Is flying with a newborn safe during pregnancy?

What does the evidence say about the right age to fly with a newborn?

1. A clinical review on fitness to fly in infants recommends that healthy, full-term newborns refrain from flying before 1 week of age, after which air travel is generally considered acceptable for this group. 1
2. The same review gives more conservative guidance for babies born preterm: those without chronic lung disease should wait until about 3 months corrected age to fly, and should avoid flying during a lower respiratory tract infection until 6 months corrected age, while preterm infants with bronchopulmonary dysplasia need a hypoxia altitude simulation test for clearance sometime in the first year of life. 1
3. The reasoning behind the more cautious preterm timeline is physiological: neonates show an immature response to low oxygen levels that can trigger apnea, a pause in breathing, and this risk is most pronounced in infants born preterm until around 36 weeks of gestational age. 1
4. Current CDC guidance states that air travel is safe for most newborns, infants, and children, without setting one specific minimum age across the board, though children with chronic heart problems, lung problems, or sickle cell disease might be at risk for hypoxia during flight and should be evaluated beforehand. 2
5. CDC guidance also notes that pressure in the middle ear can be equalized by swallowing or chewing, so infants should nurse or suck on a bottle during a flight, and that antihistamines and decongestants haven't been shown to help with this and are cautioned against in very young children. 2
6. Separately from the cabin-pressure question, newborns and young infants rely more heavily on innate immunity because their adaptive immune system, including their supply of lymphocytes and memory T cells, is still underdeveloped, and even that innate system runs comparatively weaker, with delayed immune-cell response and lower antiviral signaling than an older child's. 3
7. Documented microbial exposure occurs in aircraft cabins through direct contact, droplets, and airborne transmission, including respiratory pathogens such as influenza and rhinovirus, with case reports of tuberculosis transmission during long flights, illustrating the separate, infection-exposure side of the timing decision beyond cabin pressure alone. 4
8. The safest place for a child on an airplane is in a government-approved child safety restraint system, and the FAA strongly recommends securing children in one for the whole flight, though whether this is required or just recommended varies by airline. 2

When flying is considered acceptable, by birth status