Health Information

Symptoms

• Usually cause itchy, red bumps in a group or line
• Often they look like a hive or mosquito bite
• Bite may have a red dot (puncture) in the center. This is where the bed bug bit through the skin.
• Occasionally, a small blister can occur in the center
• Bites are usually on exposed skin (arms, legs and face)
• Bites are usually first noted in the morning

Diagnosis

• Live bed bugs hide and are not usually seen. Close inspection of the mattress may find some.
• They are ¼ inch (6 mm), flat, oval shaped, reddish-brown bugs.
• Suspect bed bugs if over 3 red bumps in a row are on exposed skin. The bumps or bites are very itchy.
• Bed bug waste (feces) are found on bedding or mattress seams. It looks like dark brown flecks or coffee grounds.
• A blood stain on the sheet may sometimes be found. This is from a bug smashed after feeding.

Cause

• Bed bugs are small visible blood-sucking bugs. They are about ¼ inch (6 mm) in length.
• During the day, bed bugs hide in the corners of mattresses. They may also be found in bed crevices, floors, and walls.
• At night, the bed bugs come out of hiding. They feed on humans for about 5 minutes.

Prevention of Getting Bed Bugs

• Over half of bed bug infestations within homes start after recent travel.
• Avoid hotels and hostels where bed bugs have been reported. (see bedbugregistry.com)
• When you check into a hotel room, look for signs of bed bugs. Look for flecks of their waste (like coffee grounds) in the bedding and mattress. If present, ask for another room.
• Keep your luggage and clothing on a luggage rack off the floor.
• When you return from a trip, place all travel clothing into the clothes dryer. Run the dryer for 20 minutes. (Reason: The heat will kill any bed bugs or their eggs that are present). One pregnant bed bug can spread bed bugs to an entire house.

Care Advice

1. Overview:
   • Bed bug bites cause itchy red bumps.
   • They are usually less than ½ inch (12 mm) in size.
   • Some are larger (like a hive). These are normal reactions to a bed bug.
   • A large hive does not mean your child has an allergy.
   • The redness does not mean the bite is infected.
   • Bed bugs do not carry any infectious diseases.
   • Don’t panic: You can get rid of bed bugs from your home.
   • Here is some care advice that should help.
2. Steroid Cream for Itching:
   • To reduce the itching, use 1% hydrocortisone cream (no prescription needed).
   • Apply 3 times a day until the itch is gone.
   • If you don’t have, apply a baking soda paste until you can get some.
3. Allergy Medicine For Itching:
   • If the bite is still itchy, try an allergy medicine by mouth.
   • Benadryl is a good one. No prescription is needed.
4. Try Not to Scratch:
   • Cut the fingernails short.
   • Help your child not to scratch.
   • Reason: Prevent a skin infection at the bite site.
5. Bed Bug Repellents - Not Helpful:
   • Insect repellents do not keep bed bugs from biting.
   • Repellents containing DEET (used on skin) and permethrin (used on clothing) do not help.
6. Removing Bed Bugs from Your Home:
   • Getting rid of bed bugs requires a licensed pest control service.
   • Look in the phone book or on the internet under Pest Control.
7. What to Expect:
   • Any pinkness or redness usually lasts 3 days.
   • The swelling may last 7 days.
   • The itch may last for 2 weeks.

Call Your Doctor If

• Bite looks infected (redness gets larger after 48 hours)
• Large red bumps last more than 7 days
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

#AAP