What You Need to Know Before Carrying on a Medical Device
The inspiration for this post came from a friend of TPG who had a difficult experience when she traveled for the first time since having a baby. She did her due diligence before the flight since she'd be traveling with a cooler, ice and breast milk, but unfortunately didn't contact American Airlines ahead of time to inquire about carrying on her breast pump, purse and roll-aboard suitcase. At check-in, the agent told her that she could only have two carry-ons. She argued that her breast pump was a medical device and shouldn't count toward the carry-on limit, but neither the agent nor the supervisor would allow it.
This got us thinking about medical devices in general and whether AA was right in classifying her pump as a third carry-on. The Food and Drug Administration does consider breast pumps to be medical devices and regulates them accordingly, so she has since filed complaints with both AA and the Transportation Security Agency. But where does the responsibility fall? Is this an airline-specific policy, or does the TSA provide guidance in this area? Let's dig in.
What Does the TSA Say?
For starters, it's important to note that the TSA's primary responsibility when it comes to travel is its middle name: security. This takes on a variety of forms at the airport, including but not limited to ensuring you have appropriate identification and screening your bags to prevent prohibited items from making it on board in either checked or carry-on baggage. While the TSA may stop you from bringing a 30-inch rolling suitcase through security — since it won't fit through the X-ray machine — an agent typically won't count your carry-ons, as there's no TSA rule that addresses this.
But there is an entire page on the TSA's website devoted to travelers with disabilities and medical conditions. Again, though, this is entirely focused on accommodations for the security-screening process rather than guidance for bringing medical devices or other support items aboard the actual plane. These policies are, in fact, left up to the individual airlines — and they're not universally followed across carriers.
The only all-encompassing regulation that all airlines must follow when it comes to traveling with medical devices is the Air Carrier Access Act, which "prohibits discrimination by US and foreign air carriers on the basis of physical or mental disability." In fact, the DOT Rule Part 382 (Section 121) includes the following language:
These devices and aids cannot be counted against the airline's carry-on limits.
Unfortunately, these guidelines only refer to assistive devices for travelers with disabilities, like those needed to help with breathing or administering medication. As a result, an airline may not allow all medical devices. Let's take a look at the three major US carriers — American Airlines, Delta and United — to see where they stand when it comes to carrying these on.
American Airlines
AA's page for medical devices indicates that a traveler must contact special assistance to ensure that the given device is approved for travel and to make any special requests to ensure a smooth experience. Specifically, "48-hour notice is required to approve electronic medical devices for use during flight," and these approved devices must be battery-operated. The page also provides guidance for wheelchairs and portable oxygen containers, or POCs.
But farther down the page, the carrier specifically notes that onboard power outlets may be used for POCs and breast pumps, so it could easily be interpreted to mean that breast pumps are pre-approved for use in flight — on planes that have power outlets, at least. This same page also includes the following language:
Mobility and medical devices don't count toward carry-on limits.
This same policy is reflected on American's carry-on baggage page, explicitly pointing out that medical devices (among other items) don't count as a carry-on or as a personal item. Again, though, if you are planning to travel on AA with a mobility or medical device, it's a good idea to contact special assistance at least 48 hours before your flight to confirm this policy and ensure that your device is permitted in addition to the standard carry-on allowance.
Based on these published guidelines, I believe that the two American agents were mistaken in not allowing TPG's friend to travel with her breast pump as a third carry-on. She reached out to the airline directly and received the following response:
In accordance with the most recent directive issued by the FAA, we have changed our carry-on baggage policy to limit our customers to one carry-on and one personal item (briefcase, purse, laptop or small backpack). Items allowed above and beyond this restriction include: outerwear such as coats/wraps/hats, books or newspapers, small bag of food to eat on the flight, approved safety seats for lap or ticketed child, pillows or blankets, umbrella strollers for lap or ticketed child, diaper bags for lap or ticketed child, and assistive devices for passengers with disabilities.
Unfortunately, this isn't what is posted on American's website. "Assistive devices for passengers with disabilities" is much more specific than "mobility and medical devices," so either the individual who wrote the response is incorrect or the website needs to be updated with the narrower definition.
Delta
Delta provides a similar exception for customers traveling with medical devices, but it's not quite as expansive as American's. Here's the specific language from the carrier's carry-on baggage page:
The following items do not count as personal items — they're freebies:
- A jacket or umbrella
- Food or drink purchased after clearing the security checkpoint
- Duty-free merchandise
- Special items like strollers, child restraint seats or assistive devices such as wheelchairs or crutches
The special-items page contains some additional details related to medical devices and supplies, but doesn't explicitly say what is and isn't allowed: "Some medical items can be carried on the plane as an 'additional carry-on item,' as long as they meet the standard size and weight limits." The page does explicitly discuss breathing apparatuses and needles/syringes but doesn't provide much more guidance on exactly what constitutes a medical device. There's a little more information on the traveling with disabilities page, but your best bet is to call reservations and add a note to your booking.
So what if TPG's friend had been traveling on Delta instead of AA? The carrier doesn't have the best track record when it comes to breast pumps, and this policy doesn't make it clear whether they count toward the standard carry-on allowance. That said, the infant travel section of the children's travel page does include the following information:
Delta fully supports a woman's right to breast-feed on board Delta and Delta Connection aircraft and in Delta facilities. Breast pumps are allowed on board.
This would likely come down to the individual discretion of a check-in or gate agent. Allowing breast pumps on board isn't the same as allowing them as an additional carry-on, so I'd again encourage travelers to contact Delta ahead of time to inquire about the specifics and place a note on your reservation.
United Airlines
Like American and Delta, United also allows individuals to bring medical devices on board as an extra carry-on item — many are detailed on the carrier's carry-on baggage page. Here's what you can bring in addition to the one bag and one personal item:
- Jacket or umbrella
- Reading material
- Food or merchandise purchased in the airport
- Assistive devices (collapsible wheelchair, cane, one set of crutches, medical devices needed to administer prescription medications, portable oxygen concentrator, etc.)
- FAA-approved child-restraint system or safety seat
- Diaper bag
- Breast pump
- Pet carrier (service charges apply for in-cabin pets)
United's special-travel-needs page contains a ton of additional information for these assistive devices, but the general advice is similar to that of American and Delta: If you are traveling with a medical device (including POCs and ventilators/respirators/CPAP machines), you should call United's accessibility desk at 1-800-228-2744 at least 48 hours before your flight to confirm that your device meets FAA requirements.
What's interesting about United's policy is that a breast pump is specifically called out on the list of items that don't count toward the standard carry-on requirements. While I strongly believe that TPG's friend was wrongly denied by AA based on the above policy, there's no doubt she would've been allowed to bring it on a United-operated flight.
Bottom Line
If you or a travel companion need to carry on a medical device on your next trip, it's important to recognize that there's no blanket policy that covers all devices. While the Air Carrier Access Act does provide protection for travelers with disabilities, that protection doesn't necessarily apply to medical devices that aren't related to a covered disability — like a breast pump. That said, some airlines do provide additional leeway for carry-on devices above and beyond these restrictions, with United going as far as to explicitly mention breast pumps as an exception to the airline's standard carry-on allowance. Your best bet is to call the airline ahead of time and ensure that your specific device is not only allowed but also noted on your reservation to avoid any headaches while traveling.
What are your experiences with carrying on medical devices? Share your own advice with other travelers, below.