Flying with an ex-premie?

[DdJames]

Has anyone ever been given any advise on flying with an infant who was born prematurely?

I am researching and developing a resource looking at the risk of hypoxic episodes on commercial airplanes and was wondering what, if any, advice was being given. There doesn't appear to be much information on the topic aimed at parents at present.

How old is the infant? Have they had health problems previously?

I'm sure a visit to the doctors before you fly won't harm anyone and will put your mind at ease.

Just realised your researching! Knackered pants here.

My dd travelled at 11 months and was completely fine. Flew for three hours and slept most of the journey. No health issues and doctor on return said she was fine.

No one has ever mentioned this to us

Sorry - DS has flown short and long haul without problems. He was born at 35 weeks

We wanted to take our baby (who was born at 29 weeks) on a short-haul flight at 3 months corrected age and asked our NICU whether there were any risks. They said that it should be fine in her case, though they wouldn't advise taking her to any high-altitude destinations. She didn't have any respiratory problems or illnesses after discharge. I don't know what their advice might have been if she'd been on oxygen, for example.

No one mentioned anything to us, but then we've had no follow up at all so not sure what's standard advice. DS didn't need any help with breathing so I'd assume it's ok. We've not been anywhere yet but it wouldn't have crossed my mind, apart from in the early months, if I hadn't seen this

Thank you for the replies. Current research seems to suggest caution in ex-premies with or without a history of respiratory disease until they are 6 months due to the lower fraction of inspired oxygen (15% instead of 21% at sea level) and their immature hypoxic ventilatory responses. Advice is to monitor signs for respiratory distress and give supplementary oxygen as required.

Do you think this is a topic you would have been interested in receiving information on when you were getting ready to take your babies home and would it have made you reconsider any travel plans?

I'd have been interested, yes. But we received no information at all about preemies from the hospital (last September so not long ago) so anything to go home with would've been great.

No information at all Abbey?! That makes me really sad, we (most of us!) work really hard on our unit to make sure parents have all the information they might need. Sometimes it's probably a bit too much.

We had a ventilated 32-weeker and had no advice at all really - save that when we did fly for the first time (long haul at 18m) I asked the paediatrician who said it would be fine but had to jump through quite a few hoops to get travel insurance. Some accurate guidance would have been really helpful.

I think you need to revisit the science. The 21% is a constant within the atmosphere. What falls is the atmospheric pressure with increasing altitude. This leads to a smaller total amount of O2 available (aka partial pressure) even though the percentage is the same.

This leaves two mechanisms for problems. The main one is worries about a degree of hypoxia, which could be more problematic if you have reduced functional capacity (basically, anyone with chronic lung disease, or chronic heart disease could get in more bother, as they are normally only just coping, with nothing to spare...).

Then there is a potential problem with not-yet-ex premmies...if they still have active RDS (respiratory distress syndrome) then they struggle to keep alveoli/airways open. This is often supported in hospitals by CPAP (continuous pressure) which helps splint things open by maintaining higher pressure in the airways. One could postulate, therefore, that if you flew with a baby who had only recently come off such support, then the atmospheric pressure dropping rather below that at sealevel (pressurised cabins not being kept all the way up to sealevel pressures) might cause alveolar collapse. Of course, that's rather more a worry for medical staff conducting airtransfers (only done one in a fixed wing...happy to keep it that way), rather than for parents!

DdJames we were on the postnatal ward as DS could breathe unaided, so I think that's why we got no information. My good friend had a preemie at the same gestation at the same hospital but was in special care and has follow up. So I suspect that's the rules?

Hi I have an ex 25 weeker here, with 7 months in hospital. Came off oxygen at 13 months old. DH then asked the paed aboutflying and the paed said "your normally chilled out consultant would.much rather you went to abersoch or newquay for your summer holiday this year".
The paed said it was mainly because planes are a hot bed of germs rather than breathing issues.
I know 24 weekers that have flown and mo warning given to them - but they may not have asked.