General Insect Sting Allergy (Child)

Home care

Medicine

• Mild, localized symptoms often respond quickly to antihistamines, steroids, and pain medicine. Severe reactions are treated with epinephrine. They may need 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 healthcare provider’s instructions when giving this medicine to your child.

• If your child had a severe reaction, the provider may prescribe a medicine called epinephrine. Epinephrine will stop the progression of an allergic reaction. Before  you leave the hospital, make 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 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. Here are things to teach your child:

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

• Don't swat at flying insects.

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

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

• Don't wear bright-colored clothes with flowery prints and patterns when outside.

• Don't 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. Stay away from garbage containers when outside.

• Keep yards and storage areas clear of debris. Cans, dead plants, pots, and old tires provide good nesting areas for certain insects.

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 right away. Once your child is away from the nest, remove the stinger as quickly as possible by doing the following:

• Scrape the stinger out with a dull, straight edge, like a plastic credit card.

• Don't use tweezers or your fingers to remove the stinger as this 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 drainage, redness, swelling, or pain around 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 as advised. Talk with the 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

• Hoarse voice or trouble speaking

• Confusion

• Very drowsy or trouble waking up

• 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

• Belly (abdominal) pain

• Seizure

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

• Drooling

When to get medical advice

Call your child's healthcare provider 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

  • More pain or swelling

  • Fluid or colored drainage from the affected site

• Fever (see "Fever and children" below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The healthcare provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4°F (38°C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older