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Kids and Altitude



What should you know about kids and altitude? Can you bring your kids safely to altitude on vacation? What about little babies? How young can they go to high elevations? The answer is - it depends! Are you at sea level? Are you headed for Machu Picchu or Denver? Do you live in Leadville, CO (10,151ft elevation) and want to hike to 12,000ft? Is your child 5 years or 5 weeks old?


In this article I’m going to give guidelines based on research and let you decide!


General altitude guidelines

Any altitude change requires a few adjustments. Hydration is key - make sure your child has at least a few ounces of extra water (for the older kids), formula, breast milk or electrolyte beverage (such as Pedialyte). The sun is much stronger at elevation too, so plan for hats, sun shirts, sunglasses and lots of sunscreen. It’s usually best to gradually adjust to elevation, meaning if you are going to Colorado you might consider flying into Denver, staying a few days, then driving to Aspen or Breckenridge. And take it easy for the first few days! Jumping straight into a lot of activity can trigger symptoms.


Altitude sickness

Mountain or altitude sickness is often mild but can become life-threatening. There isn’t much you can do except to recognize the symptoms and move quickly to lower altitude! In particular, these are the most common conditions you should watch for when traveling to altitude:


AMS (Acute Mountain Sickness) - general mountain/altitude sickness including nausea, fatigue, and headache. Babies may just breathe faster than normal, turn pale or blue around the lips, or have a worsening of periodic breathing (fast breathing followed by slow breathing or pauses in breathing). It’s common to be fussy or listless and babies with AMS usually don’t feed well. Vomiting is possible and older children may show sleepiness but refuse to nap.


HAPE (High Altitude Pulmonary Edema) - Life-threatening fluid collection in lungs.

Symptoms include all of those above with AMS but may also have a worsening cough, difficulty breathing and coughing pink mucus.


HACE (High Altitude Cerebral Edema) - Potentially fatal brain swelling.

Symptoms may include visual problems, dizziness, memory problems, disorientation, trouble with balance and coordination. This may be hard to identify in a child, so if they are fussy or not acting right, be safe and move to a lower altitude!


How young can an infant travel to elevation?

A good guideline is to wait until at least 3 months of age. Why? A baby in the womb has different circulation than outside, and it takes about 3 months to solidify that change! Because of this adjustment, babies under 3 months are more sensitive to low oxygen levels. In general the older a child is, the more they can communicate their symptoms, as well! A little baby can only cry or sleep to show they have a headache, but an older child can tell you how they feel. Because it is difficult to see symptoms in young children, some studies recommend children under 2 not sleep at elevations over 6,561 ft of elevation, and children 2-10 not sleep over 9,842 ft.


Obviously, families travel all the time to places like Aspen (8,000 ft) or Breckenridge (9,600 ft). So if you decide to travel to altitude, just make sure to follow the tips above. If you live at elevation, this may affect how adjusted your baby is to altitude as well! It’s much different going from sea level to Aspen than Denver (5,280 ft) to Aspen.


What happens to a baby’s oxygen level at altitude?

A baby at sea level normally has oxygen levels (oxygen saturations) of 99-100%. A study done in Leadville showed that babies living there had oxygen levels of 88-91% while awake and went as low as 81% for young babies (1-week-old) and 86% for older babies (2 months old). Babies really vary on whether they do well with those oxygen levels or not! So how your baby looks is a much better indicator than just the number!


What are other risks at elevation?

Some studies show a higher incidence of SIDS (Sudden Infant Death Syndrome) at higher elevations (with higher numbers at higher elevations). This is likely due to low oxygen levels and exaggeration of irregular breathing patterns of newborns at high elevation. Keep in mind that the risk of SIDS decreases dramatically after 6 months of age!


Are there certain babies/children at higher risk at altitude?

Yes, some examples are: Premature babies, babies with respiratory infections, chronic lung disease, a history of meconium aspiration, pneumonia, pulmonary hypertension, babies with bronchiolitis (RSV), or babies with Downs Syndrome. The stress of altitude might also cause some undiagnosed problems to show up!


Lots of families travel and enjoy high elevation destinations with their kids! Just make sure to be aware of possible altitude problems and be willing to descend to lower altitudes if needed! Have fun!




References:

https://www-liebertpubcom.proxy.hsl.ucdenver.edu/doi/pdf/10.1089%2Fham.2007.1068


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1719897/pdf/v089p00448.pdf


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112806/


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