Motion Sickness

Pediatrics for Parents, July, 2001 by John E. Monaco

Nothing spoils a trip faster than a child vomiting from motion sickness. It's due to unnatural or unfamiliar motion stimuli. Often reading while moving causes it.

Making the diagnosis is easy. The first symptom is a general feeling of discomfort or queasiness. You may notice your child looking pale and sweating. Next comes complaints of feeling sick or nauseous, and, if no relief is obtained, vomiting. Unfortunately, the symptoms can progress very quickly and before you know it your child has thrown up. The symptoms usually resolve quickly once the motion is stopped.

Infants rarely if ever suffer from motion sickness. If a child suffers from motion sickness, the symptoms worsen with age and generally peak at ages 10-12 years old. For some children, the symptoms then begin to lessen while for others they never get any better. Gifts are more susceptible to motion sickness than boys.

Motion sickness is not a disease. It's a normal reaction caused by a sensory mismatch. The child's brain has trouble processing the sensation of motion while looking at scenes that are relatively stable. The most common cause is trying to read while in a moving vehicle.

There are a number of steps you can take to lessen the chances your child will experience motion sickness. Make sure your child can see the outside environment in the direction of travel. If necessary, a booster seat may be required. If your child is old enough to understand, have her fix her vision on a stable reference point such as a point on the horizon.

Obviously, a child with motion sickness shouldn't read or play games that require constant changes in visual fixation. Avoiding unnecessary head movement will also help. If practical, driving at night seems to help. Reclining with closed eyes or even sleeping helps. Riding in the middle of the car, often in the front seat, seems to help for some children.

Fresh air with good ventilation helps. Avoid odors such as strong perfumes, air fresheners, etc. Light meals rather than heavy greasy meals lessens motion sickness. Stop and allow your child to get out and walk around at regular intervals.

If these measures don't work, then medicines may be necessary. The medicines, which often work quite well, are generally not recommended for children under 2 years old. One of the oldest and most effective drugs used for this problem is scopolamine. It's found in a medicine called Donnatol as a pill and liquid, and as a patch called Transderm Scop. Unfortunately, this drug can cause significant side effects in many children and so isn't recommended for children.

Antihistamines are the most commonly used drug for treating children with motion sickness. The most common side effect of antihistamines is sedation -- and that may not be a bad thing for a child with this problem. The newer, non-sedating antihistamines are not very effective in treating motion sickness because they don't get into the brain. That's why their non-sedating -- but it's the same reason they don't work against motion sickness.

It's best to start treatment before the trip begins. How long before depends on the drug and how quickly it works on your child. Most should be given about a half hour before the trip begins. Most should be repeated every 6-12 hours.

Antihistamines may cause side effects other than sedation. Common ones include headache, difficulty urinating, dry mouth, blurred vision, and upset stomach.

Drug & Therapeutic Prespectives, 5/01.