Altitude sickness in babies can present itself as the baby seeming visibly uncomfortable and beginning to throw up when traveling to the mountains or higher altitudes. It might be stressful for the parents to see their baby in distress or discomfort. Read this post to know more about the causes, types, signs, diagnosis, treatment, and prevention of altitude sickness in babies.
What Causes Altitude Sickness In Babies?
Altitude sickness is an umbrella term for a group of symptoms that might occur when you travel to a place at a high altitude. It is also known as ‘mountain sickness.’ The air in the atmosphere exerts pressure on earth. It is known as barometric pressure. As we go higher in the altitude, this pressure begins to drop. Along with the pressure, the oxygen level in the surrounding atmosphere also falls. Multiple changes in the atmosphere affect the body, thus causing altitude sickness and making the baby feel uncomfortable.
Is It Safe For A Baby To Visit High-altitude Areas?
It is safe to travel to high-altitude places once the baby is more than six weeks old (1). You may follow some precautions during the trip. Keep your baby hydrated with breast milk and water, once you have observed all the precautions and reached a high altitude region. Feed your baby small but multiple meals a day if they are on solids. Babies younger than six months should be given only breast milk.
How To Take Care Of A Baby Having Altitude Sickness?
You can observe the following simple non-pharmacological methods to help the baby with altitude sickness feel better.
Hydrate your baby through breast milk or formula. If your baby is older than six months, then you can provide them frequent sips of water.
Feed your baby small yet frequent meals that are high in carbohydrates. It is noted that craving for carbohydrates tends to increase at high altitudes (2). Carbohydrates may help provide sufficient energy to the body to overcome altitude sickness
Regions at a high altitude are often cold. Dress your baby in insulated clothing. Staying warm may help the baby feel better.
A baby can be prone to altitude sickness even when they are healthy. It is thus essential to know the variations of altitude sickness.
Types Of Altitude Sickness
Altitude sickness occurs in various levels of severity. It is broadly classified into three different syndromes.
1. Acute mountain sickness (AMS)
This is the most common form of altitude sickness but is less severe (3). Healthy babies may also have AMS.
2. High altitude pulmonary edema (HAPE)
HAPE occurs when fluid accumulates in the tissues and air spaces within the lungs (4). This leads to the impaired exchange of gases and may cause respiratory failure. HAPE has the symptoms of AMS (listed later) accompanied by breathlessness, coughing, and weakness. Oxygen support or descent might be life-saving. HAPE is significantly less common than AMS. Babies with the following conditions tend to be more susceptible to HAPE (1) (5).
Recent viral infections Recent upper respiratory tract infections Pulmonary hypertension (high blood pressure) Problems with pulmonary artery and pulmonary vein Atrial and ventricular defects (heart defects) Obstructive sleep apnea Babies with Down’s syndrome might be more prone to HAPE.
3. High altitude cerebral edema (HACE)
High altitude cerebral edema is considered the most severe form of altitude sickness but is also the rarest (6). The condition occurs when there is an influx of fluid and swelling of the brain due to low oxygen in ambient air (7). Along with all the symptoms of AMS, HACE has profound lethargy, drowsiness, dizziness, confusion, and poor muscle control. HAPE and HACE can be fatal, and usually, a prompt descent to a low altitude is suggested. Since AMS can aggravate to HAPE or HACE, it is essential to know the symptoms of altitude sickness in babies.
What Are The Signs Of Altitude Sickness In Babies?
If you just traveled with your baby to a high altitude location, then be alert to the following general indicators of altitude sickness.
Fussiness Food refusal Crying Irritability Clinginess Lethargic
Some symptoms, such as severe crying and irritability, may also happen due to tiredness from the travel. So let your baby rest well. If the symptoms persist even after resting, then it could be acute mountain sickness. There are a few severe symptoms of altitude sickness that could point towards HAPE and HACE.
Breathlessness Cyanosis, a bluish discoloration of the skin Confusion Ataxia, poor muscle control and inability to move Coughing Repeated vomiting
When Should You Call The Doctor?
See a doctor during the following situations:
The baby shows severe symptoms of altitude sickness
General symptoms of AMS persist for more than three days.
There is labored breathing with constant shortness of breath.
Repeated vomiting and dehydration
Refusal to eat or drink
These problems require prompt medical attention. The symptoms of altitude sickness could overlap with other conditions. Also, a baby cannot verbally express discomfort. Therefore, a score-based diagnostic tool could be used to determine if the baby has altitude sickness.
How To Diagnose The Severity Of AMS In Your Baby?
The severity of altitude sickness may be determined through the use of Children’s Lake Louise Score (CLLS) for the diagnosis of acute mountain sickness (AMS) in preverbal children (8). The process begins by rating the amount and intensity of baby’s fussiness measured on the following scales.
Meeting all of the following score conditions determines the presence of acute mountain sickness:
Fussiness score (FS) should be greater than or equal to 4
Eating, playfulness, and sleep score (E+P+S) should be greater than or equal to 3
The total Children’s Lake Louise Score (CLLS) should be greater than or equal to 7
CLLS is useful in providing an approximate idea to the parents about the severity of altitude sickness in their baby. It is best to consult a doctor if you have any concerns or when the baby displays severe symptoms of altitude sickness.
How Is Altitude Sickness In Babies Treated?
The doctor may suggest the following treatment methods to help the baby feel better. Do not give acetazolamide, nifedipine, and dexamethasone to the baby. These medicines are conventionally administered to teens and adults for altitude sickness. But their effect on infants is not well known, and it may cause side effects. Consult your doctor before giving any medicine to the baby.
How To Prevent Altitude Sickness In Babies?
A few simple steps can help you avoid altitude sickness in babies (9).
Does High Altitude Make A Baby Have Ear Infections?
There is no direct link between living at high altitudes and ear infections. Changes in altitude may increase the risk of infection (10). However, the risk might be due to related changes in climate since places at a higher elevation tend to be colder. If your baby has enough time to acclimatize to the altitude and weather, then they may be less prone to ear infections.
