Protecting Children from Insect Bites

Dr. GehrisWith many of the news headlines focusing on the Zika virus this year, it is more important than ever before to know how to safely and effectively protect your infants or children from insect bites. Children’s Hospital of Pittsburgh of UPMC asks Dr. Robin Gehris, chief of Pediatric Dermatology, a few common questions about insect repellent and your children.

What types of over the counter products have been found to be the most effective at repelling insects in children?

The American Academy of Pediatrics recommends:

• DEET in concentrations of 10 to 30 percent for children older than 2 months of age.
• DEET is not recommended for children younger than 2 months of age.

For babies less than 2 months and kids of all ages, what other non-medical measures can parents take to decrease the chance of insect bites?

• Protective clothing that has long sleeves and pants are best. Socks can be used to seal the bottom openings of the pant legs so that no insects can sneak in.
• A bug screen for the stroller can be a helpful measure.
• Avoid scented soaps, perfumes or hair sprays on your child.
• Avoid areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.
• Avoid dressing your child in clothing with bright colors or flowery prints which might attract insects.

How should parents apply these insect repellents to children?

Parents should choose the lowest concentration that will provide the required length of coverage and use only enough repellent to cover exposed skin. There is no need to apply repellent UNDER clothing.

• The effectiveness is similar for 10 percent and 30 percent DEET, but the duration of their effects varies.
• For example, 10 percent DEET provides protection for about 2 hours.
• On the other hand, 30 percent DEET protects for about 5 hours.

In younger children, it is best to use lotions or stick products instead of sprays in order to avoid inhalation. If you must use sprays then apply them outside to decrease inhalation risk.

Avoid applying it in areas where it could be ingested or absorbed by the child, such as around the mouth, eyes or face, on hands (which kids frequently put in their mouths) or on open scrapes or cuts.

Parents should take charge of applying the repellents so that their children don’t use too much.  They should apply the repellent to clothing or exposed skin only. Remember to wash the clothing after the child comes indoors so he/ she doesn’t have ongoing exposure to the product.

What mistakes do many people make in regards to insect repellent?

Some parents might assume that “more is better”, but it is not recommended to reapply insect repellents more than once per day.  It is also not recommended to spray insect repellants on children indoors, where they are more likely to inhale the product.

It might seem cheaper or easier to purchase a combination insect repellent/ sunscreen product (such as Avon Skin So Soft Bug Guard Plus IR3535 Expedition SPF 30 Pump Spray), but in fact the American Academy of Pediatrics \ does NOT recommend these products due to the fact that insect repellent should only be applied once a day and only to exposed surfaces or clothing.  The use of a combination product could result in toxic levels of insecticide for a child.

Are natural products better for children?

Many parents assume that “natural” products are best for their infants, but in fact many of what one might consider the most natural products are either ineffective and/ or unsafe for infants.  Examples include:

• Oil of lemon eucalyptus (OLE) products, which are not recommended at all for use on infants or toddlers under three years of age
• Citronella oil feels “natural” but in fact it only protects one for up to 30 minutes (compared to DEET 10%, which protects for up to 2 hours!).
• Other products that are not effective enough to count on for protection of your child include garlic, vitamin supplements, wrist bands or ultrasonic devices (“bug zappers”)

Can children have reactions to the ingredients in insect repellent?  What should parents do if this happens?

If you suspect a reaction you should call your doctor right away.

To prevent possible reactions parents should wash off the insect repellent as soon as the child is going to be indoors.

What can be done if despite all of your best efforts your child gets bitten by an insect?

Don’t panic.  Children get bug bites all the time and the large majority of them have no problems.

If you can see a stinger in the skin, gently back it out by scraping it with a credit card or your fingernail.

If a rash occurs at or near the site of a recent insect bite and is not improving over the course of several days, feel free to contact your pediatrician or pediatric dermatologist to be evaluated in person.

For more information, please visit www.chp.edu/our-services/dermatology.