Traveling — even for a fun vacation — can be pretty stressful. Throwing in a cold or other sickness into the mix can make travel feel unbearable.

Here’s what you need to know about traveling when sick, including tips to ease your discomfort, how to help a sick child, and when it’s best to not travel.

More than inconvenient and uncomfortable, flying with a cold can be painful.

The pressure in your sinuses and middle ear should be at the same pressure as the outside air. When you’re in an airplane and it takes off or starts to land, the external air pressure changes more rapidly than your internal air pressure. This can result in:

This can be worse if you have a cold, allergies, or respiratory infections. That’s because these conditions make the already narrow air passages that reach your sinuses and ears even narrower.

If you’re traveling with a cold, consider the following to get relief:

  • Take a decongestant containing pseudoephedrine (Sudafed) 30 minutes before takeoff.
  • Chew gum to equalize pressure.
  • Stay hydrated with water. Avoid alcohol and caffeine.
  • Bring tissues and any other items that can make you more comfortable, such as cough drops and lip balm.
  • Ask a flight attendant for support, such as extra water.

If your child is sick and you have an upcoming flight, check with your pediatrician for their approval. Once the doctor gives their OK, take these precautions to make the flight as enjoyable as possible your child:

  • Plan for takeoff and landing to help equalize pressure in your child’s ears and sinuses. Consider giving them an age-appropriate item that encourages swallowing, such as a bottle, lollipop, or gum.
  • Travel with basic medication, even if your child isn’t sick. It’s a good idea to have on hand just in case.
  • Hydrate with water. This is good advice for all passengers, no matter the age.
  • Bring sanitizing wipes. Wipe down tray tables, seat-belt buckles, chair arms, etc.
  • Bring your child’s favorite distractions, like books, games, coloring books, or videos. They may keep your child’s attention away from their discomfort.
  • Bring your own tissues and wipes. They’re often softer and more absorbent than what’s usually available on an airplane.
  • Carry on clothing changes in case your child vomits or otherwise gets messy.
  • Know where the nearby hospitals are at your destination. If an illness takes a turn for the worse, it saves time and anxiety if you already know where to go. Be sure to have your insurance and other medical cards with you.

Although these tips are focused on traveling with a sick child, many are applicable to traveling as a sick adult, too.

It’s understandable that you want to avoid postponing or missing a trip. But sometimes you have to cancel to look after your health.

The Centers for Disease Control and Prevention (CDC) recommends avoiding air travel in the following situations:

  • You’re traveling with a baby less than 2 days old.
  • You’ve passed your 36th week of pregnancy (32nd week if you’re pregnant with multiples). After your 28th week, consider carrying a letter from your doctor that confirms the expected delivery date and that the pregnancy is healthy.
  • You’ve had a recent stroke or heart attack.
  • You’ve had recent surgery, especially stomach, orthopedic, eye, or brain surgery.
  • You’ve had recent trauma to your head, eyes, or stomach.

The CDC also recommends that you not travel by air if you’re experiencing:

Finally, the CDC suggests avoiding air travel if you have a fever of 100°F (37.7°C) or more plus any one or combination of:

Be aware that some airlines keep an eye out for visibly sick passengers in the waiting and boarding areas. In some cases, they can prevent these passengers from boarding the plane.

Airlines have the right to refuse passengers who have conditions that may get worse or have serious consequences during the flight.

If encountering a person they feel isn’t fit to fly, the airline may require medical clearance from their medical department.

An airline can refuse a passenger if they have a physical or mental condition that:

  • may be aggravated by the flight
  • could be considered a potential safety hazard for the aircraft
  • could interfere with the comfort and welfare of the crew members or other passengers
  • requires special equipment or medical attention during the flight

If you’re a frequent flyer and have a chronic but stable medical condition, you may consider getting a medical card from the medical or reservation department of the airline. This card may be used as proof of medical clearance.

Traveling can be stressful. Being sick or traveling with a sick child can magnify that stress.

For minor illnesses like the common cold, there are simple ways to make flying more bearable. For more moderate and severe illnesses or conditions, check in with your doctor to make sure it’s safe for you to travel.

Be aware that airlines might not allow passengers who are very sick to board the plane. If you’re concerned, talk to your doctor and the airline.