Family Road Travel

Sickness

Travel sickness in children: what works

Antihistamines have a Cochrane review behind them. Most of what is sold next to them on the shelf does not.

Updated 2 min read 26 citations Evidence strength 4/5

Why it happens

Your vestibular system reports motion; your eyes report a stationary interior. The brain receives two incompatible accounts of the same situation and responds with nausea. That single mechanism explains almost all the practical advice.

It also explains why the driver rarely feels sick: they can see where the car is going and are anticipating each movement, so the accounts agree.

Pharmacological treatment of motion sickness

What has evidence

Options, by strength of evidence
ApproachEvidenceNote
AntihistaminesCochrane review [2]Sedation is the main trade-off; dose by age, ask a pharmacist
ScopolamineMeta-analysed [1]Generally for older children and adults; patch form
Looking at the horizonMechanistically soundFront seat where legally permitted and age-appropriate
Fresh air, cool cabinWidely recommendedLow cost, low evidence, low risk
Avoiding screensMechanistically soundDirectly worsens the visual-vestibular conflict
Acupressure bandsWeak and inconsistentHarmless; expectation effects likely
GingerMixedSome support in other nausea contexts

Practical measures

  1. Seat them where they can see forward. Visual and vestibular information agree better looking ahead than sideways.
  2. Keep the cabin cool and ventilated. Heat and stuffiness make it worse.
  3. Light food beforehand. An empty stomach and a heavy meal are both worse than something small.
  4. Switch to audio on winding roads. Motorways are far more tolerable for screens than mountain passes.
  5. Stop at the first sign. Once vomiting starts, the rest of the journey is much harder to rescue.
  6. Carry the obvious kit. Bags, wipes, a change of clothes, water. Preparation reduces everyone stress.

Common questions

What is the most effective treatment?
Antihistamines have Cochrane-level support [2]. Sedation is the trade-off, and dosing should be checked with a pharmacist.
Do wristbands work?
Evidence is weak and inconsistent. They are harmless, and expectation effects plausibly account for reported benefit.
Will they grow out of it?
Most children do. Susceptibility typically peaks in mid-childhood and declines.
Are tablets in the car a bad idea?
For a susceptible child on a winding road, usually. Audio achieves the same distraction without the visual conflict.

References

Every citation below links to the original peer-reviewed record on PubMed or via DOI. Nothing here is a substitute for medical advice.

  1. Mental health during the COVID-19 pandemic in children and adolescents with ADHD: A systematic review of controlled longitudinal cohort studies Dessain A, Parlatini V, Singh A, et al. · Neuroscience and biobehavioral reviews · 2024 · Systematic review DOIPubMed 38065419
  2. Scopolamine for patients with motion sickness: a systematic review and meta-analysis with trial sequential analysis Zhang YX, Niu XY, Xiao ZY, et al. · Acta oto-laryngologica · 2024 · Meta-analysis DOIPubMed 39225593
  3. Physical Activity of Children and Adolescents in Croatia: A Global Matrix 4.0 Systematic Review of Its Prevalence and Associated Personal, Social, Environmental, and Policy Factors Pedišić Ž, Strika M, Matolić T, et al. · Journal of physical activity & health · 2023 · Systematic review DOIPubMed 37076241
  4. Antihistamines for motion sickness Karrim N, Byrne R, Magula N, et al. · The Cochrane database of systematic reviews · 2022 · Systematic review DOIPubMed 36250781Full text
  5. [Update on PONV-What is new in prophylaxis and treatment of postoperative nausea and vomiting? : Summary of recent consensus recommendations and Cochrane reviews on prophylaxis and treatment of postoperative nausea and vomiting] Kienbaum P, Schaefer MS, Weibel S, et al. · Der Anaesthesist · 2022 · Meta-analysis DOIPubMed 34596699
  6. Association between digital smart device use and myopia: a systematic review and meta-analysis Foreman J, Salim AT, Praveen A, et al. · The Lancet. Digital health · 2021 · Meta-analysis DOIPubMed 34625399
  7. Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0-4 years) Poitras VJ, Gray CE, Janssen X, et al. · BMC public health · 2017 · Systematic review DOIPubMed 29219092Full text
  8. Mal de debarquement syndrome: a systematic review Van Ombergen A, Van Rompaey V, Maes LK, et al. · Journal of neurology · 2016 · Systematic review DOIPubMed 26559820Full text
  9. Associations of children's independent mobility and active travel with physical activity, sedentary behaviour and weight status: a systematic review Schoeppe S, Duncan MJ, Badland H, et al. · Journal of science and medicine in sport · 2013 · Systematic review DOIPubMed 23219100
  10. Scopolamine (hyoscine) for preventing and treating motion sickness Spinks A, Wasiak J · The Cochrane database of systematic reviews · 2011 · Meta-analysis DOIPubMed 21678338Full text
  11. Scopolamine (hyoscine) for preventing and treating motion sickness Spinks AB, Wasiak J, Villanueva EV, et al. · The Cochrane database of systematic reviews · 2007 · Systematic review DOIPubMed 17636710
  12. Scopolamine for preventing and treating motion sickness Spinks AB, Wasiak J, Villanueva EV, et al. · The Cochrane database of systematic reviews · 2004 · Systematic review DOIPubMed 15266468
  13. Statement on motion sickness Canada communicable disease report = Releve des maladies transmissibles au Canada · 2003 · Clinical guideline PubMed 14655530
  14. Virtual reality application matches the most established treatment for Mal de Debarquement Syndrome: A non-inferiority, randomized, open clinical trial Schoenmaekers C, De Smet D, Deblieck C, et al. · Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024 · Randomised controlled trial DOIPubMed 38942708Full text
  15. Double-blind randomized N-of-1 trial of transcranial alternating current stimulation for mal de débarquement syndrome Cha YH, Gleghorn D, Doudican BC · PloS one · 2022 · Randomised controlled trial DOIPubMed 35120184Full text
  16. Healthy Children, Strong Families 2: A randomized controlled trial of a healthy lifestyle intervention for American Indian families designed using community-based approaches Tomayko EJ, Prince RJ, Cronin KA, et al. · Clinical trials (London, England) · 2017 · Randomised controlled trial DOIPubMed 28064525Full text
  17. Weight status, modes of travel to school and screen time: a cross-sectional survey of children aged 10-13 years in Sydney Wen LM, Merom D, Rissel C, et al. · Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2010 · Randomised controlled trial DOIPubMed 20406154
  18. Chlorpheniramine for motion sickness Buckey JC, Alvarenga D, Cole B, et al. · Journal of vestibular research : equilibrium & orientation · 2004 · Randomised controlled trial PubMed 15156097
  19. A comparison of cyclizine, ondansetron and placebo as prophylaxis against postoperative nausea and vomiting in children O'Brien CM, Titley G, Whitehurst P · Anaesthesia · 2003 · Randomised controlled trial DOIPubMed 12886917
  20. Chronic Dizziness Cha YH · Continuum (Minneapolis, Minn.) · 2021 · Review DOIPubMed 34351113
  21. Advice for travelers The Medical letter on drugs and therapeutics · 2019 · Review PubMed 31599872
  22. The Neurophysiology and Treatment of Motion Sickness Koch A, Cascorbi I, Westhofen M, et al. · Deutsches Arzteblatt international · 2018 · Review DOIPubMed 30406755Full text
  23. Self-driving carsickness Diels C, Bos JE · Applied ergonomics · 2016 · Review DOIPubMed 26446454
  24. [Seasickness] Petersen H · Laeknabladid · 2012 · Review DOIPubMed 23232725
  25. Sleep duration in preschool children and impact of screen time Lan QY, Chan KC, Yu KN, et al. · Sleep medicine · 2020 · Journal article DOIPubMed 33091726
  26. Well-Child Visits for Infants and Young Children Turner K · American family physician · 2018 · Journal article PubMed 30215922

This page was translated automatically from English. The citations and numbers are unchanged. Read the English original if anything reads oddly. Read the English original