Travelling with a baby: car trips, flights, sleep and packing

Travelling with a baby is very doable, and a few safety rules matter more than anything you pack. On long drives, stop at least every 2 hours and take your baby out of the car seat, and lift them out to sleep on a firm, flat surface as soon as you arrive. On planes, feeding or a dummy during take-off and landing can help their ears. Wherever you stay, your baby sleeps on their back in a safe cot or travel cot, never on a sofa. And before an overseas trip, check vaccines and travel health with your GP at least 4 to 6 weeks ahead.

How do I keep my baby safe on a long car trip?

Your baby needs a correctly fitted car seat or capsule for every trip; car seat safety covers choosing and fitting one. On the road:

• Take regular breaks. Red Nose's guide to keeping baby safe in the car in Australia advises resting and stretching every 2 hours on long journeys and taking your baby out of the seat during breaks. The Lullaby Trust's car seat advice in the UK doesn't give a set number of hours, but says to stop regularly so you can check on your baby, take them out and let them stretch.
• Avoid very long drives with premature and young babies where you can. The Lullaby Trust says young babies may be at risk of breathing difficulties if they travel upright in a car seat for a long time.
• Watch for slumping. If your baby slumps forward, stop straight away, take them out and sit them upright again before carrying on, as the Lullaby Trust advises. Red Nose in Australia explains that a baby's head falling forward can block their airway.
• Have a second adult in the back if possible, or use a mirror to keep an eye on your baby if you're driving alone.
• Never leave your baby alone in the car, even for a short time, as Red Nose in Australia warns.
• Take your baby out when you arrive, even if it wakes them, and put them down on a firm, flat surface to keep sleeping. Car seats are for travel, not a sleep space.

Plan stops around feeds where you can. Feeding, changing and a stretch on a rug at each break uses the stop well.

Is it safe to fly with a baby, and how old do they need to be?

The AAP's guide to flying with a baby says it's generally safe to fly once a baby is at least 7 days old, but ideally to wait until 2 to 3 months, because crowded airports and planes raise a newborn's chance of catching an infection. Airlines set their own minimum ages and rules, so check when you book.

Seats, lap belts and bassinets

• Lap or own seat: in the US, the AAP says the safest option is an approved child restraint (often your car seat, if it is labelled as certified for aircraft) in a seat of your baby's own, because turbulence is the leading cause of children's injuries on planes. Rules on lap travel and car seats vary between airlines and countries, so ask your airline.
• Bassinets: many airlines offer a bassinet for small babies on longer flights, with their own weight and age limits. The AAP notes they are usually for babies under about 6 months or 9 kg (20 lb). Book early, and follow the crew's instructions.
• Lie-flat seats: the AAP says babies under 12 months should still have their own sleep space rather than sharing a sleeper seat.

Ears, illness and medicines

• Changes in air pressure during take-off and landing can be uncomfortable. The AAP says feeding from the breast or a bottle, or sucking a dummy, during take-off and landing can ease it.
• If your baby has had an ear infection or ear surgery in the 2 weeks before the trip, the AAP suggests asking your doctor whether it's OK to fly.
• Don't give medicines to make your baby sleepy. The AAP says not to give antihistamines such as diphenhydramine without asking your doctor.

Documents and security

For international flights, the AAP notes your baby needs their own valid passport, so apply well ahead. On domestic flights, the airline may still ask for proof of your baby's age. In the US, formula and breast milk are allowed through airport security in reasonable quantities, beyond the usual 100 mL liquids limit; tell security staff you have them. Check your departure airport's rules if you're flying elsewhere.

Where should my baby sleep when we're away from home?

The same safe sleep rules apply on holiday, at a relative's house and in a hotel, for every sleep, day and night. The NHS advice on reducing the risk of SIDS is to put your baby on their back, in their own cot or Moses basket in the same room as you for at least the first 6 months, on a firm, flat mattress with no pillows, bumpers, loose blankets or soft toys, and away from smoke.

• Travel cots: Red Nose's portable cot guide in Australia says to use only the mattress supplied with the cot and not to add extra mattresses or padding, which can increase the risk of suffocation. It also says to follow the assembly instructions and check for broken parts or mesh tears. The Lullaby Trust's safer sleep on holiday advice in the UK says travel cot mattresses are thinner than usual but fine if firm, flat and in good condition, and not to put folded blankets or a quilt underneath to make them "more comfortable".
• Hired or borrowed cots: ask ahead whether your accommodation has a cot that meets current safety standards, and check it over when you arrive.
• Sofas and armchairs: the Lullaby Trust says never to fall asleep on a sofa or armchair with your baby, as this significantly increases the risk of SIDS. If you might doze off while feeding, put your baby down on a firm, flat surface first.
• Bed-sharing: the Lullaby Trust says not to share a bed if anyone in it has drunk alcohol, taken drugs or medicines that make them sleepy, or smokes, or if your baby was born before 37 weeks or weighed under 2.5 kg. See bed-sharing.
• Hot destinations: the Lullaby Trust suggests a room temperature of about 16–20°C, says it's better for babies to be a bit cool than too hot, and says a baby can sleep in just a nappy if the room is very warm. Keep the cot away from windows and air conditioning. See hot weather.

Should I cover the pram to keep the sun off?

No. Red Nose's advice on pram covers in Australia says even a light muslin can significantly reduce airflow and trap heat, and makes it harder to see signs of heat stress. It suggests natural shade such as trees or umbrellas, good airflow around the pram, and avoiding the hottest part of the day.

How do I feed my baby on the go?

Breastfeeding needs no preparation, which makes it easy on the move. Offer feeds as often as your baby wants them; hot weather covers feeding in the heat.

For formula, the NHS answers to common formula questions suggest taking:

1. measured formula powder in a small, clean, dry container
2. a vacuum flask of water that has just been boiled, filled and sealed (it stays above 70°C for several hours)
3. an empty sterilised bottle with the cap and ring on.

Make up each feed when your baby needs it, then cool it under cold running water with the lid on. The NHS guide to making up formula says water at 70°C or more kills harmful bacteria in the powder, and to throw away any formula left in the bottle after a feed.

If you can't do that, the NHS says to use ready-to-feed liquid formula. A feed made at home, cooled in the fridge and carried in a cool bag with an ice pack should be used within 4 hours, or within 2 hours without an ice pack. The NHS also says bottled water isn't usually recommended for making up formula because it can contain too much salt or sulphate, so check before you rely on it abroad. Formula preparation advice differs between countries; see preparing formula.

What should I pack for travelling with a baby?

How do I handle naps, routines and time zones?

There's no simple formula for moving a baby to a new time zone, so take your lead from your baby. Many families find it helps to:

• keep the same order of feed, play and sleep rather than the same clock times (see daily rhythm)
• bring familiar sleep cues such as your baby's own sleeping bag and a bedtime song
• use daylight, meals and outdoor time to help everyone adjust to local time
• expect a few unsettled nights and shorter naps, and be flexible on travel days.

When should I see a doctor before or during a trip?

Before an overseas trip, the NHS travel vaccinations page advises getting travel health advice at least 4 to 6 weeks before you go, and says all travellers, including children, should be up to date with their routine vaccines. See vaccinations. Before you leave, find out where the nearest hospital or after-hours doctor is at your destination.

Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) or go to the nearest emergency department if your baby is under 3 months and has a fever of 38°C (100.4°F) or more. Australia's healthdirect says to take a baby under 3 months with a fever to the nearest emergency department. The Royal Children's Hospital Melbourne fever fact sheet in Australia says a baby under one month with a fever should go to hospital, and a baby under three months should see a doctor as soon as possible. Signs of dehydration need urgent medical advice too; dehydration signs explains what to look for. See also fever in babies.