Buzz Off: Fact vs. Fiction in Mosquito Repellent Choices

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//  Age Recommendations

The American Academy of Pediatrics (AAP) considers DEET safe for use on infants over two months old. The US CDC have declared that when used in any stage of pregnancy, DEET does not pose a hazard to the developing fetus.

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//  Concentration Levels

DEET-based repellents are available in various concentrations, ranging from 5% to 80%. For babies, it is generally recommended to use products with lower concentrations (around 10% or less). Higher concentrations are more suitable for older children and adults, but should still be used sparingly and as directed. 

The concentration of DEET in a product does not make it better at repelling mosquitoes, but rather indicates how long the product will be effective (within limits). You can choose the lowest concentration to match the time spent outside. For example, 10% DEET provides protection for about 2 hours, and 30% DEET protects for about 5 hours. A higher concentration works for a longer time, but anything over 50% DEET does not provide longer protection.

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//  Proper Application

It is crucial to apply DEET-based repellents correctly to ensure safety. Avoid applying the repellent near the eyes, mouth, or hands, and do not apply it on open wounds or irritated skin. Apply a thin layer evenly on exposed areas of the baby's skin, using caution to prevent accidental ingestion or contact with the eyes. A lotion or roll-on formula will limit the amount that is airbourne and reduce inhalation of the product. If using a spray formula with infants, you can spray it on your hands and then transfer that immediately onto the infant's skin (washing your hands afterwards!). With older children, apply in a well-ventilated area and encourage than to turn their head away from the area being sprayed.

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//  Limit Use

DEET should be used sparingly and only when necessary. Apply it when your baby is likely to be exposed to mosquitoes, such as during outdoor activities in mosquito-prone areas. If mosquitoes in your home are an issue, looking into getting screens for your windows and doors would be a better long-term investment than using mosquito repellent all day, everyday (especially in areas where mosquito-borne disease risk is low).

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//  Alternative Options:

Although declared safe, and the most effective repellent, some parents prefer to avoid DEET altogether. Let's look at some alternative mosquito repellents available: 

Picaridin:

Products containing the chemical picaridin, also known as KBR 3023, are also considered effective and safe for use on babies over two months old (although the AAP still recommends DEET over picaridin for effectiveness). Always read the labels and choose products specifically formulated for infants. Picaridin is noted to be about as effective as 10% DEET concentration, so keep this in mind when assessing the time it is used for.

Natural liquid repellents:

Another alternative is natural mosquito repellents. Whilst many people feel more comfortable with natural products, and they can offer some level of protection, it's important to note that natural repellents generally provide much shorter durations of protection compared to even low concentration chemical-based repellents. This means that they would need to be reapplied more frequently, increasing the overall exposure to that product. Parents are reminded that even natural ingredients can cause skin reactions, especially with repeat exposure. Additionally, natural repellents are known to be less effective in areas with high mosquito populations or when dealing with disease-carrying mosquitoes.

Note: the AAP warns specifically against using products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under age 3 years.

Nets:

For babies in strollers, covering the stroller with a well-fitted mosquito netting is a useful way of reducing their risk. However, mosquito nets are not recommended over cots or beds for babies and toddlers as they pose a risk of entrapment/strangulation.

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//  What is Not Recommended?

There are many common items available to parents that are not recommended:

Stickers or Wrist-bands:

Repellent-soaked stickers or wrist/ankle bands are not recommended by the AAP since they have been repeatedly shown in controlled trials to be ineffective against mosquitoes. Not only are they ineffective, there is known risk of irritation on the skin with the  bands, and accidental choking/swallowing in the case of the stickers.

Ultrasonic devices:

These devices supposedly give off sound waves designed to keep insects away. However, A 2009 review examined 10 field studies of ultrasonic repellent devices concluded that they have no effect on preventing mosquito bites and should not be recommended or used.