Is HBOT safe for children?

HBOT is used in children for FDA-approved conditions like CO poisoning with a safety profile similar to adults, adjusted for the child's size and developmental stage. Ear equalization is the most common challenge in younger children. Very young children may require sedation in monoplace chambers, which changes the risk-benefit calculation.

Is there a minimum age for hyperbaric oxygen therapy?

There's no FDA-mandated minimum age. Infants have been treated for CO poisoning. Clinical judgment guides age-appropriateness for each child's situation. Very young children present challenges with ear equalization and cooperation that require specialized pediatric programs.

Does HBOT work for cerebral palsy?

Evidence is mixed. Some trials have shown improvements in motor function, but high-quality randomized controlled trials have not consistently confirmed benefit. Cerebral palsy is an off-label use. Insurance won't cover it. Parents considering this should review the evidence carefully and consult a specialist before committing to private-pay treatment.

Does HBOT work for autism?

The evidence does not support HBOT as an effective treatment for autism. The FDA has issued consumer warnings about HBOT being marketed for autism. It's an investigational use, not FDA-approved, and insurance won't cover it. Parents should discuss any complementary treatments with their child's physician.

Hyperbaric Oxygen Therapy for Children: Safety, Evidence, and What to Expect

HBOT is used in children. For emergencies like carbon monoxide poisoning, it’s exactly the right treatment, applied the same way it is in adults. The evidence is solid. Coverage applies.

For off-label uses in children — cerebral palsy, autism, brain injuries — the picture is much more complicated, and the stakes are higher because parents are making decisions for children who can’t advocate for themselves.

When HBOT Is Appropriate for Children

The FDA-approved indications apply equally to children. CO poisoning is one of the most common pediatric uses. Children are often more vulnerable to CO exposure than adults because of faster respiratory rates, so the case for HBOT is actually strong in pediatric CO poisoning.

Other FDA-approved uses in children include decompression sickness, severe burns, gas gangrene, and other wound-related conditions. Coverage through insurance follows the same rules as adults for these indications.

Dosing principles are similar to adults. Pediatric hyperbaric programs adjust for body size and development, particularly around ear equalization protocols and session monitoring.

The Ear Equalization Challenge

Ear equalization is the most practical challenge in pediatric HBOT. During pressurization, the middle ear needs to equalize — adults do this by yawning, swallowing, or performing the Valsalva maneuver. Young children often can’t do this reliably on command.

For children who struggle significantly, some pediatric centers place myringotomy tubes (ear tubes) before treatment. This allows passive equalization without the child having to perform any active maneuver. Talk to the hyperbaric physician and your child’s pediatrician about whether this makes sense.

The pressurization rate is typically slower for young children to give more time for equalization. Staff watch closely for signs of ear pain.

Sedation in Monoplace Chambers

Very young children or those with developmental differences may not stay calm or still in a monoplace chamber without sedation. Sedating a child changes the risk-benefit calculation significantly. Sedation carries its own risks, and those need to be weighed alongside the expected benefit of HBOT.

Multiplace chambers are generally a better option for young children. A parent or trained attendant can be inside the chamber with the child, providing comfort and monitoring. Many pediatric programs specifically prefer multiplace for this reason.

If a facility only has monoplace chambers and indicates sedation would be required, ask whether referral to a facility with multiplace capability is possible.

Off-Label Pediatric Uses: What Parents Should Know

Cerebral palsy and autism are the two most commonly marketed off-label HBOT uses for children. Both deserve honest discussion.

For cerebral palsy, some trials have shown improvements in motor function and spasticity. The evidence is mixed, and large, well-designed RCTs haven’t consistently confirmed meaningful benefit. It’s an investigational use. Insurance won’t cover it. A 40-session protocol will cost $6,000 to $12,000 or more out of pocket.

For autism, the FDA has issued consumer warnings about HBOT being promoted as a treatment. The evidence does not support it as effective. The FDA warning exists specifically because of aggressive marketing that overstates the evidence. Before committing to private-pay HBOT for a child’s autism, review what ClinicalTrials.gov shows for current research and discuss it with a developmental pediatrician.

Neither use is fraudulent in the sense of being dangerous at appropriate pressures. But neither is supported by the evidence base needed to justify significant out-of-pocket spending in most cases.

If you’re seriously considering off-label HBOT for your child, ask about clinical trials first. Enrollment in a trial means your child receives monitored treatment, contributes to real evidence, and doesn’t bear the financial cost.

What to Ask a Pediatric HBOT Program

Not all hyperbaric programs have experience with children. Ask specifically whether the program treats pediatric patients regularly and what their experience is with your child’s age group. Ask about their ear equalization protocol, whether they have multiplace capability, and whether parental presence in the chamber is possible.

A program that treats mostly adult wound care patients isn’t the same as one with a dedicated pediatric component.

FAQ

Can a parent go inside the hyperbaric chamber with a child? In multiplace chambers, yes at many programs. Parents typically need to be medically screened before entering and must follow chamber safety protocols. In monoplace chambers, no — they hold one person.

Does HBOT help children with brain injuries from accidents? Acquired brain injury in children is an area of active research. There’s no FDA approval for this use. Some studies show promising results; the evidence isn’t strong enough to make definitive claims. Ask your child’s neurologist whether a clinical trial is available and appropriate.

Will insurance cover HBOT for cerebral palsy or autism? No. Both are off-label uses. No major insurer covers HBOT for cerebral palsy or autism. This is private-pay territory.

Medical Disclaimer: This page provides general information about HBOT use in children. It is not medical advice. Treatment decisions for children require evaluation by qualified physicians including the child’s primary care provider, any relevant specialists, and a hyperbaric medicine physician.