Most insect bites and stings are not poisonous, and are usually caused by mosquitoes, flies, fleas, spiders, ticks, wasps, bees and beetles. In Australia, it is rare for insects to transmit diseases to people. When this does happen, it tends to be in remote parts of the country.
As a rule, the size of a reaction from repeated insect bites (such as mosquitos) is larger in early childhood then slowly reduces as the child gets older.
All insect bites may cause allergic reactions. The size of the reaction also depends on the degree of allergy your child has. Very occasionally, children may have a severe allergic reaction, called anaphylaxis.
If your child has any signs of anaphylaxis, call an ambulance immediately.
Signs and symptoms of insect bites and stings
The symptoms of insect bites or stings can vary a lot depending on how sensitive your child is to that insect. Your child's allergic reaction to a bite can worsen over two to three days. If your child has been bitten or stung by an insect, they may have:
- a minor skin reaction with a painful, itchy lesion at the site of the bite or sting
- a more significant reaction, with a larger area of swelling and redness, and sometimes blisters.
If your child is having a severe allergic reaction, they may show the following signs of anaphylaxis:
- a widespread rash (hives) or severe itching
- coughing, wheezing or choking
- difficulty breathing and swallowing
- difficulty talking and/or hoarse voice
- swelling of the lips or tongue
- fainting
- becoming pale and floppy (young children).
If your child has any signs of anaphylaxis, call an ambulance immediately.
A sting or bite can sometimes cause the surrounding skin to become infected (cellulitis), and this will require antibiotics. If the skin around the sting is becoming infected, it will become increasingly warm, red and painful to touch. This can happen hours or days after the sting. If you are not sure whether your child has cellulitis, take them to see your GP.
Care at home
Most insect bites or stings can be treated at home. If your child has been stung by a bee, carefully scrape the sting out. Do not pinch and pull the sting out, as this will cause more poison to be injected.
For all bites and stings:
- Wash the skin around the bite or sting.
- A plain, unscented moisturising cream may help to decrease the itch.
- Use cool, wet towels or face washers to help with pain and swelling.
- If an arm or leg is bitten, have your child rest with the limb raised above the heart to reduce the swelling.
- If your child continues to scratch the bite or sting, you can give them an antihistamine medicine. This medicine is given by mouth, and can be purchased from the pharmacy.
- Steroid creams applied early and regularly onto the sting or bite site can often give relief. These creams are available from your chemist.
When to see a doctor
Take your child to the GP if:
- they have a lot of pain where they were stung or bitten, and it does not settle down within a few hours
- the swelling or itching gets worse after 24–48 hours
- if you are worried for any reason.
If your child has had a bad allergic reaction to an insect bite or sting, the doctor may suggest using an oral steroid drug such as prednisolone, or an adrenaline autoinjector (e.g. an EpiPen) for any future bites or stings. If these medicines are prescribed, they should be carried with your child at all times. All people who care for your child should know when and how to give the medicine if your child is bitten or stung.
Preventing insect bites and stings
Outdoors
- Keep picnic food covered and wipe up spills immediately.
- Dress your child in long-sleeved shirts and pants that fit snugly around the wrists and ankles.
- Make sure rubbish bins are securely fastened so the contents don't attract insects.
- Stay away from pools of stagnant (still) water, which are breeding grounds for mosquitos.
- Avoid perfumes and scented lotions, soaps and cosmetics.
- Cover infant strollers with netting.
Insect repellents
- Follow the manufacturer’s instructions and only use insect repellents sparingly.
- In young children, insect repellents are safest if rubbed or sprayed on clothing rather than skin. Don't spray them on the skin of children under the age of 12 months.
- The most effective repellents contain the chemicals DEET or picaridin. Choose sprays that contain no more than 10 per cent DEET/picaridin – look for repellents especially formulated for children.
- Reapply insect repellent to your child after swimming or activities that make them sweat.
- See our fact sheet Insect repellents - guidelines for safe use.
Indoors
- Don't turn the lights on in bedrooms until the windows are closed (or screened) and the curtains are drawn.
- Fit insect screens to windows.
- Consider using an electric device that releases insect repellent into the room at night. These usually plug into an electric outlet and the repellent (usually permethrin) is contained either in a bottle of fluid or a small pad.
- When required, use insect sprays from the supermarket.
Key points to remember
- Most insect bites and stings are not poisonous, and can be cared for without seeing a doctor.
- If your child has been bitten by a bee, try to scrape the sting off. Do not pull the sting out, as this causes more poison to be injected.
- Any medicine your child needs for insect bites or stings should be carried with them at all times.
- Call an ambulance if your child has symptoms of anaphylaxis.
For more information
Common questions our doctors are asked
Do you recommend the use of natural insect repellents?
Natural insect repellents including ingredients such as citronella or eucalyptus may be effective, but repellents containing DEET or picaridin are likely to be more effective.
I think my child has been bitten by a spider. What should I do?
Most spider bites in Australia are not serious, and applying an ice pack will help relieve the pain. If you think the spider was a funnel web or mouse spider, firmly bandage the area and make sure your child lies still. Call an ambulance. If you think the spider was a red-back or white-tailed spider, wash the area of the bite and apply an icepack. Seek urgent medical assistance. Try to catch the spider or take a photograph, so that the right treatment can be given, and be careful not to get bitten yourself.
Developed by The Royal Children's Hospital General Medicine department and Centre for Community Child Health, in collaboration with Child and Youth Health Services Adelaide. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.