The DEETs on Bug Spray

Summertime is here—with many sunny days and more outdoor fun. Along with the warm weather come bugs, especially mosquitos. Depending on where you live, it may feel like there is only one or two weeks to enjoy the warmer weather outside before the mosquitos come in swarms. Insects can carry diseases, and the insect bites are very bothersome and itchy. It’s a vicious cycle: the bite itches, you scratch it, and it itches more. Children are often more sensitive to mosquito bites and have more significant reactions. So, it's important to take steps to protect children from mosquito bites and manage any reactions.

Insect Repellent

Many types of insect repellents are commercially available and popularly used for children. These include DEET, Picaridin, and essential oils found in plants such as cedar, citronella, oil from lemon eucalyptus, and soybean.

DEET is one of the most common active ingredients in many insect repellents.

DEET gained a bad reputation in the 1980s due to reports of encephalopathy, or brain swelling, in children exposed to the chemical. However, there is no evidence to suggest that DEET was the cause of these reports. More recent research demonstrates that DEET has no adverse effects, making it a safe and effective option for preventing mosquito bites. DEET is one of the best defenses against insect bites—there is no reason to fear it!

DEET can be used as young as 2 months of age. For children ages 2 months to 2 years old, start with DEET <10%, and for children over 2 years, use DEET 10-30%. You can always start with a low concentration and apply as indicated on the packaging. Then, move up if age appropriate and needed. It’s important to always read the packaging for instructions on how often to apply to avoid overapplying.

Picaridin is another option for insect repellent.

It can be used on children 2 months and older. One benefit is that it’s relatively odorless and less oily than DEET. It’s thought that Picaridin has a similar length of effect to 10% DEET, which is about 2-3 hours.

Essential oils are another alternative to DEET.

They are recommended for children 3 years and older. EPA repellents with oil of lemon eucalyptus or soybean are likely to be as effective as 10% DEET; however, for those living in a Zika or Malaria endemic area, DEET or Picaridin is recommended. It’s important to note that many essential oils are not approved by the U.S. Environmental Protection Agency (EPA) for safety and efficacy.

Many parents prefer the least “chemical” option and feel more comfortable using essential oils as a bug repellent for their child. Stickers, patches, or bracelets, commonly made with essential oils such as citronella, are often popular as an “all-natural” way to prevent mosquito bites. Although these can offer some level of protection, they are less effective than topical repellents like DEET or Picaridin. It’s also important to note that their effectiveness is mostly limited to the area immediately surrounding the bracelet or patch. This means other parts of the body still remain vulnerable to bites.

When choosing an insect repellent, it’s most important to make sure it actually repels the insects! You can start with something less potent, such as essential oils, and if it works for your child—great! If not, consider a more effective repellent, such as Picaridin or DEET.

Check out the EPA website for a search tool that can help you choose the best EPA-registered repellent for you and your family. You can clarify which insects, the necessary protection time, and your preferred active ingredients.

Regardless of the insect repellent you choose, follow these general safety tips:

• First, read the label and reapply according to the instructions on the packaging.

• Patch test the product on a small area of your child’s skin before applying it everywhere to make sure there is no reaction.

• Apply insect repellent to the outside of the child’s clothing and exposed skin.

• It’s best to apply the repellent to younger children to ensure it’s done appropriately.

• DO NOT apply insect repellent to children under 2 months.

• Do not spray insect repellent directly onto the face; instead, rub it into your hands and then on the face, avoiding the eyes. 

• Avoid spraying repellent into open wounds since it will sting!

• Avoid products that combine sunscreen and insect repellent. Sunscreen needs to be applied more frequently, and using these combination products may lead to overuse of DEET or underuse of sunscreen. When you need both, apply sunscreen first and then insect repellent.

• Keep insect repellent out of the reach of children to prevent misuse or ingestion.

Preventing insect bites is multilayered, and insect repellent is just one layer. Other prevention strategies are also important to reduce the risk of bug bites. Take extra caution during dusk, dawn, and nighttime when mosquitoes are most active. Dress your child in long pants, lightweight long-sleeved shirts, socks, and closed shoes, especially in areas with high insect exposure, like during hikes. Avoid clothing with bright colors or flowery prints, as these attract insects, and refrain from using scented soaps, perfumes, or hair sprays on your child for the same reason. Additionally, be vigilant around stagnant water where mosquitoes breed, and treat your property if it is prone to mosquitoes to further reduce the risk for mosquito bites.

Looking for more information?

Watch this PedsDocTalk YouTube video for more bug bite information—including why some people seem more prone to mosquito bites, why bug bites itch, what mosquito bites look like, more prevention tips, favorite repellents to use for children, how to treat mosquito bites, and when to see a clinician.

On The Podcast

As a board-certified pediatrician in the U.S., the recommendations are usually independent sleep for a baby. But I know firsthand that many families do co-sleep and, at some point, want to transition their baby out of co-sleeping. I welcome Ashley Olson, a certified pediatric sleep consultant and founder of @heavensentsleep.

We discuss:

• The biggest mistake parents make when going from co-sleeping to independent sleep

• What “habit-stacking” is and how to implement

• What parents may struggle with when transitioning to an independent sleep space and how to approach

Ask Dr. Mona

An opportunity for YOU to ask Dr. Mona your parenting questions!

Dr. Mona will answer these questions in a future Sunday Morning Q&A email. Chances are if you have a parenting concern or question, another parent can relate. So let's figure this out together!