Dear Dr. Mama,
Our 5-year-old plays Pee Wee soccer and last weekend he collided hard with another little one when they both went for the ball at the same time. He was knocked out for a few seconds (scary!) and we went to the ER for a CAT scan, which was fine. The doctor said he did sustain a minor concussion and should be careful for the next 4 weeks — no roughhousing, etc. He’s complained of a couple of mild headaches since then that we treated with Tylenol.
Here’s my question: We’re scheduled to fly to a family reunion half way across the country and I’m worried about air pressure changes on the flight and how they could affect him. It will be 10 days out from the injury, but is it safe? We asked our pediatrician, who seemed wishy-washy about the answer. He didn’t say no, but he didn’t exactly say it’s perfectly fine, either.
Are there risks we should know about?
Concerned in Carmel Valley
Hi Concerned,
Head bonks with little guys are always scary. Even more so when there’s loss of consciousness. A concussion is basically a bruise that happens when the soft, jello-like brain bounces against the hard surface of the inner skull. The treatment is to rest the brain and let it heal, which is why the ER doc gave the advice he did.
Air travel does present some unique conditions, and you’re right to ask about air pressure changes.
At sea level, the air we breathe contains about 21 percent oxygen, while due to pressure differences on a typical commercial flight the cabin air has only about 15 percent oxygen. This can result in a slightly lower blood oxygen saturation for passengers while in the air.
For healthy individuals (adults and children) this small decrease usually goes unnoticed, however adults with recent head injury have reported an increase in symptoms like headache and nausea while on board. It’s not that these would present any long term health danger to your guy, but they could make him feel lousy during the flight.
That said, a family reunion is a big deal, and you probably don’t want to cancel your trip. Some planning and precautions can help ease any discomfort for him on the plane.
Consider pre-medication with a dose of acetaminophen or ibuprofen before boarding. It’s a good idea for him to be well-rested (or maybe sleep on the plane) and to stay hydrated during the flight. Encourage water rather than soda or fruit juices, as these can actually pull water out of the tissues.
Since brain rest is recommended following a concussion, reading, watching movies and playing video games – things kids normally do for entertainment on a plane – may make things worse. Instead, suggest your guy listen to quiet music or an audio book with the volume on the low side.
Most mild concussions in kids improve dramatically in two weeks, so chances are your son will skirt any significant symptoms, but the more prepared you are, the less you’ll have to worry.
Good luck, and have a great trip!
~ Dr. Mama
