I regularly make the multi-hour trek by bus from my home in St. John’s to my mother’s in central Newfoundland with my son, who is now seven. Unfortunately for both of us, motion sickness symptoms have always been a part of these trips. On one memorable occasion, my mother burst into laughter when we got off the bus. My toddler had spent the entire trip vomiting and the evidence was all down the front of my clothing.
Mom’s laughter was sympathetic—I regularly got sick on airplanes and boats as a child (but was fine in cars, thankfully). It’s unclear how many children experience motion sickness symptoms: Nearly everyone will become sick if there’s enough motion, but according to the National Institutes of Health in the United States about a third of people are highly susceptible. “We don't really know a whole lot about why it affects some people more than others,” says Mike Dickinson, a paediatrican in Miramichi, N.B.
Motion sickness symptoms in kids are usually more of a nuisance than anything, but in some cases, it can be a bigger problem—for example, when medication to prevent nausea isn’t effective or well tolerated, when even short trips in a vehicle bring on nausea, or when the child vomits so much they risk dehydration.
Generally, motion sickness symptoms start to show up in the toddler years and often improve once a child becomes a teen. In kids and teenagers, the brain and its underlying systems are still developing, and this plays a role in their increased susceptibility to motion sickness, Dickinson says. “Their underlying balance and vestibular system is under construction.”
In the most basic terms, that queasy feeling develops when there’s a disconnect between how our different senses are experiencing motion. For example, a kid in the backseat of a car driving on a winding road will sense the twists and turns, but may not see them because they can’t see out the window. Or a person watching a movie with a lot of jumpy camera work on a screen will see motion with their eyes even if they aren’t experiencing it physically. If there is a difference between what the inner ear, which is responsible for balance, is sensing and what the eyes or body are feeling, you can start to get cold sweats, fatigue, irritability, nausea, loss of appetite, and/or vomiting.
In cars, many people report feeling more motion sick when sitting in the backseat, which is thought to be because you don’t have a clear view of the horizon and therefore there’s a disconnect between what you’re feeling and what you’re seeing it. Planes cause less of an issue for some people because the motion is less obvious, he said, but that can change if a flight is turbulent. And boats seem to be a problem for many people. “There just seems to be something about that rocking motion of a boat that for some people they just don't tolerate,” Dickinson says.
In a broader sense, however, it’s not clear why some kids are more likely than others to become miserable in a moving vehicle. “I've never seen anything that has suggested an underlying known cause other than bad luck,” Dickinson said.
It isn’t known if childhood motion sickness does (or doesn’t) run in families, and the fact that it is so common makes it hard to say for certain. For example, Bonnie Way, who lives in Vancouver with her five children aged one to 11, says some of them get motion sick in the car, and some of them don’t.
“My husband and I have frequently chugged back our coffees so that we can pass a travel mug back to the child who feels like they need to throw up,” Way says.
Prevention really is the best medicine for motion sickness, said Dickinson. It’s hard to get the genie back in the bottle once the queasiness has begun.
Pay attention to what your child eats or drinks before a trip. Avoiding heavy, greasy, or sugary foods can help if your kid tends to become nauseated during travel. Some children do feel sick if they travel on an empty stomach, however. If that’s the case, give them a small, bland snack or meal and have plain snacks like saltine crackers handy in the car. Encourage your child to take frequent sips of water instead of drinking a lot at once.
For safety reasons, kids need to be in the back seat of the car—but the tradeoff for safety is an increased chance of motion sickness. It can help to have your child in the back middle seat, where they can face out the front window if they are old enough to sit front-facing.
On a plane, sitting by the wing can reduce motion sickness because there is less perceived motion and on a boat, it’s smart to stay near the middle of the vessel. In both cases, there is more stability and therefore less motion in the middle of a boat or plane than at the ends.
Some kids find that reading, playing video games, or watching a movie can make them feel more nauseous—probably because of the further sensory stimulation regarding motion or the appearance of motion. I refer to my ability to read in the car without trouble as my superpower, but just a few minutes of Minecraft on his Nintendo Switch sets off my son’s sensitive stomach on a road trip. In these instances, listening to podcasts, audiobooks, or music might be a better choice.
You might not be able to prevent your children from vomiting, but you can help the situation be less of a hassle. On longer road trips, Way packs an empty margarine or yogurt container (including the lids) as a just-in-case barf bucket. For long car or bus rides with my own son, I bring along large-size freezer bags, wet wipes, and an extra set of clothing, just in case the worst happens.
Finally, there’s medication. “As a general principle, we sort of try to avoid medications in kids if we can, but sometimes that's just not possible,” Dickinson says. The key is to follow dosing directions and use medications only as needed.
Gravol and other medications with dimenhydrinate are available in children’s formulations, including liquids, pills, and suppositories, though none are appropriate for kids younger than two. Some kids struggle taking Gravol because of the taste—you may need to wash it down with a drink or food they enjoy.
Try a half-dose of medication first to see if that’s effective, Dickinson says, and give it to your child about an hour before travel begins so it has time to begin working. “Once the child starts to get nausea, the chance of the Gravol being effective is pretty small.” Keep in mind that drowsiness is a common side effect of dimenhydrinate, and that should be weighed against the need for the medication. Less commonly, in some children Gravol cause cause excitability instead of drowsiness—not ideal on a long car trip. Other potential side effects include dry mouth and constipation.
Ginger-based medications like Gravol Ginger do help some people and are a safe option, barring an allergy. In Dickinson’s experience, motion-sickness wristbands like Sea-Bands don’t work, but some of his patients find them helpful. In a some cases, when there was a medication allergy or the motion sickness was very severe and Gravol wasn’t working, Dickinson has prescribed Zofran, a medication meant to prevent nausea and vomit due to chemo and after surgery, to some success. This is a last resort, however, only used in the very few cases where motion sickness was especially severe and/or Gravol was not well tolerated—for example, if there is a medication allergy or if it simply doesn’t work well enough.
It can be hard to know when a child isn’t feeling well before things are too far gone, especially if that child is non-verbal and you’re not sitting beside them. But even non-verbal children give off early cues of motion sickness, Way said. She once learned too late that her two-year-old’s fussing was a sign of upcoming trouble, she said.
“My husband and I were debating whether or not to stop for a break in the upcoming town,” Way said. “I ignored my daughter's fussing, and she answered our debate for us by throwing up all over herself and her car seat.” Other early symptoms of motion sickness would be unusual quietness or crankiness, paleness, crying, and loss of appetite.
Once a child is already feeling ill, the best solution is to stop the motion is causing that illness, says Dickinson and if your child is prone to motion sickness, it’s advisable to build time for breaks into your travel plans. Giving your child a chance to lie down on their back, with a cold cloth on the forehead, can also help.
If your child starts to complain of nausea, and it would be unsafe to stop the car at the moment, you can give them some instructions that might improve how they feel. “When someone yells that they aren't feeling well, I turn up the AC or open windows, suggest that they take off coats or hats if they are able, and remind them to focus on the scenery out the front window rather than side windows or inside the vehicle,” Way said. Leaning the head back against the seat or headrest and keeping it as still as possible may also help.
It’s unusual for motion sickness to be serious, but if your child is triggered by even short, uneventful car trips or becomes so ill that they vomit to the point of dehydration, speak to your family physician. If your child has symptoms of motion sickness like dizziness or headache when not involved in a movement activity, or if the symptoms persist for several hours after a trip has ended, go see a doctor—a different condition may be causing symptoms that look like motion sickness.
The good news in all this? Whether it’s because their bodies change, or because they get big enough to see out the window or sit in a front seat, motion sickness does seem to improve as children age.
“I would say the vast majority of people can be optimistic that over time, as their child becomes a teenager, it gets better,” Dickinson said.