Q: What kind of insect repellent should I buy for my children?
A: Warm weather means more kids are getting outside to play, hike and enjoy the fresh air with family and friends.
Warmer weather also means preventing insect bites.
Insect-transmitted illnesses include Lyme disease, West Nile disease, Zika and others from mosquito and tick bites.
One way to protect your child from biting insects is to use insect repellents.
When there's a possibility of getting a serious illness such as Lyme disease from an insect bite, make sure you choose repellent that is effective.
The U.S. Environmental Protection Agency regulates and approves insect repellents for their safety and effectiveness. DEET is approved as a safe and effective repellent.
The concentration of DEET in a product indicates how long the product will be effective — a higher concentration works for a longer time. For example, 10% DEET provides protection for about 2 hours, and 30% DEET protects for about 5 hours. Concentrations of more than 50% DEET provide no added protection. You can choose the lowest concentration to provide protection for the among of time spent outside. For example, if you plan to be outside for one hour, you can choose 10% DEET.
DEET-containing repellents should not be harmful if parents follow directions on the label to use the product safely. DEET products can cause skin rashes especially when high concentrations are used, but these reactions are rare.
In addition to DEET, picaridin and other products are considered safe and effective by the EPA.
Here are several repellent tips:
— Choose products in the form of sticks, lotions or unpressurized sprays.
— Read the label and follow all directions and precautions.
— Only apply insect repellents on the outside of your child's clothing and on exposed skin — not under clothing.
— Use just enough repellent to cover your child's clothing and exposed skin. Using more doesn't make the repellent more effective. Repellents such as DEET should only be applied once a day.
— Use spray repellents in open areas to avoid breathing them in.
— Help apply insect repellent on young children. Supervise older children when using these products.
— Wash your children's skin with soap and water to remove any repellent when they return indoors and wash their clothing before they wear it again.
— Keep repellents out of young children's reach to reduce the risk of unintentional swallowing.
— Avoid sprays in pressurized containers to avoid inhaling the product or getting it into eyes.
— Never apply insect repellent to children younger than 2 months of age. Instead, use mosquito netting over baby carriers or strollers in areas where your baby may be exposed to insects.
— Avoid applying repellent to children's hands; children sometimes put hands in their mouth and eyes.
— Avoid repellent candles that may trigger breathing problems when fumes are inhaled.
— Never spray insect repellent on your child's face. Instead, spray a little on your hands first and then rub it on your child's face. Avoid the eyes and mouth.
— Do not spray insect repellent on cuts, wounds or irritated skin.
— Do not use products that combine DEET with sunscreen. These products can overexpose your child to DEET because the sunscreen needs to be reapplied often — every 2 hours while in the sun, and after swimming or sweating.
“Natural” insect repellent ingredients include citronella, geranium, peppermint and soybean oil. These are deemed safe but have not been approved for effectiveness by the EPA. Most of these keep insects away for only a short time. In addition, some natural repellents can cause skin irritation.
There are other products marketed to families that are not proved to be effective against mosquitoes. These include wristbands soaked in chemical repellents and ultrasonic devices that give off sound waves meant to keep insects away.
Natural and other alternative repellents can be fine if there is no concern about getting a serious insect-borne illness. If you are in an area known to have ticks, however, DEET, picaridin or another product that's proved to be effective is a better option.
Dr. Sophie J. Balk is an attending pediatrician at Children's Hospital at Montefiore in New York and a professor of pediatrics at Albert Einstein College of Medicine. She also is an executive committee member of the American Academy of Pediatrics Council on Environmental Health and Climate Change. For more information, go to HealthyChildren.org, the website for parents from the AAP.