Allergic Reaction to an Insect Sting: How to Care for Your Child

Your child was stung by an insect and had an allergic reaction. If your child has another insect sting, the reaction could be even more serious. A serious allergic reaction is called anaphylaxis. Anaphylaxis can be deadly and needs treatment right away. A child with anaphylaxis may have one or more of the following:

• swelling of the face, eyes, throat, feet, hands, or inside of the ears

• hives (raised welts on the skin) over much of the body

• trouble breathing that can include shortness of breath, a hoarse voice, a wheeze, a cough, or a tight feeling in the throat

• stomach problems like belly pain, vomiting (throwing up), or diarrhea (watery poop)

• a dizzy feeling (which could lead to passing out)

Anaphylaxis is treated with epinephrine injection. In case your child has another allergic reaction, keep 2 epinephrine auto injectors (brand names EpiPen®, EpiPenJr®, and Adrenaclick®) with your child at all times. The health care provider gave you a prescription for this medicine.

• Pick up the epinephrine auto injectors from the pharmacy right away. You, your child, or your child's caregiver should always carry this medicine in case your child is stung again. Be sure you and your child (if old enough) know how to use the epinephrine auto injector. Practice with the trainer epinephrine auto injector that comes with your prescription.

• Give your child any medicines prescribed by your health care provider.

• If your child has itching or swelling from the sting, put a cold pack on it for several minutes at a time. Place a towel between the ice and your child's skin.

• Make an appointment for your child to see an allergist (a doctor who specializes in allergies and allergic reactions). The allergist may recommend testing to learn more about the reaction and help find the best treatment for your child. Sometimes, allergy shots are recommended to help prevent severe reactions in the future.

• Make any other follow-up appointments as directed.

• Make sure that caregivers, teachers, and coaches know about the allergy and have an antihistamine (Benadryl®, Wal-Dryl®, or a store brand) and 2 epinephrine auto injectors available. Be sure they know what to do if your child has an allergic reaction.

• Your child should always wear a medical alert ID bracelet stating what your child is allergic to. You can buy one in a drugstore or online.

If Your Child Gets Stung

• If a stinger is still in the skin, remove it right away. Use your fingernail or the side of a credit card to scrape or flick the stinger from the skin. Don't use tweezers. This can squeeze the stinger and push more venom into the body.

• Fire ants often stay on the body and sting again. Slap the fire ant to kill it.

• Watch for signs of an allergic reaction. For a mild reaction like itching, give an antihistamine (Benadryl®, Wal-Dryl®, or store brand) by mouth. An antihistamine doesn't stop anaphylaxis.

• If your child has signs of anaphylaxis, follow these steps:

1. Give your child the epinephrine auto injector right away, then call 911 right away and say your child is having a life-threatening emergency. If someone is with you, have that person call 911 while you give the epinephrine. Always give epinephrine if you think it might be needed.

2. Lay your child down with legs raised while you wait for the ambulance.

3. Use a second epinephrine auto injector if symptoms don't start to improve in 5 minutes, or if symptoms improve after the first dose and then return while you wait for the ambulance.

• Don't take your child to an emergency room (ER) in a car. Wait for an ambulance with trained specialists to take your child to the ER.

• You have any questions about your child's allergy or treatment.

• Swelling around a sting gets worse.

• Your child was stung and you don't have medicine with you to treat an allergic reaction. Even if your child has no signs of an allergic reaction, you need to be where your child can get treatment if an allergic reaction starts.

• Your child gets epinephrine. After getting the epinephrine, your child must go to the ER to see if more treatment is needed. This is true even if your child is doing better, because there can be a second wave of symptoms.

• Your child's symptoms go away after a sting, then start to come back in the next 3 days.

How can I help my child avoid getting stung again? To help your child avoid insect stings, teach him or her to:

• Stay away from beehives, insect nests, and other areas where insects like to be, such as flower beds.

• Be calm and quiet around stinging insects. Back away slowly.

• Check for insects in drink cups, cans, and straws when outside.

• Wear shoes when outside.

• Wear long pants, socks, and closed-toe shoes when walking or playing in grassy areas or fields. Wear gloves and long sleeves when gardening.

• Use unscented hair and body products, and do not wear perfumes or brightly colored or flowered clothing. They attract insects.