Your baby’s skin is smooth and soft, and smells addictively delicious. But it’s also pretty sensitive, so at some point or another, he might get exposed to an irritant that triggers hives.

Baby hives can sometimes look alarming, and they can make your little one uncomfortable. So what should you be doing to help his skin calm down — and keep it protected in the future? Here’s everything you need to know about baby hives, including when to call the doctor.

What are baby hives?

Hives are a common skin condition marked by red, raised bumps or welts. They often look like mosquito bites, but they can also be blotchy. And they can form anywhere on your baby’s body: Hives may cluster in one area, but they’re just as likely to occur all over. The bumps sometimes come and go within a few hours, but hives can also linger for weeks or even longer.

A mild case of hives might not bother your baby. But they can cause itching or irritation. And occasionally, they’re accompanied by more serious symptoms that call for medical attention.

What are the symptoms of baby hives?

How do you know the red, mosquito-bite-like bumps on your baby’s skin are hives and not something else? Hives often have a pale center and tend to form in clusters. And their location, shape and size can all change over the course of a few hours.

Hives aren’t always uncomfortable. But they can itch or sting, as well as cause puffiness, swelling or redness. They can sometimes occur with nausea, vomiting or stomach discomfort too.

It’s also possible (though rare) for a baby with hives to go into anaphylactic shock — a life-threatening condition marked by trouble breathing or even losing consciousness.

What causes hives on a baby?

Hives are one of the body’s responses to an allergic or inflammatory reaction. When mast cells (which are part of the immune system) sense something irritating, they release the chemical histamine into the circulation. That causes those telltale red bumps to appear.

The tricky thing is that there are a lot of irritants that can trigger baby hives. Some of the most common culprits include:

  • Foods, especially allergens like peanuts, tree nuts, egg whites, milk, shellfish or sesame, as well as fruit

  • Other allergens, like pollen or pets

  • Viral infections

  • Over-the-counter or prescription medications such as Advil or antibiotics

  • Bee stings or insect bites

  • Exposure to the sun or cold

  • Scratching

  • Contact with chemicals

Because they have so many different causes, figuring out the culprit behind your baby’s hives isn’t always easy. (In fact, around half of cases don’t have an identifiable cause.) One clue that can help? Hives tend to form within a few minutes to two hours after exposure to the offending irritant. When your baby gets them, thinking about the substances he’s recently been exposed to could give you an idea of where the hives came from.

For hives that keep showing up, keeping a log of your baby’s symptoms can also help you uncover the cause.

Remedies for hives

A mild case of hives will go away on its own, usually within a few days (and sometimes within a few hours). And if your baby isn’t bothered by them, treatment isn’t needed. For older children, a non-drowsy antihistamine may be a good option for helping your little one feel better faster. Just be sure to call the pediatrician first to figure out the right dose based on your baby’s age, weight and height.

If your baby is too young for antihistamines or you’d prefer to treat his hives without medications, you’ve still got some good options:

  • Apply cool compresses. Soak a washcloth in cool water and apply directly to the hives to soothe itching and discomfort.

  • Draw a lukewarm oatmeal bath. Sprinkle colloidal oatmeal into your baby’s tub to relieve itching, but keep baths to 10 minutes or less.  

  • Trim your baby’s nails or put on baby mittens. Both can help prevent scratching, which causes hives to get irritated.

  • Dress your baby in comfortable clothes. Loose cotton duds are less likely to irritate hives than outfits that are tight-fitting or itchy.  

  • Minimize exposure to heat or cold. If your child is sensitive to the heat, try to stay out of the sun and use air conditioning. If cold, dry air seems to be an issue, use a humidifier inside and dress him in warm layers when you go out.

What should you do about baby hives on the face?

Hives on your baby’s face might look particularly concerning. As long as they aren’t accompanied by lip or mouth swelling, though, you can treat them just like hives that appear on other parts of his body. But if you do notice any swelling around his mouth or lips, you should call 911 immediately, since that could be a sign of anaphylaxis.

When should you call the doctor if your baby has hives?

Contact your baby’s pediatrician if you suspect that the hives were caused by an insect bite or sting, from eating a certain food, or taking a certain medication. These can be signs that your baby has an allergy, and it’s possible that he could have a worse reaction next time. His doctor can help you figure out next steps to keep him safe, like referring him for allergy testing.

You should also call the doctor if your baby’s hives or itching get worse instead of better or if he develops other symptoms in addition to the hives. 

Finally, call 911 right away if your baby’s hives are accompanied by serious symptoms like trouble breathing or swallowing, mouth or lip swelling, or nausea or vomiting. These can all be signs of anaphylaxis, which is life-threatening.

Hives are a common baby woe that can leave your little one itchy or uncomfortable. The good news is that they’re easy to manage at home most of the time and they tend to go away fairly quickly. But if you have any concerns — even if the hives seem mild — give your baby’s pediatrician a call. There’s never any harm in getting some extra peace of mind.