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Bug Bites, Stings and Kids

Posted on May 20, 2019

The summer months are here, but unfortunately so are insects that love to bite and sting. Rachel Dawkins, M.D., medical director of the Johns Hopkins All Children’s Pediatric and Adolescent Medicine Clinic and director of Clinical Experiences for Physicians in Training at Johns Hopkins All Children’s Hospital, explains what stinging insects do and when parents need to worry about it.

Bites usually cause a small red bump, but some kids get a localized reaction that can look like a hive. Some bites are itchy (mosquitoes, fleas and bedbugs) and some are painful (horseflies, fire ants, caterpillars). Mosquito bites are extremely common (as we all know) and everyone reacts differently to these.

What about more severe reactions?

Bees or wasps and fire ants are the major insects that can cause severe allergic reactions or anaphylaxis. Anaphylaxis is a life-threatening allergic reaction that can cause difficulty breathing or swallowing within a couple of hours of a sting (but usually happens much quicker). If your child is having anaphylaxis, call 911 and if you have epinephrine, use it!

What’s the best treatment for a mosquito or other insect bite?

Most don’t need any treatment. If the bites are itchy use over-the-counter hydrocortisone cream or baking soda paste. Antihistamines by mouth, such as diphenhydramine (or Benadryl), can help with itching as well. Painful bites respond well to baking soda paste as well as putting something cold like an ice cube on the area.
Most insect bites will be itchy for two to three days and swelling from bites can last a week. Bites can get infected from little fingers and fingernails scratching at the bite. If the bite looks infected, it’s time to see the pediatrician.

What about bug spray for kids? Is it recommended?

The American Academy of Pediatrics says bug spray is OK for kids over 2 months old—just be careful to look at the DEET concentration and don’t apply to hands if the child sucks his or her fingers or thumb. And they only work for biting insects like mosquitoes not stinging insects like bees. Wash the insect repellant off with soap and water after you return indoors.

And, of course, avoid being outdoors during dawn and dusk. Wear long pants and sleeves if able.

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit each Monday for the latest report. 

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