Insect Stings in Children

What are insect stings in children?

Insect stings can happen anywhere on the body and can be painful and frightening for a child. Most insect stings cause only minor discomfort. Most stings are from honeybees or yellow jackets, also called ground hornets. 

What causes insect stings in a child?

Bees, wasps, yellow jackets, and hornets can sting a child. Yellow jackets cause the most allergic reactions in the U.S. Fire ants can also sting a child. These ants are usually found in Southern states.

What are the symptoms of insect stings in a child?

The following are the most common symptoms of insect stings.

Local skin reactions include:

• Pain

• Swelling

• Redness

• Itching

• Warmth

• Small amounts of bleeding or drainage

• Raised red areas (hives)

Symptoms can also affect the whole body. These symptoms may mean your child has a more serious allergic reaction. This type of reaction may be life-threatening. See the treatment section for what to do in such an emergency. Symptoms include:

• Coughing

• Tickling in the throat

• Tightness in the throat or chest

• Trouble breathing or wheezing

• Nausea and vomiting

• Dizziness

• Fainting

• Sweating

• Feeling anxious

• Itching and rash on other parts of the body, not near the sting

How are insect stings in children diagnosed?

Your child's healthcare provider will examine your child. The provider will check for a stinger and for signs of an allergic reaction.

How are insect stings treated in a child?

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

Reactions are usually not serious. But they can be life-threatening if the sting occurs in the mouth, nose, or throat area. This is because swelling can close off the airway.

Treatment for local reactions includes:

• Calm your child and let them know that you can help.

• Remove the stinger, if still present, by gently scraping across the site with a blunt-edged object, such as a credit card or dull knife. Do not try to pull it out or squeeze the area. Squeezing it may cause more venom to be injected into the skin.

• Wash the area with soap and water.

• Put a cold cloth or ice pack wrapped in a cloth on the area to help reduce swelling and pain. Do this for 10 minutes on and 10 minutes off for 30 to 60 minutes. You can make your own ice pack by putting ice cubes in a plastic bag or using a bag of frozen vegetables and wrapping the bag in a thin towel. Don't put ice directly on the skin.

• If the sting occurs on an arm or leg, raise the limb to help reduce swelling.

To help reduce the itching, consider the following:

• Put a paste of one of the following on the area. Use baking soda and water, plain meat tenderizer and water, or a wet tea bag. Leave this on for 15 to 20 minutes.

• Use an over-the-counter medicine made for insect stings.

• Put an antihistamine cream, corticosteroid cream, or calamine lotion on the area.

• Give your child acetaminophen for pain.

• Give an oral over-the-counter antihistamine, if approved by your child's healthcare provider. Be sure to follow dosage instructions carefully for your child.

• Watch your child closely for the next hour for signs of a serious allergic reaction. 

Call 911 and seek emergency care right away if your child is stung in the mouth, nose, or throat area, or if your child has signs of a serious allergic reaction.

Emergency medical treatment may include:

• Medicines, such as epinephrine, antihistamines, or corticosteroids

• Help with breathing

What are possible complications of insect stings in a child?

The two greatest complications from insect stings are allergic reaction and infection. Allergic reactions usually occur within a few hours of the sting. An allergic reaction can cause death if the reaction is serious enough and your child does not get medical care right away. Infections usually occur several days later and should be treated with antibiotics.

What can I do to prevent insect stings in my child?

The following are general guidelines to help reduce the chances of insect stings. Outdoors, your child should:

• Not use perfumes, hairsprays, or other scented products

• Not wear brightly colored clothing

• Not walk or play outside barefoot

• Use an insect repellent made for children

• Stay away from areas that have hives and nests. Have professionals remove any nests.

• Stay calm and walk away slowly if an insect comes near

If your child has a known or suspected allergy to stings, follow these tips:

• Get a referral to an allergist-immunologist.

• Have your child carry a bee sting kit such as EpiPen at all times and make sure your child knows how to use it. These products are available by prescription.

• Tell your child's school and babysitters about the allergy. Make sure they know what to do if your child gets stung, such as using an epinephrine autoinjector or nasal spray. Make certain all caretakers know where to find the epinephrine and can get immediate access to it.

• If your child has a serious allergy, have your child wear a medical alert bracelet or necklace that notes this allergy. A medical alert bracelet lets emergency responders know your child has an allergy if your child isn't able to tell them. Knowing the kind of allergy your child has helps responders know right away how to start treatment.

• Make sure your child wears long-sleeve shirts and long pants when playing outdoors.

• See an allergist for allergy testing and treatment.

Key points about insect stings in children

• Most stings are from honeybees or yellow jackets. 

• Yellow jackets cause the most allergic reactions in the U.S.

• The most common symptom of an insect sting is swelling, pain, and redness at the sting site.

• Treatment includes removing the stinger, washing the sting area, and applying a cold pack.

• To prevent insect stings, teach your child to stay calm and walk away if an insect comes near.

• Tell your child's school and babysitters if your child is allergic to stings. Always keep a bee sting kit on hand.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.