Motion Sickness

CAUSE

Motion or car sickness is fairly common in children and adults. More kids appear to have the problem, therefore there is a chance your child may grow out of it. The problem appears to be more related to the speed of rotational force, the frequency of rotation direction change, and the speed of rotational direction change. In other words, the more body roll and jerking around in the car, the more sick your going to get. It is not known why some kids get it and others donít.

CURE: tips for the car

If body roll and jerking are the cause, then we need to prevent that.

 

CURE: acupressure

There is an acupressure device marketed for sea and airsickness. I have not seen any medical studies demonstrating effectiveness. The traditional medicine theory is that they stimulant or block a flow of energy. The current medical theory has more to do with a counter irritant effect. Regardless of whether or how they work, they are safe. I am not aware of one of these devices being marketed or size specifically for children.

Cure: nonprescription medicines

Most antihistamines have a mild anti-nausea effect. If your child normally takes an antihistamine and is not taking them now, try giving it before riding in the car. Most will take 30-45 minutes to work. If it works, then continue to use that medicine as needed. If it doesnít work, or your child is already taking the antihistamine anyway, then we need to go to Dramamine (Dimenhydrinate). If you child is going to take Dramamine, then they cannot take most antihistamines with it, as it is a mild antihistamine. Check with the pharmacist to be safe. Dramamine should be given 30-60 minutes before driving or flying and will last from 3-6 hours.  You can give the medicine every 4 hours as needed. Some kids are slightly to moderately sedated with this medication and this is not necessarily a bad thing for a long car trip. Of course it is not a good idea to give it solely for this purpose. About 5% of kids are paradoxically excited or get hyper or jittery with the medication. For this reason, it is a good idea to give a test dose before using it for a trip.

                Below you will find a dosing chart for Dimenhydrinate (=Dramamine). Notice there are 2 tables. The first is a standard dosing chart based on weight for each preparation available. There are 3 liquid strengths, although 2 of them are actually the same strength just worded differently. There are also maximum total doses per day based on age. Since there are heavy young children and lighter older children, it is possible to dose right based on weight and exceed the maximum daily dose. To prevent this, first look at the standard dose per weight and then check and make sure you donít exceed the maximum dose per day on the second chart. You really should not be giving the dose more than a few times per day anyway. If you give the dose once or twice per day for travel, thatís ok. If you wish to give the dose more than a few days in a row, you should discuss this with your physician.

Dimenhydrinate /

STANDARD DOSE

16 lbs

24 lbs

32 lbs

48 lbs

64 lbs

>80 lbs

12.5mg/4ml or 15.62mg/5ml (actually same strength)

2.9ml

4.3ml

5.8ml

8.7ml

11.6ml

16ml

12.5mg/5ml

3.6ml

5.4ml

7.2ml

10.8ml

14.4ml

 

20ml

50mg chewable or 50mg tablet

 

ľ of one

2/3 of one

Ĺ of one

ĺ of one

1-2

DO NOT EXCEED

2-6 yrs

6-12 yrs

Adult

12.5mg/4ml or 15.62mg/5ml (actually same strength)

24ml per day

48ml per day

128ml per day

12.5mg/5ml

30ml per day

60ml per day

160ml per day

50mg chewable or 50mg tablet

1.5 tablets per day

3 tablets per day

8 tablets per day

                 

 

Cure: prescription medicines

Scopalamine patches have been used for years, but may not be used in pediatric patients. There are no other prescription medications used for motion sickness.

Copyright 2006 Joe Matusic, MD, FAAP, AME

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