The parent’s guide to car sickness

Endless coughs and sneezes, runny noses, and unexplained itchy bumps—kids seem to be a magnet for germs. In our parent’s guide to childhood illnesses, we talk about the symptoms and treatments for the most common conditions. Read the full series here.

What is car sickness? | Symptoms | Diagnosis | Treatments | Prevention

If you know someone who asks you to save any unused air sick bags when you fly, be kind to them. They are the parents of a child with car sickness, and they are preparing for battle.

More accurately called motion sickness—as it can occur on any type of moving vehicle or equipment—car sickness is not fun for anyone, especially children and their parents. The good news is that there are ways to help make those road trips more comfortable for everyone.

What is car sickness?

“Motion sickness is caused by the brain receiving conflicting information from the inner ears, eyes, and nerves in the joints and muscles,” says Toni Brayer, MD, internal medicine physician at Sutter Health Institute for Health and Healing in San Francisco.

“Balance is different from other senses because there are multiple inputs from the body,” explains Dr. Brayer. “Normally the brain compares and integrates these messages. If the inner ear senses motion it sends signals to the brain but if the eyes or head aren’t moving, the brain is getting confusing messages which can cause nausea, sweating and general feeling unwell.”

About 1 in 3 people will experience motion sickness in their lifetime. Anyone can experience motion sickness, but it most commonly occurs in women and in children age two to 12.

Other factors that can increase a child’s risk of experiencing motion sickness include:

• Family history of motion sickness, especially a close relative like a parent
• Inner ear disorders

While the most common form of motion sickness in children is car sickness, it can happen on anything that moves, including planes, trains, busses, boats, amusement park rides, and playground equipment.

Car sickness symptoms in children

It is hard to miss a child vomiting—a very dramatic indication of car sickness—but not all children (or adults) who experience motion sickness will vomit.

Other motion sickness symptoms include:

• Nausea (with or without vomiting)
• Headache
• Cold sweats
• Fatigue
• Dizziness
• Irritability
• Difficulty concentrating
• Increased saliva
• Pallor (pale skin)
• Rapid breathing or gulping for air
• Loss of appetite
• Restlessness
• Yawning
• Crying

Older children can usually let parents know they feel queasy, and often recognize that feeling as car sickness if they have experienced it before. Younger children may not be able to describe how they are feeling, and may just exhibit some of the above symptoms.

What should I do if my child has car sickness?

Motion sickness doesn’t usually require a visit with a healthcare provider unless something other than motion sickness may be causing the symptoms, or if it is severe enough to require medication. If needed, a visit with the child’s pediatrician is the place to start.

To diagnose motion sickness, the healthcare provider will ask about the child’s symptoms, and may do a physical exam, particularly of the eyes and ears.

Children should visit a healthcare provider if:

• They have symptoms of motion sickness at times when they are not involved with a movement activity
• They also have a headache
• They have difficulty hearing, seeing, walking, or talking
• They stare off into space

These symptoms, particularly if they occur while the child is not in motion, may indicate a condition other than motion sickness, and warrant a visit with a healthcare provider.

There is some evidence that children who experience motion sickness may be prone to migraines in the future. This is something to watch for and discuss with a healthcare provider if migraine symptoms occur.

Treatments for car sickness in kids

“Children often grow out of car sickness as the body learns to adapt to these mixed signals,” says Alexander Lightstone Borsand, MD, a board-certified lifestyle medicine physician in Scottsdale, Arizona. “Motion sickness often resolves as the body gets used to the motion and adapts.”

Natural remedies for car sickness

In the meantime, the best treatment for motion sickness is to stop the activity—stop the car, get off the ride, and let the child stay still for a while. Of course, this is not always possible. If stopping is not an option, there are other things to try:

• Offering ginger ale, ginger tea, or peppermint tea to reduce nausea 
• Sucking on sour candy or ginger candy (for children old enough that this is not a choking hazard) 
• Putting your hand out the window and letting the cold air hit the hand (if it can be done safely) to blunt the signals to the brain
• Blowing cold air from the window or AC on the face
• Looking out the window at the horizon
• Wearing acupressure wrist bands such as Sea-Bands

Distractions are helpful, such as music, or pointing out things through the window. Avoid distractions like toys, books, video games, or other objects in the car.

Medications for car sickness

If none of this works, medication is an option, especially for long journeys or for children who get motion sickness frequently. Kids’ motion sickness medicine include:

• Antihistamines, such as Dramamine (dimenhydrinate), may alleviate symptoms. Non-drowsy antihistamines are not effective. Do not give to children younger than age 2, and check dosing carefully for children 2 and older.
• Bonine (meclizine): While this is over-the-counter medicine, it is only approved for ages 12 and up. “Meclizine is slow acting so it should be taken 12 hours before the trip and again right before,” says Dr. Brayer.
• Scopase (scopolamine): This is usually administered via a patch on the skin, and is prescription only. It is only approved for people 12 years old and up.

These medications can have side effects, such as drowsiness, which need to be planned for ahead of time. They can also interact with other medications. Always check with your child’s healthcare provider before giving them medication, including over-the-counter, herbal, and “natural” medications.

RELATED: What can you take for nausea relief? 20 medications and remedies

How to prevent car sickness in kids

Prevention goes a long way when it comes to motion sickness. “The first rule is never read, or look down at a phone or computer when riding in a car,” says Dr. Brayer. Parents can also try the following tips:

• Planning the route ahead of time to include frequent stops
• Keeping the child well-hydrated
• Avoiding big meals before and during the trip—stick to small, bland snacks, and don’t let the child go more than three hours without eating
• Trying to plan the drive to happen during naptime

The choice of seating can also make a difference. Face forward when traveling (except for young children who are safest in rear-facing car seats), and try to choose the seating least likely to cause motion sickness:

• Car: Front passenger seat (for people age 13 and up who meet the requirements to safely sit in the front seat)
• Cruise ship: Cabin toward the front or middle of the ship, on a lower level (closer to the water)
• Boat: Middle of the boat (on the upper deck, if multiple levels)
• Bus: By the window
• Plane: Wing section
• Train: Forward-facing window seat

Motion sickness is simply unpleasant. Mercifully, there are ways to help prevent motion sickness and treat it if it occurs. If the non-pharmaceutical options don’t help, speak with your child’s healthcare provider about medication options. And always make sure there are plenty of disposable bags in the car.