Summer vacations are fun for every age—as long as everyone stays healthy. Here are a few helpful reminders to keep the younger set feeling fine whether they are on a road trip or 30,000 feet in the air. We caught up with Stanford Medicine Children Health’s Katie Ellgass, MD, of Altos Pediatric Associates in Los Altos to learn about common concerns and helpful hints when traveling with young children.

Q: What advice do you give parents who are taking young children on an airplane?

Dr. Ellgass: Most pediatricians recommend reducing exposure to large crowds during the first 30 days of life. Another level of protection is given once a child has their vaccinations at the 2-month wellness visit. These immunizations can be given as early as 6 weeks of life.

Parents are often concerned about their child’s ear pain while flying. If your child has a cold or ear infection you can ask your pediatrician if you should give a pain reliever 30 minutes before take-off. The biggest changes in ear pressure are typically during the ascent and then during initial descent—starting as much as a half hour before landing. If your child is over 3 years old, I recommend chewing gum or sucking on a lollipop. For infants, it’s helpful to offer a bottle, breast or pacifier. Also, it’s worth noting that only about a third of babies’ experience ear pain with flying—and the majority will outgrow it!

Another common question I hear about is flying with breast milk. A breast pump is considered a medical device so you can bring it on board in addition to your regular carry on. TSA allows you to fly with an unlimited amount of breast milk so you can pack it in bags or bottles larger than 3 ounces. Frozen milk does not require testing. But, if it is partly thawed or liquid, a TSA agent will test it to ensure it’s safe. Remember, most fellow passengers sympathize with the parents of a crying infant and thankfully the hum of the jet engines often drowns out the cries.

Q: How much of the medicine cabinet should I bring in case of illness?

Dr. Ellgass: I recommend carrying water and snacks and be sure to bring all medications that are needed for chronic conditions, such as an albuterol inhaler for asthma. It can be tough to not overpack, but consider bringing a few band aids, acetaminophen or ibuprofen and hydrocortisone cream if your child is prone to itchy skin. Wipes, SPF 30 sunscreen and a waterproof mat or sheet for an on-the-go play area are also handy. Lastly, an essential item for any travel kit is a sealable plastic bag that can serve to collect dirty diapers and potentially vomit. Ick!

Q: How should we manage time zone changes?

Dr. Ellgass: Typically, a west-to-east time shift is harder to adjust to because you’re not tired at the normal bedtime. If you are traveling more than 3 time zones, night flights work well as they allow you to take advantage of a child’s natural tendency to sleep at night. Some proactive parents will adjust their child’s sleep schedule in the days before departure to help reduce jet lag. One way to do this is to modify your child’s sleeping and eating routines 15 minutes earlier, or later, each day for a few days prior to the trip.

To help with circadian rhythm (the body’s sleep/wake cycle), have your child play outside during the day. Or take advantage of well-lit areas during the daytime to promote adjustment if the weather is bad.

Q: Any advice for healthy eating on the road?

Dr. Ellgass: I find easy and healthy options are wraps such as whole wheat tortillas filled with veggies and hummus or bananas and apples with peanut butter. My favorite on-the-go snacks are string cheese and pre-peeled hard-boiled eggs. If you are driving or flying internationally be sure to consume any produce before you arrive at customs.

Finally, I recommend bringing your child’s favorite water bottle as staying hydrated helps prevent constipation. Also, the “P” fruits such as prunes, pears, and plums can be especially helpful to combat hard stools.

Q: Do you have special tips for traveling internationally?

Dr. Ellgass: It’s very important to check with your doctor to see if any additional vaccines or preventive medications are needed depending on your destination. I also recommend bringing a copy of your child’s immunization record as some countries ask for proof of vaccination against certain infectious diseases. The Center for Disease Control and Prevention (CDC) also has helpful information.

Traveling with young kids can be challenging but also very rewarding! Above all else, wash your hands frequently when traveling and talk with your pediatrician about your travel plans ahead of time if you have any other concerns.