Insect Stings and Allergic Reactions in Children

Insect stings that most commonly cause allergic reactions

Insects that are members of the Hymenoptera family most commonly cause allergic reactions. These include:

• Honey bees

• Wasps

• Hornets

• Yellow jackets

• Fire ants

What are the symptoms of an allergic reaction to an insect sting?

Most children who are stung by an insect have a local reaction at the sting site. The reaction is brief, with localized redness and swelling followed by pain and itching. Generally, the reaction lasts only a few hours. But some may last longer.

For other children, their immune system reacts abnormally. It causes an allergic reaction that can spread to other parts of the body. Sometimes this reaction can be life-threatening.

This severe reaction is a medical emergency that can happen very quickly. It is called anaphylaxis or anaphylactic shock. It can include severe symptoms such as:

• Itching and hives over most of the body

• Throat and tongue swelling

• Trouble breathing and chest tightness

• Dizziness

• Headache

• Stomach cramps, nausea, or diarrhea

• Quick drop in blood pressure

• Shock

• Loss of consciousness

• Hoarse voice or swelling of the tongue

• Feeling of impending doom

Call 911

Call 911 if your child has the severe symptoms of an allergic reaction listed above. Medical care is needed right away. If your child has epinephrine, use it as directed first, then call 911.

Can insect stings be prevented?

Helping your child avoid insect stings is the best preventive measure. Try the following:

• Teach your child not to disturb insect nests and mounds.

• When outdoors, make sure children who have severe reactions wear socks, shoes, long pants, and long-sleeved shirts.

• When outdoors, make sure your child is careful if eating or drinking uncovered foods or drinks, which can attract insects.

• Keep your child from going barefoot. They should wear closed-toe shoes when walking in grassy areas.

• When playing outdoors, make sure you and your child watch for insect nests in trees, shrubs, and flower beds. Other areas in which to be careful include swimming pools, woodpiles, the ends of open pipes, under eaves of houses, and trash containers.

• Before letting children play in an area, check for nests. These can be found in older tree stumps, holes in the ground, and rotting wood. Car tires used in playgrounds can also contain nests.

• If your child is allergic to insect bites, don't let them play outside alone when stinging insects are active. Even a dead insect can sting if a child steps on its stinger or picks it up.

• Teach children to walk away slowly from insects. Also teach them to avoid swatting at insects or running away. This can trigger an attack.

• If your child has an allergy to stings, have them wear a medical alert bracelet or necklace. They should also carry two doses of epinephrine with them at all times during the seasons when insects are active.

Treatment for insect stings

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

If your child has had a serious reaction to an insect sting, make an appointment with an allergist. An allergist can do skin testing, diagnose the allergy, and figure out the best form of treatment. If needed, insect venom allergy shots (immunotherapy) are very effective at preventing future severe reactions.

Here's how to give treatment right away for an allergic reaction that is not life-threatening:

• Stay calm. Your composure will help your child remain calm too.

• If a stinger is present, remove the stinger right away, if possible. Use a dull, thin edge such as a credit card or fingernail to scrape over the stinger. Try not to squeeze the stinger. That could force the venom into the body. Speedy removal is the most important step.

• Call your child's healthcare provider if they get several stings. Or if hives develop in a part of the body away from the sting itself.

• Raise the affected arm or leg. This will help reduce swelling.

• Apply ice or a cold compress to reduce swelling and pain. 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. Never put ice or an ice pack directly on the skin.

• Clean the area with soap and water.

• Apply a topical steroid cream to the sting site to ease itching.

• Give your child a dose of an antihistamine taken by mouth (such as diphenhydramine) to ease itching. If your child has a serious health condition or takes prescription medicines, check with their healthcare provider before giving the antihistamine.

• For children with a history of a severe allergic reaction to a sting, always keep an emergency treatment kit with them. The kit should contain epinephrine, prescribed by your child's healthcare provider. Alert your child's school and have an emergency plan and an emergency kit immediately accessible, including during recess and on field trips.

• If your child's symptoms get worse, call 911 and get emergency care.