It is common for children under 12 to experience motion sickness, with infants being less prone to it. While medications can help, their effectiveness and safety in children under two years old are uncertain. Older children may benefit from drugs like hyoscine and antihistamines, which have side effects related to anticholinergic activity. Alternative remedies like ginger and acupuncture bands have been explored in adults.

The Prevalence of Motion Sickness

Approximately 30% of the population and 5% heavily suffer from motion sickness during travel. Children aged 10-12 are more prone to it, especially during car rides, flights, amusement park visits, and virtual reality experiences.

Preventive measures are crucial in reducing travel sickness, but if unsuccessful, pharmacological treatments can be considered for children above two years old.

Symptoms and Effects of Motion Sickness

The symptoms of motion sickness, such as nausea, pallor, and vomiting, are triggered by conflicting signals from different body systems. Other effects may include dizziness, drowsiness, and apathy. Medications like antihistamines and anticholinergics can help alleviate these symptoms.

Preventative measures are more effective than treating symptoms later, as drug absorption is slower during motion sickness. Sedative medications should not be used for calming children during flights.

Box Simple ways to prevent travel sickness

• Encourage children to look out of the window or focus on the horizon
• Avoid reading or playing games that require focus during travel
• Provide head support with pillows and minimize head movements
• Seat children near the front in vehicles
• Select seats over the airplane wing for a smoother ride
• Offer children a light snack before travel
• Ensure good ventilation and avoid overheating
• Maintain a calm and anxiety-free environment

Evaluating Motion Sickness Treatments

Hyoscine hydrobromide (scopolamine)

Hyoscine has shown effectiveness in reducing symptoms compared to a placebo, but it is not superior to antihistamines. It is less sedating but has more anticholinergic effects.

Antihistamines

Antihistamines should be used cautiously in children due to potential severe adverse effects. Sedating antihistamines are now prescription-only for children under two years old in Australia.

Complementary treatments like acupuncture bands and ginger may be beneficial, but research in children is limited.

Ongoing Evaluation of Motion Sickness Remedies

Treatments for motion sickness in children require continuous scrutiny due to the lack of controlled trials and specific studies in this age group.

It is important for researchers and healthcare professionals to prioritize the evaluation of various remedies for motion sickness in children, as the current lack of evidence-based guidance can make it challenging for parents and caregivers to determine the most effective treatment options. Gathering data through controlled trials and specific studies tailored to children’s needs is essential in order to provide safe and effective solutions for this common issue.

Key Recommendations

1. Avoid sedating children with antihistamines during flights.

2. Administer motion sickness medication at least 30 minutes before travel.

Motion sickness, also known as travel sickness or kinetosis, has been documented throughout history. It is believed to have affected people traveling by sea, land, and air for centuries. The symptoms of motion sickness can vary from person to person but commonly include nausea, dizziness, vomiting, and sweating.

The Origins and Manifestations of Motion Sickness

Over two millennia ago, Hippocrates identified motion sickness. In current times, it can manifest in various situations, affecting individuals differently based on their vestibular system’s functionality.

Symptoms range from nausea, vomiting, and drowsiness to dizziness, facial pallor, and cold sweating. The progression of symptoms differs between real-world scenarios and virtual reality experiences. Eyestrain and headaches are more prevalent in virtual reality settings.

Common Symptoms of Motion Sickness

Diverse Symptoms May Include:

• Loss of appetite
• Apathy
• Blurred vision or eyestrain
• “Cold sweating” (facial pallor and sweating)
• Difficulty concentrating
• Dizziness
• Drowsiness and fatigue
• Facial pallor
• Feelings of warmth
• Gastrointestinal discomfort
• Generalized discomfort
• Headache
• Hyperventilation
• Increased sensitivity to odors
• Nausea
• Salivation
• Sweating
• Vertigo
• Vomiting and retching

The Root Cause of Motion Sickness

The primary cause of motion sickness is a sensory conflict between vestibular, visual, and kinesthetic inputs versus expected patterns. Inconsistencies trigger brain centers, leading to symptoms. Behavioral strategies like focusing on a horizon view can help minimize these conflicts.

Future Considerations in Motion Sickness Treatment

Key Points

Aside from habituation, there are few effective ways to combat motion sickness.

Individual susceptibility and risk factors

The peak age for susceptibility to motion sickness is between 7 and 12 years, decreasing with habituation. Women, particularly those with hormonal influences, are more susceptible. Genetic factors also play a significant role.

Other risk factors for motion sickness include anxiety, history of migraines, and certain medical conditions such as inner ear problems.

Behavioral and other nonpharmacologic countermeasures

The main strategies to prevent motion sickness involve avoiding triggers such as sleep deprivation, alcohol, and nicotine. Distractions like fresh air, music, and controlled breathing can be helpful. Placebo effects may also have benefits. Habituation is the most effective method but takes time.

Pharmacologic countermeasures

Medication can be useful for occasional travel. Antimuscarinics and antihistamines are effective but should be taken prior to exposure. Common anti-motion sickness drugs work centrally in the brain. Cannabis shows potential as a treatment, though human trials are lacking.

There are side effects and contraindications to motion sickness medications. Some common side effects include drowsiness, dry mouth, and dry eyes. Scopolamine is less sedating than dimenhydrinate or meclizine but more sedating than promethazine. It is not recommended for individuals with glaucoma or prostatic urinary retention. Consider a trial dose before traveling. Tablet medication should be taken ahead of time for absorption. Cruise operators may provide information on sea conditions for preparation. Select medications based on exposure duration and stimulus intensity.

For adults:

• Short-term exposure (≤6 hours):
  • Mild to moderate stimulus: meclizine or dimenhydrinate
  • Intense stimulus: promethazine
• Longer-term exposure (>6 hours):
  • Mild stimulus: meclizine or dimenhydrinate
  • Moderate to intense stimulus: scopolamine patch

Antiemetic medications for adults include scopolamine, promethazine, dimenhydrinate, cyclizine, meclizine, buclizine, and cinnarizine. There are various formulations with different brand names. Some drugs may be available over the counter in certain countries but require a prescription elsewhere. Behavioral strategies should be attempted first. Use caution with anti-emetic drugs in children. Diphenhydramine is not recommended due to its sedative effects. Some individuals may experience mal de debarquement, or sea sickness after disembarkation, which may require evaluation and treatment for migraine headaches. Supportive measures include rest and adequate hydration. In severe cases, non-oral drug administration may be necessary, along with behavioral interventions.