It’s a hot summer day and you head out for a week of camping at a national park. Unfortunately, as soon as you step out of your tent, you are swarmed by hordes of mosquitoes! What can you do to effectively protect your family?
Getting "eaten alive by mosquitoes" is never fun, especially for kids. The first line of defense is to use physical barriers. When you push babies and young children in a stroller, or place them in a playpen outdoors, it is essential that they be protected by mesh netting. Take the time to adjust it properly and check it regularly to make sure there are no openings that could let insects in.
Everyone should wear light-coloured, long, loose-fitting clothing. Avoid tight clothes because mosquitoes can sting through the fabric. Mosquitoes are less attracted to light colours, and the light backdrop makes it easier to spot the insects and get rid of them. It’s also a good idea to tuck pant legs into socks, and to tuck shirts into pants, since bugs can easily crawl into these openings!
Experts also recommend staying indoors early and late in the day, when mosquitoes are most active. This isn’t always possible, however, and some biting insects are active all day!
Sometimes, despite all these precautions, an extra line of defense proves necessary. You can then resort to using insect repellent, which keeps insects away for a certain amount of time, preventing them from biting. They are available in the form of sprays, creams, lotions or gels, usually intended to be applied on the skin (or sometimes on clothing).
DEET is probably the best-known insect repellent for skin application. The more concentrated it is, the longer its effect: a product containing 30% DEET can last for about 6.5 hours, whereas a product with 10% DEET lasts approximately 3 hours. Products with higher concentrations are recommended for ages 12 and up, since they last longer and don’t need to be applied as often. In children under the age of 12, respect the following directions:
- Children 2 to 12 years old: Use products with a DEET concentration of 10% or lower, and apply no more than 3 times per day.
- Children 6 months to 2 years old: Use products with a DEET concentration of 10% or lower, and apply no more than once per day.
- Babies younger than 6 months: DEET products are contraindicated.
Since 10% DEET products only protect for short periods of time, what other options are available to help prevent insect bites in young children?
Icaridin (also called picaridin) is an insect repellent whose safety and efficacy has been recognized by the World Health Organization. As with DEET, the higher its concentration, the longer its effect is. It is estimated that 20% icaridin protects for approximately the same amount of time as 30% DEET. In Canada, 20% icaridin products can be used as of 6 months of age. The Canadian Paediatric Society recommends these products as a first choice in children between the ages of 6 months and 12 years.
Soybean oil, lemon eucalyptus oil (or PMD) and citronella are other repellents available in Canada. Their effectiveness has not been proven as much as DEET and icaridin. Citronella-based products are only effective for about 30 to 120 minutes, and eucalyptus oil (or PMD) is contraindicated in children 3 years of age or under. Some people feel that these products are safer because they are made with “natural” products, but as with any product applied to the skin (insect repellent or other), they may cause a reaction in some individuals (e.g. redness, itching at the application site).
Whichever product you choose, make sure to follow the following guidelines, especially in children:
- Apply a thin coat of repellent over the whole exposed skin area. Avoid putting the product on the hands in young children, because they might then get it into their eyes or mouth.
- Avoid aerosol or spray products on the face, and never apply repellent near the eyes or mouth.
- Apply aerosol products outdoors or in a well-ventilated area, far from food. Ask children to close their eyes while you apply the product, and if they can, ask them to hold their breath.
- Some aerosol repellents can be sprayed on clothing or screen netting, but make sure that young kids won’t be chewing on any fabric that has been sprayed with repellent!
- Before applying a bug repellent, make sure the skin is intact and healthy (e.g. no cuts, scratches, eczema, sunburn, etc.).
- If you also need sunscreen, apply it first and then wait 15 minutes before applying the insect repellent. Avoid combination products, because if you apply them as you should with sunscreen, they can expose the user to too much repellent. If, on the other hand, you apply it according to repellent guidelines, the sun protection may not be sufficient.
Repellents can protect against mosquitoes (and sometimes ticks as well), but they offer no protection against wasps or other stinging insects that can cause a severe allergic reaction. Persons with allergies should always carry at least two epinephrine injection devices (e.g. Epi-Pen, Allerject), especially if the closest hospital is more than 15 minutes away.
If you are travelling to a country where stinging insects can transmit serious illnesses such as malaria or Zika, you may need additional protection. Speak to your pharmacist or visit a travel health clinic for more information.