Insect stings are expected misfortunes in childhood. Even when insect stings are quite painful, they are rarely serious. True allergies to insect venom are rare, but they are potentially life threatening.

Insect stings usually cause swelling, pain and itching. Inflammation of the skin and underlying tissue can be extensive. A child's entire arm, foot or hand, for example, can puff up. When a reaction involves only swelling of the surface tissues, even if a large part of the arm or leg is involved, it is considered to be a "local" reaction. Local reactions are not usually dangerous, and they are not a sign of allergy.

If several insects sting your child at the same time, or if one insect releases a large amount of venom, it is possible for your child to have symptoms that are not part of the local reaction, but are still not allergic. This kind of reaction is called a "toxic" reaction. The usual symptoms of a toxic reaction are nausea, vomiting, diarrhea, dizziness, headache and fever. In rare cases, a toxic reaction can cause a seizure or a loss of consciousness. A toxic reaction is not caused by allergy, but the large venom exposure that results in a toxic reaction very frequently creates a new allergy that can be problematic with future stings or bites. A child who has a toxic reaction may benefit from an allergy evaluation after recovery.

In a child who is allergic to the venom of a stinging insect, a sting may cause a medical emergency. Most allergic reactions are mild, but if a reaction is severe, there is a chance it could be fatal without immediate treatment. Here are some guidelines for what to do if your child is bitten or stung:

• Watch your child closely after an insect sting so you are aware if concerning symptoms develop.
• Get immediate medical help (dial 911) if your child begins to have any of the following symptoms. These are symptoms that can come from a "systemic" allergic reaction, not a local reaction. These symptoms can each be a part of the dangerous allergic reaction called anaphylaxis, which can be life threatening if it affects your child’s breathing or blood pressure:


• Trouble breathing or swallowing
• Wheezing
• A hoarse voice
• Nausea or vomiting
• Sudden diarrhea
• Abdominal pain
• New nose discharge or eye weeping immediately after the sting that can’t be explained by crying
• Puffiness around the eyes that can’t be explained by crying
• A puffy pink rash (hives or welts) on parts of the body that are far from the original sting
• A feeling of faintness
• Tongue or mouth swelling
• A seizure or black-out (loss of consciousness)

If your child has any of above symptoms after a sting, your child needs medical attention. After recovery, you will need to talk to your doctor about carrying epinephrine (a medication used to treat anaphylaxis) in case of another sting, and about an evaluation by an allergy specialist.