The first time we flew with our kid’s portable oxygen concentrator (POC), I think I checked the batteries 40 times before we left the driveway.
Here’s a snapshot of her needs on that first flight: Tracheostomy with a ventilator 24/7, 2–3L of oxygen 24/7, and G/J tube feeds almost around the clock. We were just… a little stressed. And that was with TWO extra caregivers along besides my husband and me. Four adults to one medical kiddo. How hard could it be, right?? But I was DETERMINED not to let her medical needs get in the way of a magical childhood! (or at least, new experiences in whatever form we could manage)
Three years and thirty-plus flights later, she’s graduated off the vent, and her oxygen and G-tube needs are way down. Flying with oxygen now feels like routine logistics. Our toddler even thinks the machine can be used as a seat! (not recommended)
Here’s what got us through to where we are today.
1. Battery math is the whole game
Most airlines want enough charged battery to run the POC for 150% of your total travel time. That means gate time, taxiing, layovers, and delays, not just time in the air. A 4-hour trip means 6 hours of battery.
The part nobody tells you is that the runtime on the box isn’t your runtime. Battery life changes with your child’s actual settings. If you’re unsure, run a full test at home at their real settings and time it.
For quick trips, I stick to the 1.5x rule. For trips with layovers or longer flights, I bring closer to 2x. The goal is to feel confident you can cover any realistic delay.
2. The FAA sets the floor. Your airline sets the rules.
The FAA dropped its own doctor’s-letter requirement years ago, but airlines are still allowed to ask for one, and many do. Each airline has its own form, notice window (often 48 hours), and battery policy. For airlines we haven’t flown yet, or haven’t flown in a while, we always call the medical or special assistance desk first.
We also carry a signed physician letter no matter what. It costs nothing to have and a lot not to. (Our Documentation Kit has a template.)
3. Check for the FAA label before you book anything
Not every concentrator is approved for use onboard. When you request a POC from your DME company, ask specifically for an FAA-approved device, then look for the FAA compliance label on the unit when it arrives. This matters even more if you’re renting or borrowing a travel unit, so ask for a photo of the label before you commit.
Our DME company has been our most helpful resource for replacements and extra batteries, so that’s always where I start with any POC needs.
4. Ask your team about pulse vs. continuous flow
A lot of travel POCs are pulse-dose, meaning they deliver oxygen when they sense a breath. Some kids, especially small ones or kids who sleep on planes, may need continuous flow instead, and not every portable unit offers it. This is a care team conversation, not a Google one. Ask before you pick a device, and confirm the setting ranges match your care team’s directions for your child’s needs.
5. The POC doesn’t count as your carry-on
Under the Air Carrier Access Act, the concentrator and its needed batteries don’t count toward your carry-on limit*. You’ll occasionally meet a gate agent who doesn’t know that. Calm, friendly, and knowing the rule goes a long way.
*This is also true for other medical equipment and the supplies needed to use it. If you have any questions just check with your airline!
6. Spare batteries ride with you, always
Spare POC batteries go in your carry-on or personal item, never checked. We keep ours in one dedicated “personal item” bag with the other medical items we might need in flight, so nobody on our crew has to wonder where they are.
7. Seat strategy matters
Per FAA rules, you can’t use a POC in an exit row. Beyond that, some airlines don’t allow a POC at an aisle or middle seat. Additionally, the POC is required to be in the under-seat space for takeoff and landing, which bulkhead rows often don’t have. Even if the airline assigned your POC user a non-window seat, once you’re at the airport you can notify the gate agent and they will most likely move the POC user’s ticket to be a window seat automatically. There are some caveats and special circumstances, but these are the general rules. For an overview of planning your first trip with a POC, check out this post!
Our personal setup: our kiddo sits in the middle with one parent on each side. The POC goes under the seat in front of the window-seat parent for easy access and adjustments, and the medical bag with extra batteries goes under the middle seat so both parents can reach it. This way, the POC stays at the window and out of the aisle, our kid still has room to play, and caregivers can get to all of the equipment the entire flight.
8. TSA is easier than you think
TSA screens POCs separately, and officers see them all the time. We give ourselves extra time, keep documentation handy, and say what we have right up front.
In our experience, it goes one of two ways:
- If your child needs to stay on oxygen the whole time, TSA will walk you around the screening machines and inspect the POC by hand, including an explosives trace swab (the “wipe”).
- If your child can come off oxygen briefly, the POC goes through the x-ray, you and your child walk through the metal detector, and they’ll likely swab your hands too.
Either way, expect the POC and spare batteries to get pulled for a closer look. We’ve never once gone through without it. TSA always takes us a few extra minutes, but we’ve never had a serious issue.
9. Pack for the “what if”
Our oxygen bag always has every backup battery, a spare cannula and tubing, the car (DC) charger for the drive from the airport, and a spare set of as-needed (PRN) inhalers. I also like to know where a few hospitals are near our destination, just in case.
10. You’re not asking permission. You’re informing.
This one took me the longest. When we board, we tell the crew what we have, where the batteries are, and that we’re set. You belong on that plane as much as anyone.
On our first few flights, part of me always worried they’d deny our equipment or argue with us about it. That has never happened. The worst we’ve run into is a gate agent who didn’t realize we had a POC (even though it’s ALWAYS on her ticket) and had to confirm it was FAA-compliant.
One last tip: always know your total battery life, backups included. When the gate agent scans the boarding pass of the passenger using the POC, their system flags it, and they’ll ask how much battery you have. We give them our rough total, even when it’s way more than required. As long as you have at least 1.5x your travel time, you should be fine.
The bottom line
Flying with oxygen takes a lot of prep. But it’s learnable prep, and after a couple of trips you’ll have your system. The extra work is real, and I’m so glad we didn’t let it stop us. We’ve been to the beach, visited family, explored new places, and have so many more experiences to come.
Want a head start? Grab our free packing guide (PDF or Excel) with supply lists and flight-specific suggestions, and check out the Documentation Kit for a physician letter template, TSA card, and emergency summary. [links]
Less Stress. More Adventure.
Not medical advice. We provide the logistics; you provide the love. Always check oxygen needs, flow settings, and fitness to fly with your child’s care team.
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