By Chris Colón, MS, LCGC, MotherToBaby Teratogen Information Specialist
For many people, summer is an enjoyable time of year. The weather is warmer, more outdoor activities are available, and there are often more chances to spend time with family and friends. Summer is also a time of year that many people experience something less fun: bites and stings. Depending on your location and what you're doing, the chance of bites or stings may be much higher in the summer. Even though many bites and stings are not thought to cause medical problems, women that are pregnant or breastfeeding may be concerned about getting and treating bites and stings. Below are some common bites and stings that people can be exposed to this time of year. This information should not take the place of medical care and advice from your health care provider.
Bug bites and stings, such as those from most mosquitoes, ticks, biting flies, ants, spiders, bees, wasps, hornets, and yellow jackets can cause reactions. For most people, these reactions are usually mild, and have symptoms such as pain, redness, and swelling, which are uncomfortable but not harmful. Some people can have an allergic reaction to certain bites and stings, making those more important to treat quickly. Without medical attention, allergic reactions can cause serious symptoms, like trouble breathing or swallowing, swelling of the face, mouth or throat, and feeling dizzy or lightheaded. If you experience any of these symptoms after a bite or sting, contact a health care provider right away.
Mosquitos and West Nile Virus (WNV)
There are also some bites that can spread diseases. Rarely, mosquitos infected with West Nile Virus (WNV) can pass it to humans. Most people infected with WNV will have no symptoms at all or very mild symptoms. A few people with WNV will develop more serious symptoms, like fever, headache, tiredness, body aches, swollen glands and/or a skin rash on the chest or stomach. There are no specific treatments for WNV, and symptoms often go away on their own. More severe cases may need a lot of medical care or even a stay in the hospital. There is very little information about WNV during pregnancy. There have been reports of over 70 women who had WNV during pregnancy. Only one of these babies was born with medical problems, and it is hard to know if those problems were caused by WNV. More research is needed before we can know how WNV during pregnancy may affect a developing baby. If you think you have developed WNV, contact your healthcare provider, and be sure to let them know if you are pregnant, planning pregnancy, or breastfeeding.
Ticks and Lyme disease
Most tick bites do not carry disease or cause health problems. However, sometimes ticks carry diseases. This includes Lyme disease, an infection that is caused by Borrelia burgdorferi bacterium. Symptoms of Lyme disease are headache, stiff neck, fever, muscle or joint pain and swelling, and a red rash that may look like a "bull's-eye." It's important to treat Lyme disease to avoid more health problems, especially if you are pregnant or breastfeeding. It is usually treated with antibiotics. When correctly treated, Lyme disease has not been shown to increase risks to a pregnancy. If you think you have developed Lyme disease, contact your healthcare provider to talk about your treatment options. Be sure to tell your healthcare provider if you are pregnant, planning pregnancy, or breastfeeding.
Creatures with Venom
Some creatures, like scorpions, snakes, and spiders can have a substance that may be toxic to humans, called venom. Bites and stings from these kinds of creatures are usually not life threatening, and may not need medical treatment. However, some types of venom can be more toxic, especially to young children and older adults. Although it is not very common, bites and stings from creatures that have venom can cause problems in pregnancy such as miscarriage, birth before 37 weeks of pregnancy, the placenta detaching from the uterus before labor (called placental abruption), and stillbirth. Depending on the type of creature and the venom they have, these bites and stings may require medical treatment. If you are stung by a scorpion, snake, spider or other creature that has venom during pregnancy or breastfeeding, contact your healthcare provider. If your symptoms are severe or spread, you should seek medical attention and information from your provider, a local care center or poison control center as soon as possible.
Treating Bites and Stings
If you have a bite or sting and are experiencing only mild symptoms, you can usually treat it yourself. If you need to, remove the stinger or tick carefully without squeezing it. Wash the area with soap and water, and then apply an antiseptic to kill germs. You can use a hydrocortisone cream or calamine lotion and cover the area with a dry, sterile bandage. If there is swelling, use an ice pack or cold compress. Many people take an over-the-counter medicine to treat itching, swelling, and hives, such as an antihistamine. Some also take a pain reliever for mild pain. However, it is suggested that you contact your healthcare provider before starting or stopping any medications (even over-the-counter ones) during pregnancy or breastfeeding.
Preventing Bites and Stings
There are ways to limit your exposure to bites and stings. If you can, avoid places and conditions where you are more likely to get bitten or stung, like wooded and brushy areas with high grass, brush, and leaves. If you are going to be outdoors where and when bugs, snakes and scorpions may be present, wear long sleeves and pants if possible. Avoid wearing sandals or walking barefoot in grass. When eating outdoors, try to keep food covered at all times. Avoid wearing sweet-smelling perfumes, hair sprays, colognes and deodorants, as well as bright-colored clothing. Keep window and door screens in good repair to shield against bugs.
Using bug repellent can reduce and prevent bug bites. Many common brands contain DEET (N,N-ethyl-m-toluamide or m-DET) as the active ingredient, and come in the form of a lotion, spray, or oil that is put onto skin or clothing. DEET use is the most effective protection against malaria, Lyme disease, dengue fever, yellow fever, and the West Nile Virus. Because illness caused by any of these diseases during pregnancy can be harmful to a developing baby, it's important to protect yourself. When used as directed on the package label, DEET has not been shown to cause an increased risk of problems with pregnancy or breastfeeding.
In general, although bites and stings can be annoying, they most often do not lead to serious health problems. Most can be treated without needing medical attention. In rare cases, some bites and stings can lead to allergic reactions or the spread of disease. However, when treated properly, these complications are thought to have low risks, if any, to pregnancy or breastfeeding. So go out there and enjoy the summer and remember to use bug repellent!
MotherToBaby has facts sheets on West Nile Virus and DEET in pregnancy and breastfeeding, which can be found at MotherToBaby.org. For more information on medications and exposures during pregnancy and breastfeeding, call MotherToBaby toll-free at (866) 626-6847. MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS). MotherToBaby and OTIS are suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC).
Chris Colón is a licensed genetic counselor based in San Diego, California. She works as a Teratogen Information Specialist for MotherToBaby and is co-chair of the organization's Education Committee.
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Pregnancy Medications During Pregnancy Exposures During Pregnancy