Should parents drug babies on long flights?
Parents taking infants on long flights are turning to medication to help their children sleep. But is the practice safe - or a dangerous abuse of parental power?
On a recent afternoon flight from Miami to Los Angeles, travellers were impressed with the three young children who slept most of the way and then played quietly. How sweet and well behaved they were, the passengers commented.
But the woman sitting next to me was not buying it.
"I think she drugged them," she whispered, gesturing toward the mother watching a film as her children snoozed.
Parents who medicate their babies and toddlers with allergy or cough medicine on long flights say it helps the children sleep in increasingly cramped planes and helps combat jetlag. It is a polarising topic on parenting blogs, with debates often turning nasty.
On the Urban Baby website, which allows users to post anonymously, a typical post about how to occupy tots on long flights quickly grows heated:
"Drug your spawn, please. For the love of GOD, anesthetize the little beast."
"Do people actually do that? That seems a bit extreme to me. Just looking to keep her occupied."
"Psychos who pop pills all day would drug their kids. Normal folks would never do that."
While the American Academy of Pediatrics says it never recommends sedating children on long flights, many parents say their paediatricians do quietly advise a bit of the allergy medicine for a flight.
But there are risks.
"It's not a good idea," says Dr Daniel Frattarelli, chair of the American Academy of Pediatrics committee on drugs. Take the drug marketed in the US as Benadryl, diphenhydramine HCL (quite different from the product known as Benadryl in the UK, which is the drug cetirizine).
"When using Benadryl to sedate, you are using it for its side effects rather than its therapeutic effect. It can be dangerous - especially in children under two. Kids have died from this."
Diphenhydramine HCL tends to concentrate in fluid around the brain in young children and can have unpredictable results in infants and toddlers, he says.
"The last place you want something to go wrong is up in the air," Frattarelli says.
But parents who have successfully used allergy medicine to help children sleep swear by it, albeit in hushed tones.
One mother of two who did not wish to be identified used the over-the-counter allergy and motion-sickness medicine Phenergan for a recent flight from Australia to the US. She said the first eight hours of the flight were "agony" and that she used the medication as a last resort to help her three-year-old daughter sleep.
"It actually has directions to use for travel," she says.
A dad from New Zealand with children ages five and two, both of whom often take 10-12-hour flights, says he has used antihistamines to help his son sleep and that a doctor had recommended it.
"It was a safe dose of a kids' medicine, with side effect of sleepiness," he says.
"We only used the suggested dose for his weight. We don't do this now, as our young kids travel well."
But Ben Adair, a father of two in Los Angeles, says the allergy medicine backfired the one time he tried it.
"Our four-year-old was under the weather anyway, so we gave him some Benadryl to help him sleep through a couple flights," he says. "But instead of sleeping, he turned into the groggy, zombie toddler - somewhere between asleep and awake and completely miserable.
"I felt terrible about it and won't do it again."
Jo Andrews, a British mother of three who lives in Dubai, says she takes about three long flights a year with her children and buys them all new, small toys to unwrap on the plane and brings extra snacks and sticker books to keep them occupied.
"I would never, ever drug my kids when they are young on a flight," she says. "Imagine if there was an emergency on the plane.
"They trust their parents unconditionally, and will do pretty much whatever we tell them is right or wrong. Well, taking any drugs without need is wrong."
My children's paediatrician Dr Noosha Shaheedy says parents often ask about sedating babies on long-haul flights.
She recommends against it. But she knows parents ignore that advice, and urges them to be careful with dosage and never to give a child medication for the first time in the air, as they do not know how the child will react.
The sedate debate for parents grappling with the challenges of modern air travel might be relatively new, but parents have drugged their babies for generations to keep them quiet during more serious getaways.
Syrians fleeing the violence in their country in recent months have been sedating their children to keep them quiet as they escape, according to the UN Refugee Agency.
Some refugees fleeing warfare in Laos during the 1970s gave their babies opium to knock them out for the journey.
"When families had to escape communist countries by running through jungles or crossing the Mekong River, the cry of a baby could mean death by gunfire for the entire travelling group," says Leilani Chan, an actress and writer touring the US with Refugee Nation, a performance she created with her partner Ova Saopeng, a refugee from Laos.
"Many would sedate their babies with a taste of opium. Often we hear this story with a chuckle - obviously from refugee moms and dads whose children survived the escape. But indeed many children died from accidental overdose."
Chan and Saopeng have a young son and have never medicated him on flights.
"I choose not to use a drug and let my toddler wander the aisles saying 'hi' to passengers. I figure if he is bugging people it's better than having him screaming in his seat," she wrote in an email.
"I console myself with this perspective... bugging other passengers is a small deal in the larger scope of things."