Mosquitoes, bees, wasps, fleas, spiders and ticks are the most common perpetrators of insect bites and stings in children. The symptoms and extent of the reaction your child experiences following a bite or sting will depend largely on how allergic they are, but most pain and irritation is only temporary.
Often there is only slight, transient inflammation (redness and irritation) of the skin in the spot where the insect has bitten or stung. The bite/sting may be sore, tender or itchy and usually resolves within a few days. More intense reactions involve redness and swelling over a larger area which can take a week or so to settle.
Very occasionally a child can have a severe allergic reaction to an insect bite or sting, known as anaphylaxis. Symptoms may include; dizziness, collapse, widespread hives or rashes, nausea or vomiting, swollen lips or tongue, wheezing, coughing and difficulty breathing or swallowing. Anaphylaxis is a medical emergency; seek immediate treatment for the child as these reactions can be fatal. Some people with known allergies carry an oral steroid drug, such as prednisolone, or an injection of epinephrine ("epi-pen") to treat anaphylaxis. Ensure you know how to locate and administer these medications if you are caring for a child with acute allergy. A medical alert bracelet may also be useful for teenagers or children who are traveling with other guardians (such as teachers or sports coaches).
Treatment for minor insect bites
To care for mild insect bites at home:
- Gently wash the affected area with clean water
- Apply an ice/cold pack to minimize pain and swelling (be sure to wrap this in a cloth to prevent skin burn)
- Apply calamine lotion several times each day to ease itchiness and try to stop your child from scratching when possible
- Where necessary, oral antihistamines can be given to reduce the skin reaction. Over-the-counter antihistamine medications containing promethazine hydrochloride or cetirizine hydrochloride are usually effective. It is important to speak with your chemist about the particular medication and dose appropriate for your child, as these vary with age.
- Application of topical steroid creams may also provide your child with some relief; however these often require a prescription from your doctor or discussion with your chemist.
- Administration of a mild painkiller such as paracetamol or aspirin may help with painful bites.
If an extreme reaction occurs, symptoms persist for longer than a week or the skin becomes infected, seek professional medical advice.
Bee and wasp stings
Getting stung by a wasp or bee is quite painful and can cause swelling, which may increase over the following 24 hours. Stings are usually sore for several hours and swollen or itchy skin may last for up to a week.
To treat a bee or wasp sting:
- A bee leaves its stinger in the skin, remove this as quickly as possible. Stingers contain venom and the longer a stinger is in place, the more venom will be injected.
- Press a wrapped ice pack onto the affected area to minimise the pain and swelling.
- If the reaction persists for longer than a week or spreads over a large area, consult a medical professional.
- You will need to take the child to hospital if they have been stung a number of times.
Bee and wasp stings can sometimes cause the extreme reaction, anaphylaxis, if the child is allergic to proteins in the venom. If a child’s lips or tongue begin to swell or they experience trouble breathing or swallowing, seek emergency medical assistance.
Preventing insect bites
Insect repellents are an effective way to prevent insect bites when outdoors, though should be applied in moderation. DEET (N,N-Diethyl-meta-toluamide) is the most commonly used active ingredient in insect repellant. Products with a concentration of less than 10 percent are safe for use on children’s skin, however the ingredient should not be used on infants less than two months.
Physical barriers such as mosquito nets are useful when sleeping outdoors or camping, netting can also be fitted to prams. It is a good idea to keep food and rubbish contained to avoid attracting insects (such as ants and wasps); heavily scented soaps, deodorants or perfumes may also entice them. Additionally, you can cover your child’s exposed skin with long pants and tops to protect their skin.
Close windows before turning on lights in a room (this attracts insects) and have screens fitted to open doors or windows. Aerosols containing insecticide can be used to deal with individual insects and automated units can be used to control insects in the home. These devices should be operated in open, ventilated spaces away from children’s regular activities.
The Royal Children’s Hospital Melbourne 2010, Insect bites and stings’, retrieved 14 March 2011, <http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=3729>.
Sydney Children’s Hospital n.d., ‘Factsheet - Bites and stings’, retrieved 14 March 2011, <http://www.sch.edu.au/health/factsheets/joint/?safbitej.htm>.