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Editor,—Probably like most doctors looking after children, we feel uneasy when asked whether it would “be alright” to take small children and infants on plane journeys for holidays. Controversy continues as to whether flying might be harmful for infants,1-4 and it is questionable whether infants benefit from weekend breaks or long distance holidays in search of better weather. However, we suspect that the air travelling population will get increasingly younger and we will be asked more frequently. As long as solid data about the safety of plane journeys for infants are lacking, anecdotal experience will be the only basis of advice.
In this context we would like to report the case of an 11 week old twin boy, corrected age 6 weeks for prematurity of 35 weeks, who was admitted to the Accident and Emergency Department of our hospital directly from an aeroplane after an emergency landing at Manchester Airport. Shortly after take off from London Gatwick for Florida the infant stopped breathing and went blue. On the plane resuscitation was attempted by the parents, a stewardess, and a paramedically trained fellow passenger. With oxygen and mouth to mouth breathing the baby's colour improved and the plane staged an emergency landing in Manchester. On arrival the picture was typical of bronchiolitis and respiratory syncytial virus (RSV) infection was subsequently confirmed. There was a three day history of coryzal symptoms and “snuffliness”, for which a family doctor was consulted. The family had understood that the good weather in Florida would “do him good”.
Although this infant's RSV infection might have resulted in apnoea, hypoxaemia, and hospitalisation anyway, it seems likely that lower oxygen pressures in the aeroplane will have aggravated the symptoms. For this family the Christmas period was spent in a paediatric ward in Manchester and not in a holiday resort in Florida. Although we have no information from the airline, we assume that for the emergency landing the plane would have to empty its tanks, filled for a transatlantic distance, in order to achieve a safe landing weight. We presume these tanks will have been emptied over the Irish Sea. In addition to the potential harmful episode to the child and the inconvenience for the family, this infant's flight probably also caused significant environmental damage.
We accept the contention of Ward Platt et althat any danger from air travel must be very small,4 but that may not be so for infants who are unwell, and some evidence based guidelines on this subject might be helpful. In the meantime we wonder if we should regard suspicion of bronchiolitis as reason to advise against flying.