Can babies use off-the-shelf (over-the-counter) bug sprays?

Bug Spray Safety for Babies

Babies can use insect repellents, but only after 2 months of age, with strict age-based restrictions on product type, concentration, and frequency of application.

Age-Specific Recommendations

Infants Under 2 Months

• Insect repellents should NOT be applied to infants younger than 2 months of age 1
• For this age group, rely exclusively on physical barriers: mosquito netting over cribs, strollers, and carriers 1
• Permethrin-treated clothing and netting provide protection without direct skin application 2, 3

Infants 2-6 Months

• Topical repellents may be used only in exceptional circumstances of severe arthropod exposure risk (e.g., endemic areas with high disease transmission) 1
• Maximum of 1 application per day when use is absolutely necessary 1
• Use the lowest effective concentration available 2

Infants 6-12 Months

• Topical insect repellents can be used once daily as standard practice 1
• This represents the age when routine use becomes more acceptable for disease prevention 1

Children 1-12 Years

• Up to 2 applications daily are considered safe 1
• DEET-based products at concentrations providing adequate protection can be used 4

Recommended Active Ingredients

DEET (N,N-diethyl-3-methylbenzamide)

• Most effective repellent against mosquitoes, biting fleas, gnats, and chiggers since 1956 2
• Provides longest duration of complete protection compared to all alternatives 4
• A 23.8% DEET formulation provides mean protection time of 301.5 minutes 4
• Minimum 10% DEET concentration needed to repel ≥94% of insects for 9 hours when disease vectors are present 5
• Risk of serious side effects is slight when used appropriately 2
• Use the lowest effective concentration to minimize any potential risks 2, 1

Alternative Repellents (Less Effective)

• Picaridin (7%): Demonstrated little repellency in controlled studies 5
• IR3535: Provided only 22.9 minutes of average protection 4
• Soybean oil-based products: Protected for average of 94.6 minutes 4
• Oil of lemon eucalyptus (PMD): May offer protection but duration significantly shorter than DEET 3
• Botanical repellents: Provided mean protection of less than 20 minutes 4

Application Guidelines

Safe Application Practices

• Apply to exposed skin only; avoid application under clothing 2
• Never apply to hands, eyes, mouth, or irritated/broken skin 2
• Adults should apply repellent to their own hands first, then apply to child's skin 2
• Wash treated skin with soap and water when protection is no longer needed 2
• Wash treated clothing before wearing again 2

Permethrin for Clothing

• Apply permethrin to clothing, not directly to skin 2, 3
• Permethrin-treated clothing provides better protection against ticks than DEET alone 2
• Offers longer-lasting protection when combined with topical DEET 3
• 0.5% permethrin showed little direct repellency but works through contact insecticidal effects 5

Critical Safety Considerations

Neurotoxicity Concerns

• Risk of severe side effects has been related to DEET misuse and potential neurotoxicity 1
• This underscores the importance of following age-based frequency restrictions 1
• Long-term (subchronic/chronic) toxicity data in pediatric populations is limited 1

Products to Avoid

• Repellent-impregnated wristbands offer no protection and should not be relied upon 4
• Products claiming repellent effects without active ingredients (e.g., certain moisturizers) are ineffective 4

Environmental Health Context

Broader Pesticide Concerns

• The American Academy of Pediatrics recognizes that exposure to certain chemicals during critical developmental periods has been linked to poorer cognitive, behavioral, and social development 6
• However, this primarily applies to organophosphate (OP) pesticides used in agriculture, not topical insect repellents 6
• Pediatricians should help reduce exposures to potentially harmful substances through education 6

Risk-Benefit Assessment

• In endemic areas where arthropod-borne diseases pose substantial threats (malaria, dengue, Zika, Lyme disease), the benefits of appropriate repellent use outweigh potential risks 1, 3
• Physical barriers should always be the first line of defense, with chemical repellents as an additional protective measure 1

Common Pitfalls to Avoid

• Never use repellents on infants under 2 months except mosquito netting 1
• Do not exceed age-appropriate application frequency (critical for preventing toxicity) 1
• Avoid high-concentration products when lower concentrations are adequate 2
• Do not apply DEET to plastic materials as it can dissolve certain plastics 5
• Never rely on botanical or "natural" products alone in high-risk disease transmission areas 4