Insect repellents are generally available without a prescription, but they should be used sparingly on infants and young children. In fact, the most common insecticides include DEET (N, N-diethyl-m-toluamide), which is a chemical not recommended for use in children under two months of age. Do not apply repellents containing DEET more than once a day on older children.
The concentrations of DEET vary significantly from product to product—ranging from less than 10 percent to more than 30 percent (or even higher)—so read the label of any product you purchase. The higher the concentration of DEET, the longer it stays working. Its effectiveness peaks at a concentration of 30 percent, which is also the maximum concentration currently recommended for children.
The safety of DEET does not appear to be related to its level of concentration; therefore, a practical approach is to select the lowest effective concentration for the amount of time your child spends outdoors. You should avoid products that include DEET plus a sunscreen since sunscreen needs to be applied frequently while DEET should only be applied once a day. If you apply DEET more frequently, it can be associated with toxicity. Also be sure to wash off the DEET with soap and water at the end of the day.
An alternative to DEET is a product called picaridin (KBR 3023). While it is more widely used in Europe, picaridin has recently become available in the US. It is a generally pleasant-smelling product without the oil residue associated with DEET and is available in concentrations of 5 to 10 percent.
The American Academy of Pediatrics recommends that repellents used in children over six months of age have 30 percent DEET or 5 to 10 percent picaridin repellent and be applied once before going outdoors. These repellents are effective in preventing bites by mosquitoes, ticks, fleas, chiggers and biting flies but have virtually no effect on stinging insects such as bees, hornets and wasps. Contrary to popular belief, taking antihistamines continuously throughout the insect season does not appear to prevent reactions to bites.
Here is look at some of the environments where you should be using repellent and what insects to look out for:
Insect Bites and Stings
|Insect/Environment||Characteristics of Bite or Sting||Special Notes|
Water (pools, lakes, birdbaths)
|Stinging sensation followed by small, red, itchy mound with tiny puncture mark at center.||Mosquitoes are attracted by bright colors and sweat.|
Food, garbage, animal waste
|Painful, itchy bumps; may turn into small blisters.||Bites often disappear in a day but may last longer.|
Cracks in floor, rugs, pet fur
|Multiple small bumps clustered together; often where clothes fit tightly (waist, buttocks).||Fleas are most likely to be a problem in homes with pets.|
Cracks of walls, floors, crevices of furniture, bedding
|Itchy red bumps occasionally topped by a blister; usually 2–3 in a row.||Bedbugs are most likely to bite at night and are less active in cold weather.|
Mounds in pastures, meadows, lawns, and parks in southern states
|Immediate pain and burning; swelling up to 1⁄2 inch (1.2 cm); cloudy fluid in area of bite.||Fire ants usually attack intruders.|
|Bees and wasps
Flowers, shrubs, picnic areas, beaches
|Immediate pain and rapid swelling.||A few children have severe reactions, such as difficulty breathing and hives/swelling all over the body.|
|May not be noticeable; hidden on hair or on skin.||Don’t remove ticks with matches, lighted cigarettes, or nail polish remover; grasp the tick firmly with tweezers near the head; gently pull the tick straight out.|
Author: Steven P. Shelov, M.D., M.S., FAAP
Last Updated: 6/9/2011
Taken from AAP website, healthychildren
This is Dr. Budiasih’s second blog in a series of three blogs on bug bites and prevention. Her final topic will be on the treatment of bug bites.
Santi Budiasih attended the University of Indonesia and completed her residency training at the University of Nebraska/Creighton University, Children’s Hospital in Omaha, Nebr. Her medical interests include well baby / well child care, adolescent health and sports medicine.