Sue Hubbard, M.D.

It's that time of year again when pediatricians see a host of children suffering from uncomfortable bug bites.

The best way to prevent bites from mosquitoes, mites, chiggers, flies and fleas is to use insect repellent. (Repellents don't prevent bites from stinging insects such as bees, hornets and wasps.) The American Academy of Pediatrics recommends bug sprays for children older than 2 months of age for preventing insect bites during outdoor activities.

The most common insect repellent is DEET, a chemical that's been studied for over 50 years. Most over-the-counter bug sprays contain DEET in different strengths. The higher the concentration of DEET, which typically ranges from 5 percent to 30 percent, the greater the protection and length of effectiveness.

I usually recommend starting with the lowest concentration of DEET, which typically provides protection for 1 to 2 hours, and using a higher concentration as needed for longer protection.

The number of bites a child receives and their reaction to the bites varies, so each child may need a different concentration of DEET for effective protection. When concentrations of DEET exceed 50 percent (not recommended for children), the effectiveness and duration of protection actually plateaus.

Another product approved for use in the United States about 5 years ago is picardin, which provides similar protection in both duration and effect to DEET. Cutter, Skin So Soft and Off all offer some products containing 7 to 10 percent picardin.

The advantage to picardin products is that they're odorless (unlike DEET), don't feel as greasy on the skin and are less likely to cause skin irritation and damage to fabrics. With all products, read the labels carefully to see what you're getting.

There has been some recent data on the use of natural products to repel insects, such as oil of eucalyptus, which the U.S. Centers for Disease Control And Prevention (CDC) has found to be comparable in its duration of effectiveness in preventing mosquito bites to lower concentrations of DEET. It may also work well against ticks (Repel). Eucalyptus oil may be poisonous if ingested in large quantities and should not be used in children younger than age 3.

Other studies have found that 2 percent soybean oil (Bite Blocker for Kids) has similar levels of protection to products containing 5 percent to 15 percent DEET, and may provide up to 90 minutes of protection from mosquitoes. This may be a useful product for short-term exposure.

Chemical repellents containing permethrin kill ticks on contact but should never be applied to the skin, though they may be sprayed on clothing.

Insect repellents should not be reapplied throughout the day, as is sunscreen. Parents should spray the repellent on their hands first, then apply it to their child. Do not apply to areas around the nose and mouth. It's also a good idea to wash off repellent with soap and water at the end of the day.

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.


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