure Changes
Swallowing is the most reliable way to open the eustachian tube. During a normal swallow, muscles in the palate contract and briefly pull the tube open, letting air flow through to equalize pressure. Your job is to create as many swallowing moments as possible during the 15 to 20 minutes of ascent and descent.
For younger toddlers, nursing or offering a bottle works well. A sippy cup with water or juice is another good option. Pacifiers also promote swallowing, though less effectively than actually drinking. For older toddlers (around age 2 to 3), snacks that require a lot of chewing and swallowing can help. Lollipops and popsicles are especially useful because they promote continuous swallowing over a longer period. Pouches of applesauce or yogurt that your child sips slowly also work. The goal is sustained, repeated swallowing, not just a single sip.
Yawning opens the eustachian tube too. You can sometimes trigger a yawn in a toddler by yawning exaggeratedly yourself, since yawns are contagious even in young children.
Pressure-Regulating Earplugs
Specialized earplugs designed for air travel are available in children’s sizes, typically for ages 1 and up. These aren’t standard foam earplugs. They contain a ceramic filter or membrane that slows the rate of pressure change reaching the eardrum, giving the eustachian tube more time to adjust naturally. Small rings around the plug create a gentle seal in the ear canal without being uncomfortable.
These plugs also reduce cabin noise by about 20 decibels, enough to take the edge off engine roar without isolating your child from your voice. They’ve been used in aviation settings for over 25 years and are recommended by some pediatricians. You’ll find them at most pharmacies and airport shops, often marketed under names like “EarPlanes” for kids. Put them in about 30 minutes before descent for the best effect, or wear them for the entire flight if your child tolerates them.
What About Decongestants and Medications?
Many parents wonder about giving a decongestant before the flight. The AAP recommends against using oral decongestants in children under age 4 for any reason. The CDC adds that antihistamines and decongestants have not been shown to actually help with flight-related ear pain. Decongestant nasal sprays are only recommended for children 12 and older.
If your toddler is in pain, acetaminophen or ibuprofen can help. You can give a dose about 30 minutes before descent if you know your child tends to struggle with ear pressure. These won’t prevent the pressure imbalance, but they reduce the pain it causes. If your child has allergies that are actively causing nasal congestion, an allergy medication prescribed by your pediatrician may help keep the eustachian tubes clearer.
Flying With Congestion or a Recent Ear Infection
A stuffy nose from a cold makes everything harder because swollen tissues can block the eustachian tube entirely. If your toddler has significant nasal congestion on travel day, saline nasal drops before takeoff and descent can help thin mucus and open the nasal passages. Gently suction with a bulb syringe or nasal aspirator afterward.
If your child has an active ear infection or just finished one, the middle ear may still contain fluid that can’t equalize. This makes pressure changes more painful and increases the risk of eardrum damage. There’s no universal rule for how long to wait after an ear infection, so if your flight is within a week or two of diagnosis, it’s worth checking with your child’s doctor before flying.
Recognizing Ear Pain in a Toddler
Toddlers who can’t yet say “my ears hurt” will show you in other ways. Watch for pulling or tugging at the ears, sudden inconsolable crying that starts during ascent or descent, turning the head side to side, or pressing the side of the face against your shoulder or a blanket. Some toddlers become rigid and arch their back. Others go quiet and seem stunned rather than crying. If your child was fine during cruise and suddenly becomes distressed as the plane begins its descent, ear pressure is almost certainly the cause.
Start offering a drink or snack immediately. If your child refuses to swallow anything, try a pacifier or encourage them to cry (which also involves swallowing). Placing a warm, damp cloth over the ear can provide some comfort while you wait for the pressure to equalize after landing. In most cases, the pain resolves within a few minutes of the plane reaching the gate.
A Quick Flight-Day Checklist
- Pack drinks and snacks in your carry-on. Sippy cups, pouches, lollipops, and a bottle or nursing plan for takeoff and landing.
- Bring pressure-regulating earplugs. Children’s sizes fit most toddlers over 12 months.
- Carry saline drops and a nasal aspirator. Use them before boarding if your child has any congestion.
- Have pain relief on hand. Acetaminophen or ibuprofen, dosed for your child’s weight.
- Time naps for mid-flight. Keep your toddler awake during the first 20 minutes after takeoff and the last 20 minutes before landing.
- Sit near the back of the plane. Descent tends to feel slightly more gradual in rear seats, though this is a minor factor.
Descent is typically harder on ears than ascent because the cabin pressure increases and pushes the eardrum inward, where the eustachian tube has to work against the pressure to open. If you only have energy to focus on one phase, make it the landing. Start offering drinks about 20 minutes before touchdown, when the captain typically announces the initial descent.