Wasp and bee stings in children: what helps and when it is dangerous

Scrape out the sting if it was a bee, wash, cool for ten to fifteen minutes and ease the itch with an over-the-counter cream or antihistamine from the apotek (pharmacy). That is enough for almost every sting, even when the swelling gets large. Call 112 (the emergency number) if your child's face, lips or throat swell, if they wheeze, come out in hives all over the body, go pale and dizzy, or have been stung in the mouth. Call 1177 (the national healthcare helpline) for many stings at once or swelling that keeps growing after two days.

A Saturday at the end of August, a picnic on a blanket in Hagaparken, a can of squash and a three-year-old barefoot in the clover. That is what a wasp sting looks like in Stockholm almost every time: late summer, a sweet drink, bare feet. Wasps are at their most numerous and most irritable in August and September, and children get stung more often than adults because they flap, run and drink from cans they cannot see into. Here is what to do in the first minutes, what is normal over the next few days, and the signs that mean you stop waiting.

First aid, in order

1. Move away from the spot, calmly. Wasps sting again and call in others if they are swatted.
2. Sting out if it was a bee: scrape along the skin with a fingernail, a bank card or a knife. Don't squeeze with fingers or tweezers, that pushes more venom in. A wasp leaves no sting behind.
3. Wash with soap and water.
4. Cool for ten to fifteen minutes: something cold wrapped in a towel, a cold wet top, a bag of frozen peas.
5. Soothe: an over-the-counter hydrocortisone cream for swelling and itching, or an over-the-counter antihistamine in the dose for your child's age. The apotek will help you choose. Pain relief in the dose for age and weight if needed.
6. Keep an eye on them for half an hour. Allergic reactions come on fast. If your child looks their usual self after thirty minutes, it is almost always just a sting.
7. Take off rings and bracelets if the sting is on the hand, before it swells.

Normal or allergic?

	Normal reaction	Large local reaction	Allergic reaction
Where	At the sting	Around the sting, up to ten centimetres or more	Parts of the body away from the sting
What	Pain, redness, swelling, itching	Heavy swelling that grows for one to two days, a whole hand or forearm	Hives on the body, swelling of the face, lips or throat, wheezing, hoarseness, dizziness, paleness, vomiting
When	Straight away	Increases over two days	Usually within half an hour
What you do	Cool, cream, go home	Cool, antihistamine, call 1177 if it keeps growing after two days or is on the face	Call 112. Adrenaline pen if your child has one

Call 112 if

• Your child has trouble breathing, wheezes, is hoarse or coughs after the sting
• Lips, tongue, face or throat swell
• Your child comes out in hives or redness over large parts of the body, far from the sting
• Your child goes pale, dizzy, drowsy, clammy or faints
• Your child vomits or gets stomach pain shortly after the sting
• The sting is in the mouth, on the tongue or in the throat, even without other symptoms
• Your child has a known allergy to wasps or bees and has been stung: give the adrenaline pen first, then call

This is what makes wasp stings different from mosquito bites. Serious allergic reactions are rare in children, but they move fast, and they are the most common reason a sting becomes dangerous. A child who has had an allergic reaction should then be assessed by a doctor and is often given an adrenaline pen to carry, and the förskola (municipal preschool, from age one) and the nanny should know where it is.

Call 1177 if

• Your child has had many stings at once, for example after stepping on a nest
• The swelling keeps growing after two days, or spreads far from the sting
• The sting is close to the eye or the swelling closes the eye
• The sting becomes infected after a few days: increasing redness, heat, pus, fever
• Your child is under one and you are unsure

The next few days

The swelling is often at its worst on day two, and the itching arrives once the pain has passed. It itches most at night. Cut the nails, dress them in cool clothes, put a cold wet towel around the sting at bedtime, and give antihistamine in the evening if the apotek has approved the dose. A child who scratches the sting open gets an infection, and that is the most common complication, not the venom. Redness that grows after three days, with heat and pus, is an infection and should be looked at. How to care for a sting that has been scratched open is in Wound care for children.

How to avoid stings, from July onwards

• Drinks in a glass or a bottle with a lid, never from a can. Wasps crawl into the fizzy drink can and sting in the mouth.
• Cover the food at the picnic and eat quickly. Jam, fruit, ice cream and barbecued meat attract wasps.
• Shoes on in the grass in August, especially in clover and under fruit trees where bees and wasps sit.
• Stand still. Teach your child that a wasp that lands flies away if you stay still, and stings if you swat. It is hard for a three-year-old, but it can be practised.
• Wipe mouth and hands after ice cream and fruit.
• A wasp nest near the play area or the house: don't go near it, and get help to have it removed.
• Check the sting in the evening while you are looking for ticks anyway, see Tick bites in children.

How we do it with our families

In late summer our nannies swap the juice cans for bottles with lids without being asked, and they clear away the jam as soon as the children have eaten. In August, Denise was with a four-year-old in Solna who was stung on the foot at a picnic in Hagaparken. She took off his shoe, cooled it with a wet top from her bag, and then sat with him on her lap and watched him for half an hour while his big sister played: his breathing, his lips, his skin. Then she rang his mum and told her what had happened and that he was his usual self. Her note gave the time, where the sting was and that cream would be needed in the evening. If a child is allergic we want to know at the first meeting, and where the adrenaline pen is kept.

This article is general information and does not replace advice from BVC (the child health clinic every family is enrolled in), your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.

Read more: Tick bites in children · Food allergies in children · Wound care for children · Summer holidays in Stockholm with kids

Frequently asked questions

What is the difference between a wasp sting and a bee sting?

A bee leaves its sting with the venom sac in the skin and then dies, so the sting needs to come out straight away: scrape with a fingernail or a card, don't squeeze. A wasp keeps its sting and can sting several times. Otherwise the pain and the treatment are the same: wash, cool, ease the itch.

How long does a wasp sting hurt?

The sharp pain passes within one to two hours. Swelling, redness and itching can increase for one to two days and last up to a week. Local swelling of ten centimetres around the sting is unpleasant but normal. Swelling that spreads far from the sting, or to the face, is a reason to call 1177.

How do we know if our child is allergic?

In an allergic reaction, symptoms appear in parts of the body away from the sting: hives all over the body, swelling of the face, lips or throat, wheezing, hoarseness, dizziness, paleness or vomiting, usually within half an hour. That is a call-112 situation. Your child should then be assessed and is often given an adrenaline pen.

Our child was stung in the mouth, what do we do?

Call 112. A sting in the mouth, on the tongue or in the throat can swell enough to block the airway, even in children who are not allergic. Give them something cold to suck on, like an ice cube or an ice lolly, while you wait, and keep your child upright and calm.

What eases the itching?

Cooling for ten to fifteen minutes, an over-the-counter hydrocortisone cream or an over-the-counter antihistamine in the dose for your child's age, which the apotek will help you choose. Cut the nails so your child doesn't scratch the sting open, because that is how stings get infected. A cold wet towel works at night.