My child was stung by a bee or yellow jacket: WHAT SHOULD I DO?
by Maria I Diaz, MD, FAAP
Summer is finally here! There are more outdoor activities, gardening, barbecuing… and with that, exposure to our flying friends. Stings by honeybees, bumblebees, hornets, or yellow jackets may have two types of reactions: a local or an anaphylactic reaction. Having one type of reaction does not mean you will always have the same reaction every time you are stung.
The main symptoms of a local reaction are pain, itching, swelling and redness at the sting site. The pain or burning may last 1 to 2 hours. The normal swelling from venom can increase for 24 hours. Stings of the upper face can cause severe swelling around the eye, but this is harmless. Bee stings can normally become red. That does not mean they are infected. Infections rarely occur in stings. The redness can last 3 days and the swelling 7 days. You should remove the stinger as soon as you can; use your fingernails or a tweezer. Wash the sting area with soap and water, and apply cold compresses or ice to relieve pain and ease swelling. You can give acetaminophen or ibuprofen for pain, and give an over-the-counter oral antihistamine. Follow dosage instructions for the age and weight of your child. You can also apply a corticosteroid cream or calamine lotion to the sting area. A sting anywhere in the mouth needs immediate medical attention; this can quickly cause severe swelling that may block airways.
A severe life-threatening allergic reaction is called anaphylaxis. The main symptoms are wheezing or difficulty breathing; tightness in the throat or chest; swelling of the lips, tongue, or face; hives; nausea; vomiting or diarrhea; and dizziness or fainting. Use an epinephrine auto-injector if it is available, and call 911 right away. After giving epinephrine, give an over-the-counter oral antihistamine, if the child is able to swallow.
To prevent stings, avoid activities outdoors with sugary drinks, brightly colored clothing, and strong fragrances or perfumes because some insects may be attracted to them. If a few bees are flying around you, stay calm and slowly walk away from the area. Swatting at an insect may cause it to sting. Keep outdoor dining and camping areas clean and free from garbage.
If you know your child is allergic to bees, you should always carry a bee sting kit that includes an epinephrine auto-injector; a bronchodilator inhaler like albuterol, which will dilate the airways and allow your child to breathe; and an over-the-counter oral antihistamine. Your child should also wear a medical alert bracelet or necklace.
Always call your doctor if you have any questions.