Flying can be uncomfortable on the ears under the best circumstances. As the plane changes altitude and air pressure fluctuates, your ears may feel blocked or pop. Normally, this is just a regular part of flying. However, if you or a child you’re traveling with has an ear infection, it could lead to a ruptured eardrum.

If you have an ear infection and an upcoming flight, here are a few things you need to know about making your flight as safe as possible.

What Happens to Your Ears When You Fly

If you’ve ever flown before, you’ve probably experienced your ears popping. This occurs when the eustachian tube, a narrow canal in your ear, equalizes your ear pressure.

It can also happen when driving through high altitudes or scuba diving.

However, when the eustachian tube is blocked, it is unable to appropriately equalize pressure in your ear. This can be caused by colds, ear infections or sinus infections. A child’s eustachian tube is more likely to become blocked than an adult’s due to its smaller size.

If the pressure within your ear builds too much, it can lead to a ruptured eardrum—turning your uncomfortable flight into an incredibly painful and dangerous experience.

How to Safely Fly with an Ear Infection

If at all possible, it’s best to avoid flying with an ear infection. This is particularly true for small children, whose eustachian tube is more likely to be blocked.

However, if you absolutely have to board a plane, here are a few steps you can take to reduce pressure in your ears.

1. Treat the source of your infection.

If you haven’t already, make sure to see a doctor and get the appropriate prescription to reduce inflammation and fight the infection. Let your doctor know you have a flight coming up and ask for tips on how to make the travel process as safe as possible.

2. Take a decongestant or anti-inflammatory.

Taking a decongestant or anti-inflammatory drug, like acetaminophen or ibuprofen, can relieve some discomfort and swelling before your flight. This can help prevent your ears from getting blocked. However, be sure to talk to your doctor before taking anything.

3. Stay hydrated.

It’s always important to stay hydrated when you’re flying. This is especially true if you’re feeling under the weather. Drinking water throughout your flight can help the eustachian tube equalize pressure.

4. Pack gum or hard candies.

Consistent swallowing can prevent your ears from becoming blocked—and the more saliva you produce that more often you will swallow. Be sure to grab a pack of gum or some hard candies and pop one in your mouth during takeoff and landing to keep you consistently swallowing.

5. Avoid sleeping.

It’s tempting to try and fall asleep during a long flight. Unfortunately, you don’t swallow as much when you’re snoozing. Do your best to stay awake—particularly when taking off or landing.

If at all possible, avoid flying when you have an ear infection. If it isn’t possible to reschedule your flight or skip the trip, be smart. A ruptured eardrum can be incredibly painful and even lead to hearing loss, so be sure you’re doing all you can to prevent pressure from building.