General Insect Sting Allergy (Child)

Any insect can cause an allergic reaction. Some children’s immune systems are very sensitive to an insect sting or bite. The venom or poison from an insect causes the body to release chemical substances. One substance, histamine, causes swelling and itching. This reaction can happen after a sting by a wasp, honeybee, yellow jacket, or other insects. 

Symptoms of an allergic reaction to a sting can range from mild to life threatening. Areas of the body far from the sting site may swell. The skin may become warm, itchy and may break out in raised, red, itchy spots (hives). Other general symptoms include nausea and vomiting, confusion, and trouble breathing. Venom from certain insects may cause paralysis, seizures, and shock. Severe allergic reactions may occur within 5 to 10 minutes. Less severe reactions may occur within a few minutes to several hours. Symptoms of an allergic reaction include:

  • Rash, hives, redness, welts, blisters in areas other than the sting site

  • Itching, burning, stinging, pain in areas other than the sting site

  • Dry, flaky, cracking, scaly skin

  • Swelling in areas other than the sting site  

  • Stomach pain or cramps

More severe symptoms include:

  • Swelling of the face or lips, or drooling

  • Trouble swallowing, feeling like your throat is closing

  • Trouble breathing, wheezing

  • Dizziness or a sudden decrease in blood pressure

  • Hoarse voice, or trouble speaking

  • Severe nausea or vomiting or diarrhea

  • Feeling faint or lightheaded

  • Rapid heart rate

Home care

Medicine

  • Mild, localized symptoms usually respond quickly to antihistamines, steroids, and pain medicine. Severe reactions are treated with injected epinephrine. They may require a stay in the emergency room for observation or admission to the hospital.

  • Your child’s healthcare provider may prescribe medicine to relieve swelling, itching, and pain. Follow the provider’s instructions when giving this medicine to your child.

  • If your child had a severe reaction, the provider may prescribe an epinephrine kit. Epinephrine will stop the progression of an allergic reaction. Before  you leave the hospital, be sure that you understand when and how to use this medicine.

  • Oral diphenhydramine is an antihistamine available at pharmacies and grocery stores. Unless a prescription antihistamine was given, diphenhydramine may be used to reduce itching if large areas of the skin are involved. Always check with your child’s healthcare provider for instructions  before  giving your child any antihistamine.

  • Don’t use antihistamine cream on the child's skin. It can cause a further reaction in some people.

  • Calamine lotion or oatmeal baths sometimes help with itching.

  • You may use over-the-counter pediatric pain medicine to control pain, unless another pain medicine was prescribed. Again, talk to your child’s provider before  giving any pain medicine. Don’t give ibuprofen to a child younger than 6 months old. Don’t give aspirin (or medicine that contains aspirin) to a child younger than age 19 unless directed by the provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder that most often affects the brain and the liver.

General care

Try to identify and teach your child to stay away from the problem insect. Future reactions may be the same or worse. Teach your child to:

  • Not walk in grass without shoes. Don’t have your child wear sandals.

  • Not leave food uncovered when eating outside. Sweet treats, watermelon, and ice cream attract insects.

  • Not drink from uncovered sweetened drinks in cans when outside. Insects are attracted to soda drink cans and sometimes crawl inside them.

  • Not wear bright colored clothes with flowery prints and patterns when outside.

  • Not wear perfume when outside. The smell of perfume can attract insects.

  • Be aware that honeybees nest in trees. Wasps and yellow jackets nest in the ground, trees or roof eaves. Avoid garbage containers when outside.

Ticks

If you try to remove a tick, do the following:

  • Use a set of fine tweezers and grip the tick as close to the skin as possible.

  • Pull up, using even, steady pressure. Don’t jerk or twist the tick. Don’t squeeze, crush, or puncture the tick’s body. Its bodily fluids may contain infection-causing organisms. Don’t use a smoldering match or cigarette, nail polish, petroleum jelly, liquid soap, or kerosene. They may irritate the tick.

  • If any mouth parts of the tick remain in the skin, try to remove them with the tweezer. If you can’t remove the mouth easily with clean tweezers, leave it alone and let the skin heal. 

  • After the tick is removed, clean the bite area with rubbing alcohol, soap and water, or iodine. 

  • Put the tick in a sealed container and completely cover it with alcohol. Never try to kill or crush a tick with your hand or fingers.

Stings

  • Wasps, yellow jackets, and hornets don’t leave a stinger behind. But if a honeybee stings your child, a stinger may stay in the skin. The stinger of a honeybee releases a substance that will attract other bees to your child so try to move away from the nest immediately. Once your child is away from the nest, then remove the stinger as quickly as possible by doing the following:

  • Scrape the stinger out with the edge of a dull knife or plastic card (credit card).

  • Don't use a tweezer or your fingers to remove the stinger since that may squeeze more toxin from the stinger. 

  • Wash the affected area with soap and clean, running water 2 to 3 times a day. Don't break a blister, if present. 

  • Next apply an ice pack for 5 to 10 minutes. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put ice directly on the skin.

  • Contact your child's healthcare provider and ask what can be used to help decrease the swelling and itching to the affected area. 

  • To prevent an infection, don't scratch the affected areas. Always check the sting area for signs of an infection. This includes increased redness, swelling, or pain to the affected area.

After an allergic reaction

  • Have your child wear a medical alert bracelet or necklace that identifies the allergy.

  • Keep a record of symptoms, when they occurred, and any problem insects. This will help your child's healthcare provider determine future care for your child.

  • Inform all care providers and school officials about your child’s allergic reaction. Tell them how to use any prescribed medicine.

Follow-up care

Follow up with your child's healthcare provider or as advised. Talk with your child's healthcare provider about a safe insect repellant for your child.

Call 911

Call 911 if any of these occur:

  • Trouble breathing or swallowing, wheezing

  • Cool, moist, pale or blue skin

  • New or worsening swelling in the mouth, throat, or tongue

  • Hoarse voice or trouble speaking

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Feeling dizzy or weak or a sudden drop in blood pressure

  • Feeling of doom

  • Severe nausea or vomiting or diarrhea

  • Seizure

  • Swelling in the face, eyelids, lips, mouth, throat, or tongue  

  • Drooling

When to seek medical advice

Call your child's healthcare provider or seek medical attention right away if any of these occur:

  • Spreading areas of itching, redness, or swelling

  • Signs of infection to the affected area such as:

    • Spreading redness

    • Increase pain or swelling

    • Fluid or colored drainage from the affected site

  • Fever (see fever section below)

Fever and children

Here are guidelines for fever temperature.  Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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