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Bug bites and insect stings make most kids pretty miserable. And, for some, the stings can be life-threatening. What’s a parent to do? Many look to stores advertising bug bite creams. And, wow, there are a lot of options. Today’s post goes over the two main ways to address bug bites:

• trying to prevent bug bites and stings
• what to do once a child has already been bitten or stung

and what to look for in the pharmacy. It depends on your child’s age and what their needs are. For example, homemade baking soda paste is a great option as a bug bite cream for toddlers. (It can help with itching after a bite. Scroll down for details).

Bug Bite & Sting Emergencies

First, though, let’s address emergency situations. These are times when a bug bite cream is not the answer.

Anaphylactic Reactions to Insect Stings

Severe allergic reactions to insect stings are possible. If someone is showing signs of an anaphylactic reaction, they should use their prescribed epinephrine injection (if available) and call 911. The epinephrine injector may be referred to by its brand name, such as EpiPen, Adrenaclick or AUVI-Q. Symptoms of anaphylaxis include:

• Difficulty breathing
• Swelling, especially around the mouth, lips, or tongue
• Wheezing or coughing
• Skin color changes to look more pale or blue
• Difficulty swallowing
• Hives
• Dizziness or fainting
• Confusion, agitation or otherwise acting abnormal
• Sometimes severe vomiting or stomach pain along with other symptoms listed

It’s worth noting that Benadryl or other oral antihistamines are usually not adequate treatment for anaphylaxis. Epinephrine and the emergency room (ER) are needed. If someone has these symptoms, this is an emergency. And, it may not just be due to bug bites or insect stings. It could also be a food allergy, for example.

Any child with a diagnosed allergy can use an Allergy and Anaphylaxis Emergency Plan to share with schools and other caregivers.

Skin Infections or Cellulitis

Sometimes, what was thought to be a bug bite or a severe reaction can end up being a skin infection. So, if the presumed bite was a few days earlier and things are looking worse, an urgent medical appointment or ER visit is needed.

Signs of Infection After a Bug Bite

Bacterial infections of the skin often begin with a tiny pink or red dot. Sometimes people assume that dot is from a bug or spider bite, so I’m including it here. Signs that the area is infected include:

• Area is warm to the touch
• Oozing pus (white liquid)
• Area is tender (hurts when touched)
• Area is swollen or becoming more swollen
• Redness of the skin is spreading or streaking
• Fever

A lot of these symptoms may overlap with a non-emergency reaction to a bug bite, so when in doubt, it’s best to seek medical care. Sometimes the treatment may be as simple as an antibiotic ointment. Other times, more medicine or care is needed.

Ways to Prevent Bug Bites and Stings in Children

So, to avoid the medical emergencies like allergic reactions or infections, parents can try to prevent bug bites or stings from happening in the first place.

Aside from the urgent situations described above, we must remember the diseases that insects can carry. From Lyme disease to West Nile virus to malaria, there are many serious illnesses that are essentially “caused” by various bug bites from infected insects. This is another huge motivation to avoid bites, especially from certain ticks and mosquitos.

There are many insect repellants available, marketed to babies and children. Some of the most effective include the ingredient called DEET.

This post may contain Amazon affiliate links, meaning I may receive a small commission at no additional cost to you. See full disclosure here.

DEET in Insect Repellants for Children

DEET is an effective ingredient in many insect repellents. It’s commonly advertised and used for mosquitos. Generally, it’s recommended that kids choose a repellent with less than 30 percent DEET. These are often labeled as safe for families, like this OFF! Family Care product (affiliate link). While some parents balk at the use of DEET, as they prefer a more “natural” insect repellant, there’s good information that serious events are uncommon, as long as it is used as directed.

Tips for using DEET in babies and young kids

Even though it’s a reasonable choice for many families, there are a few things to consider with DEET use.

• First, DEET is not for babies under age 2 months. They need other ways to protect them from bug bites. See below.
• DEET should not be ingested (swallowed or breathed in), so avoid it on body parts that a child may put in their mouths (like a baby’s hands). Also consider spraying away from the face or choosing non-spray options to avoid breathing it. Parents can spray their hands and then wipe the repellant on the child’s skin.
• There’s no need to apply DEET-containing repellants under clothing. Applying to exposed body parts is enough. Depending on the situation, some people also apply to the outside of the clothing itself.
• Do not apply DEET more than once a day. For this reason, don’t choose a product that mixes DEET and sunscreen, as it’s often a good idea to reapply sunscreen several times a day.
• After coming in from outside, wash off DEET repellants with soap and water. And, wash any clothing that was sprayed with DEET-containing repellent.
• Remember to store DEET-containing insect repellents away from young children. Again, even though it’s fine to use on their skin, it’s dangerous if swallowed. (This post has more information on preventing accidental ingestions).

Preventing Insect Bites with Clothing

Aside from insect repellents, there are other ways to prevent bug bites. Simply keeping the skin covered is a good idea, a great first step. Wearing long sleeves and long pants helps prevent some bites. If kids spend time in places where they’re likely to encounter ticks, mosquitos, ants, or other insects, wearing closed-toed shoes and socks also helps.

Some people tuck their pants into their socks to limit any gaps where a bug may enter and bite.

These simple tips are especially important in a wooded area where bug bites are more likely.

Babies, especially those too young for DEET repellents, may need more physical barriers to bug bites, like sleeves, pants, and hats. If they are in a stroller, a loose breathable mosquito netting is an option too for protecting a baby’s skin. Here is an affiliate link to one mosquito net for strollers.

Color of clothing matters.

General advice is to avoid bright colors or fabric with flowery prints, as bugs may be attracted. A recent article on mosquitos got much more specific. It covered a study that found that mosquitos are attracted to certain colors (red, orange, black) and tend to ignore other colors (green, purple, blue, white).

This research is pretty preliminary, but if you have options, it might be worth choosing a white shirt over a black one, for example.

Essential Oils for Bug Bites

Most insect-repellents are registered by the Environmental Protection Agency (EPA) as being safe and effective. This is why it’s recommended to choose repellents that are EPA registered.

That being said, there are many insect repellents on the market that have been evaluated for safety, but not effectiveness. So, they’re not dangerous to use, but may not work that well. In other words, they’re sold legally, but aren’t registered by the EPA. This includes many repellents that contain essential oils. Common ones include citronella oil and peppermint oil.

Both citronella and peppermint oils may cause skin irritation.

Tea Tree Oil

Tea tree oils have many potential uses on the skin, but allergic reactions are common. As effectiveness and reactions depend on many factors (more common if the oil is not diluted, for example), it’s best to discuss a product with a child’s pediatrician before using. And, be sure to follow application instructions.

Lavender Oil

There is some anecdotal evidence for using lavender essential oil for a variety of ailments. However, there’s not enough good quality research that shows it would be helpful for bug bites. (Please share in the comments if you have experience or information on this. We really do have a lot to learn).

Areas at Higher Risk for Bug Bites

Of course, we can also try to limit kids spending time where they’re more likely to get bit. Being outdoors is so great for their health overall, so it may be worth making a few adjustments to make the outdoors safer.

For example, make sure there is no standing water around the home. This is where mosquitos may lay their eggs. While you can’t control a pond, you can control your garbage cans. Check to see that they are emptied regularly, especially after a rain. This ensures there’s no standing water left in the bottom of the can. And, if you keep a lid on the garbage cans, make sure to clear it of rainwater too. It doesn’t take much standing water for mosquitos to breed.

After a Bug Bite or Sting: How to Care For a Bug Bite

Despite best efforts, bug bites still happen. A child may not know they’ve bitten by a bug right away. Maybe they’re too busy enjoying playing or hiking. Later, they may find a small red bump, itchy red bumps, or even a small water blister.

First, ensure there are no signs of a more serious issue (like a severe allergic reaction or infection as discussed at the beginning of this article). Then wash the area well with soap and water. It doesn’t need to be very hot water, especially if there’s a risk of a scalding burn with toddlers.

Cool compresses, like an ice cube wrapped in cloth or an ice pack, can be applied next.

If it’s a tick bite . . .

If a tick has been found on your child’s skin, using tweezers is the best way to remove it. Gently grip the tick body without squeezing it. Gently lift the tick away. At first, it may feel like the tick won’t move unless you squeeze harder. But, (in my experience), if you maintain the gentle tug for several seconds that feel like an eternity, the tick seems to release and allow itself to be lifted off the skin. It’s as if the tick holds and holds and holds . . . until it can’t anymore and it gives up.

At this point, it’s a great idea to place the tick in a plastic ziptop bag or small container. Some ticks carry Lyme disease, but not all. Bringing the tick to a doctor’s appointment can help narrow things down a lot. Many physicians who work in areas where Lyme disease is common can identify relevant ticks.

Also, try to make note of how long the tick may have been on your child. For example, let’s say your child had a thorough shower in the morning, then went hiking at noon, but you found the tick at 8pm. In this case, you could guess that the tick wasn’t on for more than 8 hours. This kind of information is also helpful when figuring out risk for illness.

After tick removal, the bite site can still be washed and cold compresses applied, if needed.

If it’s a bee sting . . .

If a child has been stung by a honey bee and there is no serious reaction, the first step is to remove the stinger. Using a credit card to gently scrape against the skin is an effective way to remove the stinger without squeezing it.

Then, after washing with soap and water, an ice pack can help soothe.

Tips for Itchy Bites

Even if there is no life-threatening reaction, itchy bug bites are very annoying! Parents often ask what they can put on the bite to help prevent itching. There are several reasonable options.

Calamine Lotion

Calamine lotion is over the counter (no prescription needed) and can be used several times a day. Although labels often say calamine lotion is for children over 2 years of age, consider asking your child’s pediatrician if you want to use it on an infant or younger children. In some cases, it may be fine.

Dabbing the calamine lotion on the itchy red bumps from insect bites is a reasonable way to deter scratching. Avoiding scratching matters!

Even bites that don’t carry any diseases can lead to a skin infection if someone scratches it enough. This is the main risk with chigger bites, for example. These are more common in the summer months and can lead to intense scratching, but not severe pain. So, calamine lotion is a good option for chigger bites as well.

For what it’s worth, calamine lotion is also labeled for use with poison ivy.

Hydrocortisone Cream

Hydrocortisone cream or ointment is the classic anti-itch cream, and for good reason. It works. It is a mild steroid cream and can also be dabbed on itchy insect bites only once or twice a day. This is a fine bug bite cream for toddlers and older kids. It is not for parts of the body with very sensitive skin, like around the eyes or groin. Many families like to apply a small amount to bug bites before bedtime, to hopefully help prevent itching at night.

It should not be used for more than a few days at a a time. In other words, if you’re still needing hydrocortisone cream 3 days after a big bite, it’s a good idea to check in with the pediatrician to make sure something else isn’t going on.

Baking Soda Paste

Baking soda mixed with water makes a paste that can be smeared onto bites or stings, then covered with a bandage for about 10-15 minutes. This can help with pain and swelling. There are some that think that the venom is neutralized with the baking soda paste, but there doesn’t seem to be great evidence that this is the reason baking soda provides relief.

(Baking soda is a base. Bee venom is slightly acidic, so we can see where the theory comes from).

It is a pretty safe option for most ages though, especially just a dab on the skin. Toddlers and young children can use baking soda paste as a bug bite cream. Yes, this is the same baking soda used in the kitchen or to help with irritated skin during bath time.

In the photo above, I mixed 1 teaspoon of baking soda with about half a teaspoon of water.

Fire ant bites may be relieved by baking soda paste too.

It’s also worth noting that the active ingredient in the popular product After Bite Kids (affiliate link) is, yes, baking soda. The label states that After Bite is only for kids over age 2.

Summary: There are safe bug bite creams for toddlers and older children alike.

DEET-containing insect repellents are a reasonable choice for most people over age 2 months. If a child does get bit or stung, families are wise to seek immediate medical attention if there are any signs of severe allergic reaction, very painful bites, or signs of skin infection.

If it’s just itch and mild swelling, there are several options for treatment at home. Baking soda paste, calamine lotion, and hydrocortisone cream are all reasonable for children young and old. Please discuss any treatments with your child’s pediatrician.

Maya M. Mahmood, D.O., FAAP is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.

Mosquito photo by Vladislav Balakshii on Unsplash