Choosing an Effective Insect Repellent for Your Child: A Guide

By Dr. Sophie J. Balk, American Academy of Pediatrics

As the weather gets warmer, children have more opportunities to go outside and enjoy outdoor activities with their loved ones. However, it’s important to be mindful of insect bites during this time. Biting insects like mosquitoes and flies can make children uncomfortable, and some insect bites can even lead to serious illnesses. In fact, the prevalence of insect-borne diseases has increased due to the impact of climate change in certain areas.

To protect your child from insect bites, it’s recommended to use insect repellents. Choose a repellent that is effective against the insects commonly found in your area. Follow the instructions on the label for proper usage.

It’s important to note that insect repellents do not kill insects. Instead, they keep biting insects like mosquitoes, ticks, fleas, chiggers, and flies away. Repellents with ingredients like DEET, picaridin, or oil of lemon eucalyptus, which are registered with the Environmental Protection Agency (EPA), are recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. You can find EPA-registered insect repellents at https://bit.ly/44Rt1mI.

DEET-based products are deemed safe and effective, with the concentration of DEET determining the duration of protection. Lower concentrations, such as 10% DEET, provide protection for around two hours, while higher concentrations, above 50% DEET, do not offer extended protection. It’s worth mentioning that high concentrations of DEET may cause skin rashes, although such reactions are rare.

Picaridin-based repellents also provide protection against mosquitoes and ticks, with the duration of protection dependent on the concentration of picaridin. For instance, repellents containing 5% picaridin protect for three to four hours, while those with 20% picaridin offer protection for eight to 12 hours. When using insect repellents with lemon eucalyptus oil, make sure they are EPA-registered and avoid using them on children under the age of 3. Concentrations of 8% to 10% of lemon eucalyptus oil protect for up to two hours, while concentrations of 30% to 40% offer six hours of protection.

When applying insect repellent on your child, consider the following tips:

Do:

• Choose repellents in the form of sticks, lotions, or unpressurized sprays.
• Read the label and follow the instructions and precautions.
• Apply repellent on exposed skin and the outside of your child’s clothing.
• Use enough repellent to cover the skin and clothing, but avoid using excessive amounts.
• Apply spray repellents in open areas to prevent inhalation.
• Supervise young children when applying repellent and help them with the application.
• Wash your child’s skin with soap and water when they come indoors and wash their clothing before wearing it again.
• Keep repellents out of the reach of young children to prevent accidental ingestion.
• Use mosquito netting over baby carriers or strollers if your baby may be exposed to insects.

Don’t use:

• Pressurized spray containers that can be inhaled or get into the eyes.
• Repellent on your child’s hands, as they may put them in their mouth or eyes.
• Repellent candles if your child has respiratory issues.
• Insect repellent directly on your child’s face. Instead, apply a small amount on your hands and then rub it on their face, avoiding the eyes and mouth.
• Repellent on cuts, wounds, or irritated skin.
• Combination sunscreen/repellent products. Sunscreen needs to be reapplied frequently, and combining it with repellent may expose your child to excessive amounts of repellent.

While “natural” repellents containing ingredients like citronella, geranium, peppermint, and soybean oil are considered safe, they have not been approved by the EPA for effectiveness. Additionally, their repellent properties only last for a short time, and some natural repellents can cause skin irritation.

Wristbands soaked in chemical repellents and ultrasonic devices are examples of products that have not been proven to be effective against mosquitoes.

In situations where there is a concern about serious insect-borne illnesses, such as Lyme disease, it’s advisable to use DEET, picaridin, or another approved effective product rather than relying solely on natural or alternative repellents.

What if my child has a reaction to an insect repellent?

If you suspect your child is experiencing a reaction to an insect repellent, such as a rash, take the following steps:

• Stop using the product and wash your child’s skin with soap and water.
• Contact your child’s pediatrician or Poison Help at 1-800-222-1222 for assistance.
• If you visit the doctor’s office, bring the repellent container with you.

If you have any questions about protecting your child from insect bites, consult with your child’s pediatrician.

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ABOUT THE WRITER

Dr. Sophie J. Balk, an attending pediatrician at Children’s Hospital at Montefiore and a professor of pediatrics at Albert Einstein College of Medicine, is a member of the American Academy of Pediatrics Council on Environmental Health and Climate Change Executive Committee. Her clinical practice and research focus on pediatric tobacco issues, skin cancer prevention, noise hazards, and climate change. Dr. Balk has served as a chair of the AAP Council on Environmental Health and an associate editor of the AAP handbook Pediatric Environmental Health.

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