Shaken Baby Syndrome

A large number of child deaths are reported in South Africa each year. A lot of deaths relate to neglect, abuse or murder. Despite this, there's a knowledge gap in relation to understanding the issue....

Amniotic fluid problems

The importance of amniotic fluid Amniotic fluid is essential for pregnancy and foetal development. Amniotic fluid is a watery substances residing inside a casing called the amniotic membrane or sac. ...

Choosing a pre-school

Becoming a parent is a momentous; life-changing event filled with hopes, expectations and naturally some fears. Parents often learn and grow alongside their children, as they face the challenges of pa...

Newborn reflexes

Although newborn babies are physically helpless and vulnerable at birth, they have a number of amazing innate abilities or reflexes. Reflexes are involuntary movements or actions, designed to protect ...

Mastitis

Mastitis is an inflammation of the breast that can lead to infection. The word “mastitis” is derived from the Greek word “mastos” meaning “breasts”, while the suffix “-itis” denotes “inflammation”. Ma...

Pelvic floor exercises

Although your new baby will probably bring you immense emotional satisfaction, physically you may feel uncomfortable and strange in your own skin. After 9 months of pregnancy and hormonal changes, you...

Colic

Babies cry because they need to communicate something and most parents, especially new moms, find it distressing to see or hear an unhappy baby. In time, you will learn to recognize the various causes...

Antenatal Classes

Antenatal classes are informative sessions provided to prepare expecting parents for the birth of their child and the early days of being a parent.Most antenatal classes are run by Midwives and occasi...

Strap-in-the-Future

The Decade of Action for Road Safety 2011-2020 was launched on the 11 May 2011. It is a global declaration of war against road crashes and fatalities. According to Mr Sibusiso Ndebele, MP Minister of ...

  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Insect Bites

Insect bites and stings are common in children, particularly during the summer and spring months. Arthropods that often bite and sting include spiders, mites, ticks, mosquitoes, wasps, bees, ants, flies and fleas. Stings from bees, wasps and other insects are generally more painful than dangerous. The body’s natural response to the stinger and injected venom is localised pain, redness and mild swelling. Most insect bites result in a small red bump; others are larger, having a hive-like appearance, and some have a small water blister in the centre. These are normal reactions to an insect bite and do not mean that your child has an allergy or that the bite is infected. However, a small percentage of people are hypersensitive to insect bites and stings, resulting in more serious conditions such as anaphylaxis and Lyme disease. Bees (the domestic honey bee, the Africanised ‘killer bee’, and the bumble bee), wasps (including paper wasps, hornets and yellow jackets), and ants (including fire ants) are more likely to cause allergic reactions than any other type of bite or sting. It is therefore important to know how to prevent and treat common insect bites and stings (About.com, 2010; eMedicinehealth, 2010; Netdoctor, 2010; Seattle Children's Hospital Research Foundation, 1995-2010).

 

Symptoms

The symptoms of insect bites vary, depending on the type of insect, the age of the child, her sensitivity to it, the number of stings and whether or not she has been exposed to the insect before. Insect bites may be single or multiple, depending on the feeding habits of the insect involved. For example, fleas produce multiple bites, while mosquitoes may only bite once. Symptoms may include localised pain, mild swelling, redness, itching, blisters or, in severe cases, life-threatening anaphylactic reactions. As a rule of thumb, if the reactions stay localised to the site of the bite or sting, they are not serious (About.com, 2010; dhysanijivani, 1965).

 

The signs and symptoms of anaphylaxis include

·         Problems swallowing

·         Tightness in the throat and chest

·         Hypotension or low blood pressure

·         Diaphoresis or sweating

·         Dizziness, racing heartbeat or fainting

·         Weakness

·         Itching

·         Hives

·         Wheezing and breathing difficulties

·         Stomach cramps, diarrhoea, or nausea (About.com, 2010; Advameg, Inc., 2010)

 

Diagnosis

Your doctor will determine if your child has an allergy to an insect sting by taking a thorough history from his patient or their parents, as well as performing a medical examination, to determine the severity of the insect bite or sting and the presence of any symptoms common to insect sting allergic reactions. An allergist may perform skin testing on your child to determine her specific sensitivities (Advameg, Inc., 2010).

 

Treatment

 

Itchy insect bites

·         Place an ice cube in a wet washcloth and press it gently against the wound for 20 minutes

·         Apply calamine lotion or baking soda to the wound

·         If the itching is severe, apply 1% hydrocortisone cream to the wound, 3 times per day, until                the itching subsides

·         If the bite is still very itchy after local treatment, give your child an oral antihistamine such as              Benadryl. This is particularly helpful in allergic children and children who are having sleep       difficulties due to severe swelling and itching

·         Discourage your child from scratching the bite, in order to prevent infection (Raising Children             Network, 2006-2010; Seattle Children’s HospitalResearch Foundation, 1995-2010)

 

Painful insect bites

·         Bees leave their stinger and its attached venom sac in the wound. If you can see the sting,  brush or scrape it off sideways, using a bank card, the blunt edge of a knife or your finger.     Avoid squeezing the sac as this will only inject more venom into the wound. Wasp stingers do          not have an attached venom sac

·         Place a cold compress on the affected area for 10 minutes, to reduce the pain and swelling

·         A cotton wool ball soaked in baking soda solution can also be applied to the wound for 15-20              minutes to ease the pain

·          Give your child liquid paracetamol or ponstan in appropriate doses for pain relief (Collins,    2003; Leary, 1990; Seattle Children’s Hospital Research Foundation, 1995-2010).

 

Infected insect bites

If the insect bite has a scab on it that looks infected:

·         Wash the wound thoroughly

·         Apply an antibiotic ointment 3 times per day

·         Place a Band-Aid on the wound

·         Repeat this process until the wound is healed

·         If the infection is not responding to treatment and seems to be spreading (drains pus,          increases in size, has red streaks, increasing redness or tenderness in general), your child  needs to be seen by a doctor (The Children’s Hospital, 2010)

 

Anaphylactic shock

Sometimes the sting of an insect produces a severe allergic reaction. Swelling of the face, hands and neck, watery eyes, constriction of the airways and breathing difficulties can occur within minutes of an insect sting. If the symptoms of anaphylactic shock appear, urgent medical attention is required.

·         Call an ambulance immediately as an allergic reaction to insect stings can be fatal

·         Support your child in a way that makes it easiest for her to breathe, such as in a semi-sitting                position

·         Loosen your child’s clothing around the neck and waistband to facilitate breathing

·         Provide your child with reassurance while you wait for help

·         If your child loses consciousness, check her condition. If she is breathing, place her in the     recovery position. If not, give her rescue breaths (Collins, 2003)

 

The recovery position

·         Place your child on her left-hand side

·         Grasp the thigh furthest from you and gently roll your child over, by pulling the bent leg       towards you

·         As you roll, keep her right hand under her left cheek

·         Bend her upper leg to form a right angle

·         Place her lower arm in a position that will prevent her from rolling forwards

·         Tilt her head slightly backwards, to ensure that her airways are open (Collins, 2003)

·         Hold your child securely in your arms

·         Tilt her head downwards to keep the airways open (Collins, 2003)  

 

Rescue breaths

Rescue breathing is the act of breathing for a person who is not breathing, but has a pulse.

·         Tilt your child or infant’s head backwards, in order to open up her airways

·         Place your mouth over hers and provide 1 slow breath, every 3 seconds

·         Count the seconds as ‘one-one thousand’, ‘two-one thousand’, etc

·         In the case of infants, gently pinch their nose shut when placing your mouth over theirs, to                 make a seal

·         After 5 rescue breaths, check for signs of circulation such as movement, breathing , coughing             or normal colour

·         If there are no signs of circulation, begin CPR (cardiopulmonary resuscitation), chest               compressions with rescue breaths, until medical treatment can be given

·         For babies, place your middle and index fingers just below the line on the breastbone between the nipples. Press down sharply with your fingertips to one-third of the depth of the chest. Release the pressure but keep your fingers in this position. Repeat 5 times in approximately 3 seconds. Give 1 rescue breath and repeat this cycle, i.e. 5 compressions to 1 rescue breath

·         For children less than 8 years, find the point where the ribs meet under the breastbone. Place your middle finger on the bottom of the breastbone and your index finger on the bone just above it. Slide your other hand down the breastbone until it reaches your 2 fingers and press down sharply on the chest 5 times in 3 seconds, as above (Collins, 2003; Oracle Think Quest, 1997)

 

Insect bites and allergies

People who are allergic to insect bites should carry a card, bracelet or necklace to let other people know that they have an allergy. Ensure that your family knows how to use any prescribed medication if an allergic reaction occurs. Give an epinephrine injection into the muscle of the upper thigh, if you have an anaphylactic kit. Children who have had severe reactions to insect stings should have allergy shots (venom immunotherapy) or hyposensitisation to all 4 members of the stinging insect family. These shots are generally very effective (Leary, 1990; Netdoctor, 2010; The Children’s Hospital, 2010).

 

Prevention

In order to prevent insect bites and stings:

·         Cover your child’s skin with light clothing, including a long-sleeved shirt, long pants, socks and            a hat

·         Lighter coloured clothing is less likely to attract bugs

·         Avoid using fragranced skin care products on your child, as they tend to attract bugs

·         Apply insect repellents on a regular basis. Insect repellents that can safely be used in children            include those with less than 10% DEET, or those made from citronella or soybean oil. Carefully                 follow the instructions and age restrictions on the insect repellents you are considering using

·         Apply insect repellents to your child’s clothing so as to minimise absorption into their skin

·         Use insect repellents sparingly and make sure they do not get into your child’s mouth or eyes.          Roll-on repellents are preferable to aerosols when used in children

·         Wash insect repellents off as soon as possible

·         Insect repellents do not protect against stinging insects including bees, wasps and fire ants

·         When your child has possible exposure to ticks, such as when camping or hiking, perform daily          tick checks to prevent tick-borne diseases, such as Lyme disease

·         Use insect screens on all doors and windows to prevent insects from getting into your house.            Use mosquito nets over beds and your baby’s cot in endemic areas.

·         Make sure all household pets are free of fleas by regularly using anti-flea preparations. All  carpets and furniture should also be sprayed

·         Avoid drinking directly from open soft drink cans, especially when outdoors. Insects such as               wasps and bees are attracted to sugar and may enter a can. If a child inadvertently drinks from

     the can, she runs the risk of being stung

·         If you are surrounded by a swarm of wasps or bees, back away slowly. Do not make any       violent movements, such as trying to wave them away, as this will only excite them, make       them more aggressive and more likely to attack

·         Look out for insects’ nests in your garden or home and have them removed immediately.   Never aim a blow at an insect’s nest or attempt to throw them because this will result in the     insects becoming violent and attacking

·         Keep the windows in your car and home closed to keep insects out (About.com, 2010;          dhyansanjivani, 1965; Netdoctor, 2010; Raising Children Network, 2006-2010).

 

 

References

http://www.dhyansanjivani.org

http://www.seattlechildrens.org

http://library-thinkingquest.org

http://thechildrenshospital.org

http://www.emedicinehealth.com

http://www.healthofchildren.com