Insect Bite and Sting Reactions in Children

Many children tend to have large reactions to mosquito bites. Typically the reaction becomes enlarged, itchy and uncomfortable. And parent worry about the reaction spreading to the whole body and want to know what exactly they can do.

Children who have asthma or other allergies tend to have more exaggerated reactions to bites from insects such as mosquitoes, flies and fleas. The other important point is whether or not the reaction is local or spreads beyond the area of the bite itself. Although much less common than a local reaction, symptoms of a generalized or anaphylactic reaction extend beyond the area of the bite itself and include:

  • Sudden difficulty breathing
  • Weakness or fainting
  • Itchy rash(hives) all over the body, not just around the bite location itself
  • Swelling of the face, including on the lip or tongue area.

Anaphylactic reactions usually occur following bee, wasp or hornet stings. If a child ever experiences such a reaction, medical attention should be sought immediately, as unfortunately this can be fatal. Children who have had a sting-induced generalized(anaphylactic) reaction should have allergy tests to determine which venomous insect they are allergic to. Only children allergic to a stinging insect are prone to developing an anaphylactic reaction. Also, children who have had an anaphylactic reaction to a sting will need to carry a special medication containing adrenalin (Epipen or Twinject)to be administered in case of a sting. The good news is that there are specific allergy shots for bee and wasp/hornet sting allergy that have been shown to be very effective in actually curing or getting rid of the allergy.

What about local reactions?

Fortunately, most insect bite reactions are local and not generalized, and although may seem large and uncomfortable, the reassuring feature is that the reaction is indeed local. Although in most cases it is easy to distinguish a local reaction from anaphylaxis, if there is a doubt, do not hesitate to consult a doctor.

How do we approach a local insect bite reaction?

Most insect bite reactions can be treated quite simply by applying calamine lotion to the area. Giving antihistamines prior to exposure to insects does not appear to prevent reactions to bites. Insect bite reactions usually go away within 1-3 days. If the reaction persists beyond this or gets redder or more swollen(with or without pus), these may be signs of an infected reaction which may need to be treated with antibiotics. Certainly the best way to prevent a reaction is to try to prevent the insect bite in the first place by:

  • Avoiding the use of scented soaps, perfumes or hair sprays
  • Not dressing children in clothing with bright prints
  • Dressing children in long pants and light-weight long sleeved shirts when going into an area with a lot of insects
  • Avoiding areas where insects are found, such as garbage cans, pools of water(even puddles)
  • Using insect repellants containing DEET(no more than 10%, and used very sparingly in younger children)

Remember that insect repellents do not prevent stings from bees, wasps or hornets.