Keeping Kids Healthy
By Dr. Sally Robinson and Dr. Keith Bly

Summer is here and with it comes warm weather, more daylight and bugs. Many insects have bites or stings that can cause problems, but what is the difference between a bite and a sting?

Venomous insects inject painful, toxic venom through their stingers. The stings are painful, red and can swell up to 12 inches from the site of the sting. This is called a local reaction. A person allergic to the venom of the insect may have a systemic or “whole body” reaction. Redness, hives and swelling may occur, and this type of reaction can affect airways, as well as circulation and may become life-threatening if not treated in time.

Nonvenomous insects bite in order to feed on your blood. Allergic reactions do occur from nonvenomous insect bites, but severe allergic reactions are rare.

The two greatest risks from most insect stings and bites are allergic reaction, which can be fatal, and infection.

Here are a few tips as to what you should do if your child is stung or bitten:
• A bee leaves behind a stinger attached to a venom sac. Don’t try to pull it out because more venom may be released. Gently scrape it out with a blunt-edged object, such as a credit card.
• Wash the area carefully with soap and water. Repeat two to three times a day until the skin is healed.
• Apply a cold pack, an ice pack wrapped in a cloth, or a cold, wet washcloth for a few minutes.
• Apply a paste of baking soda and water and leave it on for 15 to 20 minutes.
• Give acetaminophen for pain.
• To relieve pain and itching, dab a tiny bit of household ammonia on the area or use an over-the-counter product that contains ammonia and give an over-the-counter antihistamine, if your doctor says it’s OK.
• If your child is stung in the mouth or nose, seek immediate medical attention because swelling may block airways.

Insect repellents can used to keep biting insects away. Check the label on the insect repellents and choose a product containing between 10 and 30 percent DEET, which is the most effective insect repellent. DEET can be used on children older than 2 months.

Important things to remember when using insect repellent include:
• Apply repellents to exposed skin and clothing. Do not use under clothing.
• Do not use repellent on wounded or irritated skin.
• Spray on hands first and apply to face, avoiding the eyes and mouth. Never spray directly on face.
• Do not allow children to handle insect repellent. Do not apply to children’s hands or spray directly on a child. Apply the product to your hands first and then put it on the child.
• Do not spray in enclosed areas and avoiding breathing the repellent.
• Do not use near food.
• After returning indoors, wash the treated area with soap and water or bathe.

If your child experiences a large area of swelling, abnormal breathing, tightness in the throat or chest, dizziness, hives or rash, fainting, nausea or vomiting, or pain and swelling that lasts longer than 72 hours, he or she may be having an allergic reaction to the sting or bite and you should seek immediate medial attention.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.