Lyme Disease in Babies and Toddlers

If your little one spends a lot of time outside, she’s likely learning about the creatures found in the great outdoors: birds, butterflies and all sorts of lovable critters. One introduction you’ll want to avoid, however, is an encounter with ticks. It's extra important to protect babies and toddlers from ticks — and learn the signs and symptoms of Lyme disease, a serious but treatable condition spread via tick bites.

What is Lyme disease?

Lyme disease is a bacterial infection that’s transmitted through the bite of infected black-legged ticks, also known as deer ticks. You’ll most likely find these ticks in the spring and summer months and in the Northeastern, Mid-Atlantic and Central regions of the U.S. The western black-legged tick also spreads the disease along the Pacific Coast.

Immature deer ticks called “nymphs" cause the most infections. They’re about the size of a poppy seed and small enough to remain undetected on the skin for days — although adult deer tick bites can also cause Lyme disease. After an infected tick latches on, it usually takes 36 to 48 hours for Lyme disease to be transmitted. 

The Centers for Disease Control and Prevention (CDC) estimates that 476,000 people contract Lyme disease each year in the U.S. That number may increase since many cases go unreported and the tick’s geographic range has increased. Most cases are reported in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia and Wisconsin.

Lyme disease symptoms in children

The signs of Lyme disease are the same for children of all ages as well as for adults. If you do notice symptoms, contact your pediatrician immediately. Symptoms of Lyme disease get more serious the longer the illness goes untreated.

Early symptoms

Lyme disease may make itself known early on with signs like:

• A red, circular rash that later resembles a bull’s eye. It may get bigger or multiply the longer the infection remains untreated. It can be warm to the touch or itchy, but it's not normally painful.
• Flu-like symptoms, including fever, chills, nausea, headache, joint pain, swollen lymph nodes, poor appetite and neck stiffness.

Later symptoms 

When Lyme disease isn’t caught in the early stages, it can spread to other parts of the body. It most commonly ends up in the joints, particularly the knees and wrists, where it can lead to swelling and pain (aka arthritis).

If Lyme disease spreads to the nervous system, it can also cause swelling around the brain and spinal cord (called meningitis), typically resulting in headache, neck stiffness and nausea. In some cases, it can cause a facial droop, also known as facial palsy.

You may also notice:

• A red rash on other parts of the body
• Irregular heartbeat
• Fatigue
• Flu-like symptoms similar to those found in early stages
• Swollen lymph nodes

All of these conditions are treatable and usually have good outcomes, but it’s important to catch the disease in the early stages to avoid more serious complications.

Treatments for Lyme disease in kids

Your child’s doctor can check for Lyme disease with lab tests. If the tests come back positive, the pediatrician will start an antibiotic treatment.

The treatment for Lyme disease is the same for babies, toddlers and children of all ages. It's safe, and children usually respond really well to it.

Infections with less severe symptoms are usually treated for two weeks with amoxicillin. When Lyme disease causes truly swollen joints, not just pain, it can take four weeks to treat, often using doxycycline.

Preventing Lyme disease in kids

Since it usually takes 36 to 48 hours for a deer tick bite to transmit Lyme disease, the best prevention is to check for ticks after spending time outdoors and safely remove deer ticks before they can cause infection. To help prevent and protect against Lyme in your little ones:

• Dress for success. Long sleeves and pants may keep ticks from biting your little one's skin. Light clothing, in particular, makes it easier to spot deer ticks, which are brown and about the size of a poppy seed.
• Treat clothing and gear with 0.5 percent permethrin. This insect repellent is especially effective in repelling ticks and protects clothing over several washes.
• Use insect repellents on exposed skin. Tick repellents containing either DEET or picaridin are considered safe and effective at preventing tick bites. That said, the American Academy of Pediatrics (AAP) does not consider DEET safe for babies under 2 months of age and cautions against using products with more than 30 percent for children of any age. Most experts suggest applying 10 percent DEET before your little one heads outside and only using repellent once per day. Do not use DEET-containing sunscreen on small kids, because sunscreen needs to be applied more often than insect repellent.
• Do thorough, daily tick checks. When your little one comes in from the outdoors, especially near wooded areas, make sure to do a head-to-toe tick check, being careful to scan hidden areas like the scalp, groin and armpits. It’s a good policy to check your child at bath time each night. Also, screen your pets with fur regularly. They can carry ticks and then pass them along to your baby or toddler.
• Remove ticks the right way. To safely remove ticks, use tweezers, working as close to the skin as possible. Pull the entire tick from the skin slowly and steadily until it releases to ensure that it remains intact. Wipe down the area with warm soap and water. Do not use petroleum jelly or a lit match to remove the tick, since doing so actually causes the tick to embed deeper into the skin. If you can't remove the tick entirely or think the bite occurred more than 24 hours ago, talk to your doctor.
• Save the body. If possible, place the tick in a plastic bag for identification.

Is it Lyme disease or is it the flu?

While there are some similarities between early Lyme disease symptoms and the flu, they’re very different illnesses. Flu symptoms in babies and toddlers include fever, cough, sore throat, runny nose, muscle aches, fatigue, nausea, vomiting and diarrhea. 

Lyme disease symptoms include joint pain, swollen lymph nodes and headache in addition to fever, chills and nausea. Lyme is also most common during the spring and summer months, when the flu is usually uncommon. Additionally, many people who get Lyme disease also have a noticeable bull’s eye rash.

If you notice symptoms in your child — like the familiar bull’s eye rash — talk to your doctor immediately. The sooner the illness is treated, the less likely your baby or toddler will experience more serious complications. Luckily, Lyme is very preventable, and even if your little one does become infected, treatments are safe and effective.