Altitude sickness in children is a syndrome that develops when children go to high altitude (2,000 feet or higher, depending upon the age and health) destinations. This AptParenting article describes its causes, symptoms, and treatment.
Also termed as acute mountain sickness, altitude sickness is a general term used to describe the physiological and symptomatic reactions of the human body to the low oxygen pressure (‘thinner’ air) that occurs at high altitudes. Though altitude sickness can happen to anyone irrespective of age, some people are more vulnerable to it than others. Especially, children who are physically active often find trouble adjusting to changed elevations and atmospheric conditions, and suffer from altitude sickness.
Causes
Generally, it is believed that oxygen concentration in the air decreases as you go to higher altitudes, resulting in altitude sickness and breathing problems. But the fact is, the oxygen concentration in the atmosphere is same on top of a mountain as it is at the sea level, but it is the air pressure that decreases. Hence, lower the air pressure, lesser the oxygen one is able to breathe in. And since our body is not able to function at this amount of oxygen, one starts feeling sick. Also stresses of the high altitude environment, including cold, low humidity, increased ultraviolet (UV) radiation, etc., can also contribute to altitude sickness, especially in children. There are basically three types:
- Acute Mountain Sickness (AMS), the most common type of altitude illness caused by rapid ascent to high altitude (above 2500 m).
- High Altitude Pulmonary Edema (HAPE), is acute pulmonary edema caused due to altitude hypoxia (oxygen deficiency), affecting the lungs.
- High Altitude Cerebral Edema (HACE), is a severe progression of AMS often associated with pulmonary edema which mainly affects the brain.
Symptoms
The symptoms of this condition may be mild to severe. Usually they do not appear until it has been a day on the high altitude. Some of the common symptoms include:
- Throbbing headache, which gets worse during night and early morning
- Loss of appetite
- Dizziness and vomiting
- Feeling weak or lazy
- Improper sleep
- Drowsiness and confusion
- Unable to walk straight (ataxia)
- Having blue or gray lips or fingernails
- Difficulty breathing
In case of any delay in descent, the child should be closely monitored for neurologic deterioration, as severe AMS may lead to HACE. Labored breathing even when at rest, increased heart rate, dry cough, pink frothy sputum, and crackling sound in lungs are some of the symptoms of HAPE. If the headache is followed by changes in vision, hallucinations, and confusion, it can be due to HACE, and it can eventually lead to a seizure and coma.
Treatment
The best way to treat this problem is to go down to a lower altitude. Stay only if your child has mild symptoms, and will get acclimated after a day or so. While staying at high altitude, make your child rest, and limit any kind of physical activity. Make your child drink plenty of water, and avoid going to a higher altitude until the symptoms go away. For headache, you can give the child a few over-the-counter medications like acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), but only under a doctor’s recommendation. The doctor may prescribe acetazolamide (Diamox)m, Nifedipine (Procardia), and dexamethasone, as these medications help the body to get used to higher altitudes and prevent altitude sickness. You can also keep an oxygen concentrator to relieve breathing difficulty due to altitude sickness.
Preventive Measures
Below are some simple steps one can take under consideration for preventing altitude sickness in children:
- Acclimatize your child to high altitudes by slowly ascending the height over a couple of days.
- Avoid sleeping at altitudes higher than 300 m of the previous night.
- Drink lots of water, in fact it is recommended to double the normal intakes of fluids at higher altitudes.
- Eat diet rich in carbohydrates like pasta, noodles, bread, etc.
- Keep your child from doing any strenuous exercise or activity, at least for the initial few days after arriving at high altitudes.
- While moving up, take frequent pauses to rest, and walk slowly.
Expert trekkers suggest that you should not sleep at an altitude that is higher than 2000 m with children aged under 2, and not at an altitude that is higher than 3000 m with children aged 2-10 years. In fact, high altitude should be avoided, if the child is likely to become symptomatic. As infants have relatively smaller airways, fewer alveoli, and increased airway reactivity, they are more prone to HAPE or HACE than adults.
Though altitude sickness is not a life-threatening medical problem, if not diagnosed and treated in time, it can become severe. Hence, as you observe any signs of altitude sickness in your child, immediately go down to a lower altitude, and for safe side, consult your doctor about altitude sickness before leaving for any such high altitude destination.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.
