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The Blog

Insect repellent (bug spray) and kids

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Check out the PedsDocTalk YouTube video: BUG BITES IN KIDS for more information and guidance on preventing and managing bug bites, including ways to manage bug bites at home and symptoms to monitor for.

Are you or your child a magnet for mosquito bites LIKE ME?!

Almost all of us have likely had a mosquito bite at some point, some more than others.

I personally am a mosquito magnet, whereas my husband and son could be with me in the same area and not get bit. Also, even for those who do get bit by mosquitos, some may have small reactions and others may have larger local reactions.

Why are mosquito bites so itchy?

When we get bitten by mosquitos, an immune response to the insect’s saliva is initiated. When we get bitten, the insect’s microscopic amount of saliva can set that immune response into a cascade which leads to the release of histamine. Histamine is what causes use to get those hives, swelling, and redness associated with bug bites. With this immune response, immune cells come to the area to fight this foreign substance aka the insect’s saliva.

For some people, this response is more pronounced, including for some young children. Also, the more we scratch a bite, the more itchy it becomes, causing an itch-scratch cycle. The bite itches, you scratch it, the body sends more immune cells to the area to fight the itch, and you keep on scratching.

Let’s start with WHY we should protect our children from insect bites?

Insect repellents help protect us from biting insects such as mosquitos and ticks. Insects like these can carry illnesses, but more commonly, insect bites can be very bothersome and itchy to children. And for some kids can lead to a supra-infection (infection after getting bit).

Children tend to be very sensitive to the saliva of insect bites which can cause local reactions and irritation.

Therefore, insect repellent can protect against insect bites, especially when you live in or are visiting areas prone to these insects.

So which insect repellent should you use?

There are three main types of insect repellents commercially available and popular for children:

  • DEET
  • Picaridin
  • Essential Oils found in plants such as cedar, citronella, oil of lemon eucalyptus, and soybean

I find that parents most often want to go with the less “chemical” of insect repellents such as oil of lemon eucalyptus. This is an appropriate choice, IF it’s preventing insect bites. But, if it’s not, then consider Picaridin or DEET. According to the CDC, DEET, Picaridin, or Oil of Lemon Eucalyptus are all good options for tick prevention; however, Oil of Lemon Eucalyptus is not recommended for children under 3 years of age. For more on TICK PREVENTION including the use of permethrin for treating clothing, read here.

Of note; insect repellent bracelets or patches have not been show to have any efficacy. Some people swear they work–and if they do–wonderful! But if they don’t; consider using something below.

DEET, Picaridin, and EPA registered essential oils are all great options, let’s take a closer look at those.

Is DEET a harmful insect repellent?

DEET got a bad reputation in the 1980s from reports of encephalopathy (brain swelling) in children exposed to DEET. However, no evidence suggests that DEET was the cause of these reports and more recent research demonstrates no adverse effects of DEET.

  • Can be used as young as 2 months of age.
  • If your child is between age of 2 months – 2 years of age start with DEET <10%.
  • If over 2 years of age, you can use DEET 10-30%
  • 10% DEET provides protection for about 2-3 hours and DEET 30% protects for about 6-8 hours
  • ALWAYS read packaging for instructions on how often to apply and DO NOT over apply
  • You can always start with a low DEET concentration and apply as indicated on packaging and move up if needed.

Since then, there are other options, but the AAP, CDC, and EPA all agree that DEET is safe for children and is also consider it to be the best defense against biting insects like mosquitos and ticks. Topical citronella is effective for 20 minutes or less while bracelets impregnated with repellent offer protection for a few seconds.

Options:

Other insect repellent options: Picaridin and essential oils

PICARIDIN

  • Can be used 2 months+
  • Approved in the US in 2005, Picaridin is an alternative to DEET and may work as well as DEET.
  • It’s also odorless compared to DEET products. Currently, it’s thought that Picaridin has a duration of action similar to 10% DEET.
  • Many prefer Picaridin over DEET because it’s less oily feeling.
  • It typically needs to be re-applied every 1-3 hours.

Options:

ESSENTIAL OILS

  • From a safety perspective, these are recommended for children 3 years+.
  • EPA repellents with oil of lemon eucalyptus or soybean are likely to be as effective as 10% DEET.
  • Safe when used as recommended, however if not effective for child, consider using PIcaridin or DEET.
  • If living in a Zika endemic area or malaria endemic area, DEET or Picaridin is recommended.

Options:

In regards to essential oils not approved by the EPA, remember that these are not approved for safety or efficacy. This means you will be using it at your own discretion of benefit vs. risk.

As someone who personally uses essential oils, make sure you dilute with carrier oil if using on your older child

To find the right insect repellent for you or your family, visit the EPA website’s insect repellent search tool.

Safety tips when using insect repellent

  • Read the label and reapply according to packaging.
  • Apply insect repellent to outside of children’s clothing and exposed skin.
  • For younger children, it’s best to apply the repellent for them.
  • DO NOT apply insect repellent under two months of age.
  • DO NOT spray insect repellent directly onto a face. Rub into your hands and then onto their face, avoiding the eyes.
  • DO NOT spray insect repellent on open wounds or cuts (will sting).
  • DO NOT use combination sunscreen/insect repellent products. These products may cause overuse of DEET as sunscreen needs to be applied more frequently than DEET.
  • When using sunscreen, apply sunscreen FIRST and then insect repellent.
  • Test product in small area of child’s skin before applying everywhere.
  • Make sure to keep insect repellent out of reach for children due to potential for ingestion (it’s safe for skin AND NOT FOR DRINKING!)
  • Always use other insect bite prevention tips too.

Other insect bites prevention tips

  • Take extra caution during dusk, dawn, and nighttime for mosquito-bite prevention.
  • Dress your child in long pants and a lightweight long-sleeved shirt, socks, and closed shoes if you will be exposed to insects: Think hiking.
  • Avoid dressing your child in clothing with bright colors or flowery prints because they seem to attract insects.
  • Avoid scented soaps, perfumes, or hair sprays on your child because they also attract insects.
  • Be careful around stagnant water – that’s where mosquitos love to congregate and breed. Make sure to treat your property if prone to mosquitos.

Remember that insect repellent is just one layer of protection and it’s important to use other ways as mentioned above to reduce insect bites.

Watch the PedsDocTalk YouTube video HERE!

P.S. – Subscribe to the PedsDocTalk newsletter to stay updated on all things child health and parenting!

Dr. Mona Admin

Hi there!

I’m a Board Certified Pediatrician, IBCLC, and a mom of two.

I know the ups and downs of becoming a mom and raising kids.

I help moms ditch the worry and second-guessing so you can find more joy in motherhood.

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