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Health Issues

Your child’s reaction to a bite or sting will depend on her sensitivity to the particular insect’s venom. While most children have only mild reactions, those who are allergic to certain insect venoms can have severe symptoms that require emergency treatment.

In general, bites are usually not a serious problem, but in some cases, stings may be. While it is true that most stings (from yellow jackets, wasps, and fire ants, for example) may cause pain and localized swelling, severe anaphylactic reactions are possible.

Treatment

Although insect bites can be irritating, they usually begin to disappear by the next day and do not require a doctor’s treatment. To relieve the itchiness that accompanies bites by mosquitoes, flies, fleas, and bedbugs, apply a cool compress and/or calamine lotion freely on any part of your child’s body except the areas around her eyes and genitals. If your child is stung by a wasp or bee, soak a cloth in cold water and press it over the area of the sting to reduce pain and swelling. Call your pediatrician before using any other treatment, including creams or lotions containing antihistamines or home remedies. If the itching is severe, the doctor may prescribe oral antihistamines.

If your child disturbs a beehive, get him away from it as quickly as possible. The base of a honeybee’s sting emits an alarm pheromone (hormone) that makes other bees more likely to sting as well.

It is very important to remove a bee stinger quickly and completely from the skin. The quick removal of a bee stinger will prevent a large amount of venom from being pumped into the skin. If the stinger is visible, remove it by gently scraping it off horizontally with a credit card or your fingernail. Avoid squeezing the stinger with a pair of tweezers; doing this may release more venom into the skin. The skin may be more swollen on the second or third day after a bee sting or mosquito bite.

Keep your child’s fingernails short and clean to minimize the risk of infection from scratching. If infection does occur, the bite will become redder, larger, and more swollen. In some cases you may notice red streaks or yellowish fluid near the bite or your child may get a fever. Have your pediatrician examine any infected bite right away, because it may need to be treated with antibiotics.

Call for medical help immediately if your child has any of these other symptoms after being bitten or stung:

  • Sudden difficulty in breathing
  • Weakness, collapse, or unconsciousness
  • Hives or itching all over the body
  • Extreme swelling near the eyes, lips, or penis that makes it difficult for the child to see, eat, or urinate

Prevention

Some children with no other known allergies may have severe reactions to insect stings. But if you suspect that your child is allergy-prone, discuss the situation with your doctor. He may recommend a series of shots (hyposensitization injections) to decrease your child’s reaction to future insect stings (but not bites). In addition, he will prescribe a special auto-injection kit containing epinephrine for you to keep on hand for use if your child is stung.

It is impossible to prevent all insect bites, but you can minimize the number your child receives by following these guidelines:

  • Avoid areas where insects nest or congregate, such as garbage cans, stagnant pools of water, uncovered foods and sweets, and orchards and gardens where flowers are in bloom.
  • When you know your child will be exposed to insects, dress her in long pants and a lightweight longsleeved shirt.
  • Avoid dressing your child in clothing with bright colors or flowery prints, because they seem to attract insects.
  • Don’t use scented soaps, perfumes, or hair sprays on your child, because they also are inviting to insects.

Insect repellents are generally available without a prescription, but they should be used sparingly on infants and young children. In fact, the most common insecticides include DEET (N, N-diethyl-m-toluamide), which is a chemical not recommended for use in children under two months of age. Do not apply DEET-containing repellents more than once a day on older children.

The concentrations of DEET vary significantly from product to product—ranging from less than 10 percent to over 30 percent—so read the label of any product you purchase. Some products have concentrations much higher than 30 percent, and the higher the concentration of DEET, the longer the duration of action. Its effectiveness peaks at a concentration of 30 percent, however, which is also the maximum concentration currently recommended for children. The safety of DEET does not appear to be related to its level of concentration; therefore, a prudent approach is to select the lowest effective concentration for the amount of time your child spends outdoors. You should avoid products that include DEET plus a sunscreen, because sunscreen needs to be applied frequently while DEET should be applied only once a day. If you apply DEET more frequently, it may be associated with toxicity. Also be sure to wash off the DEET with soap and water at the end of the day.

An alternative to DEET is a product called picaridin (KBR 3023). While it has had wider use in Europe, picaridin has more recently become available in the US. It is a generally pleasant-smelling product without the oil residue associated with DEET, and is available in concentrations of 5 to 10 percent.

Where We Stand: Insect Repellents

The American Academy of Pediatrics recommends that repellents used in children over six months of age have 30 percent DEET or 5 to 10 percent picaridin repellent, applied once before going outdoors. These repellents are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies, but have virtually no effect on stinging insects such as bees, hornets, and wasps. Contrary to popular belief, giving antihistamines continuously throughout the insect season does not appear to prevent reactions to bites.

Insect Bites and Stings 

 

 

Insect/Environment

Characteristics of Bite or Sting

Special Notes

Mosquitoes

Water (pools, lakes, birdbaths)

Stinging sensation followed by small, red, itchy mound with tiny puncture mark at center.

Mosquitoes are attracted by bright colors and sweat.

Flies

Food, garbage, animal waste

Painful, itchy bumps; may turn into small blisters.

Bites often disappear in a day but may last longer. 

Fleas

Cracks in floor, rugs, pet fur

Multiple small bumps clustered together; often where clothes fit tightly (waist, buttocks). 

Fleas are most likely to be a problem in homes with pets.

Bedbugs

Cracks of walls, floors, crevices of furniture, bedding

Itchy red bumps occasionally topped by a blister; usually 2–3 in a row.

Bedbugs are most likely to bite at night and are less active in cold weather. 

Fire ants

Mounds in pastures, meadows, lawns, and parks in southern states

Immediate pain and burning; swelling up to 1⁄2 inch (1.2 cm); cloudy fluid in area of bite.  

Fire ants usually attack intruders.

Bees and wasps

Flowers, shrubs, picnic areas, beaches

Immediate pain and rapid swelling.

A few children have severe reactions, such as difficulty breathing and hives/swelling all over the body. 

Ticks

Wooded areas

May not be noticeable; hidden on hair or on skin.

Don’t remove ticks with matches, lighted cigarettes, or nail polish remover; grasp the tick firmly with tweezers near the head; gently pull the tick straight out.

 

 

Last Updated
5/11/2013
Source
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.