Bug Bites and Kids: When to Worry and What to Do

bug bitesAll it took was one bug bite, and my daughter's ear looked like she'd been in a boxing match.

Ever heard the term cauliflower ear? That's what she had -- bright red, swollen, and sore to the touch.

Insect bites can you leave you wondering whether you need to take your kids to the hospital or if they are developing an allergy, so The Stir checked with Dr. Leslie Barakat, a pediatrician with Cigna Medical Group, to find out when we should bug out.


Why should parents be worried about bug bites in the summer?

In general, most insect bites and stings are harmless and do not cause any significant illness. Most treatment is centered around managing the discomfort associated with insect bites.

In very rare instances, children can exhibit an allergic reaction to certain insect bites and stings, and these necessitate prompt intervention. Many parents are concerned about the risk of contracting West Nile Virus with mosquito bites, but healthy kids, teens, and adults under 50 are at very low risk of catching this virus.  

And although West Nile Virus can put people at risk for developing a serious infection of the brain called encephalitis, in reality this hardly ever happens. Less than 1 percent of people who are infected with WNV become seriously ill.

What's the best prevention?

In general, we should teach our children to take precautions such as avoiding walking barefoot while on grass, playing in areas where insects nest, breed, or congregate such as bodies of water or areas with tall grass, and drinking from soda cans outside. Try to stay inside when bugs are most active (dawn and dusk), and wear insect repellent or cover up when you are outside.

Repellents that contain 10 to 30 percent DEET (N, N-diethyl-meta-toluamode) are approved and considered safe for children over 2 months of age to prevent bites from mosquitoes, ticks, and other bugs.

Repellents that contain picardin (KBR 3023) or oil of lemon eucalyptus (p-menthane 3,8-diol or PMD) are effective against mosquitoes. Follow the instructions on the product carefully and do not overuse. Replace after swimming or eating.

How do we treat after the bite?

For treatment of the redness and swelling associated with insect bites, immediate gentle cleansing of the area and cool compresses are the initial first actions recommended.  

Parents can give antihistamines such as Benadryl or long-acting ones like Claritin or Zyrtec to offer some relief while the reaction to the bites is resolving.

What are the signs that we need to seek treatment for our kids?

  • In general, parents should seek medical care if the sting or bite is inside or near the mouth, if the child has a known history of severe reaction to a stinging or biting insect.
  • If they are having a severe reaction, such as swelling of the face or mouth, difficulty swallowing or speaking, chest tightness, wheezing, or difficulty breathing, or dizziness or fainting, parents should call 911 immediately and administer an Epinephrine pen if they have been prescribed one by their pediatrician.
  • Parents should also seek medical attention for any insect bite or sting if the site looks infected, meaning that there is increasing redness, warmth, swelling, pain, or pus occurring several hours or longer after the sting or bites.  
  • Redness and swelling right after the bite is a typical reaction and does not necessitate seeking medical attention.

Are there any bites that are worse than others?

In general, the stinging insects pose more of a risk of allergic reaction than the biting insects, but again, not everyone is allergic to wasps, bees, or hornets, so local care is recommended for these and in most cases is adequate.

Tick bites can pose a small risk for contracting tick-borne illnesses such as Lyme Disease and Rocky Mountain Spotted Fever. So it's important to remove the tick carefully with tweezers as soon as possible and save it for the physician to test.

Most spider bites cause local discomfort and are not dangerous. However, spiders such as black widows and brown recluse spiders are venomous and can cause severe illness, so if a parent suspects their child has been bitten by one of these, they should seek immediate medical attention.

If kids swell up, does that mean they have an allergy?

Most children will have some degree of local swelling after an insect bite or sting, and this does not mean they have an allergy to that insect.  

It's common for the saliva of the insect to cause irritation under the skin, which causes the bump and itching.

The signs of severe reaction mentioned, including facial or mouth swelling, difficulty breathing or swallowing, confusion, or dizziness, are more indicative of a true allergy.

Check out tips for keeping the mosquitoes at bay if you're an adult and tell us, are your kids being bitten this summer?


Image via ©iStock.com/mashabuba

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