Insect Bites & Stings

Your child’s reaction to a bite or sting will depend on his or her sensitivity to the particular insect’s venom. Most children will have only mild, local reactions; however, those who are allergic may have severe symptoms that require emergency treatment. In general, bites are less serious than stings. Most stings will cause immediate pain and localized swelling, but severe, anaphylactic reactions are uncommon.

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Can I use insect repellent on my child?

What is anaphylactic shock?

What do I do if my child has an anaphylactic reaction?

TREATMENT

Insect bites usually begin to heal within 1-2 days and do not require medical attention. To relieve the itching caused by mosquito, fly, flea, or bedbug bites, apply a cool compress, calamine lotion, or an over the counter hydrocortisone cream to any part of your child’s body except around the eyes or genital area. Anti-histamines, such as Benadryl may also be beneficial, but if you have a child under age 6, please contact us for dosing
Remove the bee stinger quickly, if it is still embedded in the skin, in order to prevent further venom from entering the skin. Using horizontal strokes gently scrape off the stinger using a credit card or your fingernail. Avoid using tweezers, as this may squeeze more venom into the wound. The swollen area may increase in size for 2-3 days after a bee sting or mosquito bite
Keeping your child’s fingernails short can minimize the risk of infection from scratching. If infection does occur, the bite will become redder, larger, and more swollen. You may also notice red streaks or pus. Have your child evaluated promptly if signs of infection are noted

PREVENTION

Remain alert when outdoors and maintain a safe distance away from anthills, bee hives, or other insects that may cause an allergic reaction. Use mosquito netting for young infants in strollers
Avoid other areas that attract bugs such as garbage cans, gardens, etc
Do not go barefoot
Do not wear perfume
Do not wear colorful or floral clothing
Diligently apply insect repellent (Insect repellents should not be used in children under 2 months of age.) The most common insecticide is DEET, which should not be applied more than once a day as it can cause toxicity. Do not apply insect repellent on the hands of young children or infants as they will commonly put their fingers in their mouths (Read more information on DEET in this PDF document)

ANAPHYLAXIS

Bees, yellow jackets, wasps, hornets, and fire ants can cause anaphylactic reactions. An individual’s immune system and sensitivity to the insect’s venom will determine the severity of the reaction. A vast majority of people do not have serious reactions, even those with a history of allergies or asthma, although the risk of a more serious reaction is increased. In order to have an anaphylactic reaction, your child has to have been stung by the same species of insect previously.

If your child has had an anaphylactic reaction in the past, you should carry your epinephrine kit (both doses) with you at all times. If your child goes to an ER or urgent care for a serious reaction, be sure to schedule a follow up appointment with us. Consulting an allergist for possible venom immunotherapy is an option for those with a history of anaphylaxis. Parents should make sure teachers, the school nurse, camp counselors, coaches, and other care providers know of the child’s allergy.

Call 911 immediately if:

Your child has difficulty breathing shortness of breath, rapid breathing, coughing, hoarseness, weakness
Dizziness, cool / clammy skin, fainting, or unconsciousness
Hives or itching all over the body
Swelling around the eyes, lips, or genitals
Vomiting

IDENTIFYING INSECT BITES & STINGS

Mosquitoes – found near water and attracted to bright colors and sweat. Bites may cause a stinging sensation followed by a small, red, itchy mound. For younger children, the bite may increase in size and potentially bruise
Biting flies— found near food, garbage, and animal waste. Bites cause painful, itchy bumps that can turn into small blisters. Usually resolves within 1-2 days
Bedbugs— found in cracks in walls, floors, bed frames, and crevices of furniture. Bites cause itchy red bumps, often 2-3 in a line and often occur at night. They are less active in cold weather
Fire Ants— cause immediate pain, burning, and are very itchy. Swelling can be significant and a cloudy fluid bubble often occurs centrally
Fleas— found on the floor, in rugs, and are most likely to be problematic in homes with pets. Bites usually occur in clusters or lines, often where clothes fit tightly (waist/buttocks)
Bees / Wasps / Yellow Jackets / Hornets— found near flowers, shrubs, picnic areas or beaches. Stings cause immediate pain and rapid swelling. Anaphylaxis can ensue, if previously stung (see above)
Ticks— found in wooded areas. When attempting to remove a tick, grasp the tick near the head with tweezers and gently pull the tick straight out. Do not use matches, lit cigarettes, or nail polish remover

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