Masks and children during Covid-19

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Courtesy of American Academy of Pediatrics

The CDC now recommends people over age 2 wear cloth face masks when outside their homes. Below are some frequently asked questions about the use of face masks for children during the COVID-19 pandemic.

Why are people wearing masks right now? 

  • CDC recommends that people wear a cloth face covering over their nose and mouth in the community setting during the COVID-19 pandemic, however, children younger than age 2 should not wear masks.
  • The purpose of people wearing masks in public right now is to protect the community. Since so many people who have COVID-19 don’t have symptoms, wearing masks can help reduce the possibility that someone with no symptoms could transmit the disease to others.
  • Since masks reduce the spray of that person’s spit or infectious respiratory droplets, masks can help reduce this kind of spread of the virus.
  • Masks also can protect you from others who may have coronavirus but are asymptomatic and who could come within 6 feet of you, which is the range of transmitting infection through acts like sneezing or coughing.

Is there a “right way” to wear and use a mask? 

  • Yes. For a mask to be safest and most protective for children and adults, they should securely cover the nose and mouth and stretch from before the ear to the other side.
  • Masks should not be worn when eating or drinking.
  • Masks should not be touched when on.
  • Hand washing should take place before and after you remove a mask.
  • Masks should be washed after each wearing. Remove the mask from behind without touching the front of the mask.

Should children wear masks?  

  • The CDC does not recommend masks for children under age two.
  • If children are at home with just the usual residents, they do not need to wear a mask, assuming that they have not been exposed to anyone with COVID-19.
  • If children can be kept at least 6 feet away from others, and not be in contact with surfaces that could harbor the virus, then they do not need a mask for the protection of themselves or others.
  • For example, during a walk outdoors, as long as children can maintain social distancing of more than 6 feet and do not touch tables, water fountains, playground equipment or other things that infected people might have touched, then they will not acquire the infection and would not need masks.
  • Especially for younger children who may not understand why they can’t run up toward other people or touch things they shouldn’t, the best approach is to keep them home and in spaces away from other people and common surfaces.
  • Places where a child would benefit from wearing a mask are places where they are likely to encounter other people at a closer than 6 foot range. For example, if you must take your child to the doctor, or the pharmacy or grocery store, and are unable to leave them at home, wearing masks in those settings could be beneficial.
  • Children with fever or respiratory or GI symptoms like a cough, congestion, runny nose, diarrhea, or vomiting should not leave home.
  • Children with severe cognitive or respiratory impairments may have a hard time tolerating a face mask, so special precautions may be needed with these children, such as monitoring with a pulse oximeter if available, and/or maintaining greater physical distance from others outside their home.
  • Situations in which children should not wear a mask include:
    • Children under the age of 2 years, due to risks of suffocation.
    • If the only face covering available is a possible choking or strangulation hazard.
    • If the child has difficulty breathing with the face covering or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.
    • If wearing the face covering causes the child to increase risk of getting exposed to the virus because they are touching their face more frequently.

What about infants or children with special health care needs? 

  • If you must go outside or to a place where you are not able to practice social distancing with an infant, cover the infant carrier with a blanket, which helps protect the baby, but still gives them the ability to breathe comfortably. Do not leave the blanket on the carrier in the car or at any time when the baby and carrier are not in direct view.
  • Children who are considered high-risk or severely immunocompromised are encouraged to wear an N95 mask to best protect themselves.
  • Families of children at higher risk are encouraged to use a standard surgical mask if they are sick to prevent the spread of illness to others.

What if a child is scared of wearing a mask, or too young to understand not to tamper with it? 

  • If your child is scared of wearing a mask, parents should wear masks too so your child doesn’t feel alone. Some other ideas to help make masks seem less scary are:
    • While wearing masks, look in the mirror and talk about it.
    • Put a mask on a favorite stuffed animal.
    • Decorate a mask so it’s more personalized and fun.
    • Show your child pictures of other children wearing masks.
    • Draw a mask on their favorite book character.
  • Have your child practice wearing a mask at home first.
  • For children under 3 years old, it’s best to answer their questions simply in language they understand. If children ask about people wearing masks or other face coverings, parents can explain that sometimes people wear masks when they are sick, and when they are all better, they stop wearing the mask.
  • An important way to reassure children is to emphasize how you are taking steps to stay safe. Children feel empowered and less afraid when they know what to do to keep themselves safe.
  • For children over age 3, try focusing on germs. Parents can explain that germs are special to your own body and we need to make sure they stay within your body. The masks help keep your own germs to yourself. Some germs are good, some are bad – we can’t always tell which are good or bad, which is why you need to wear a mask.  Some germs can make you sick. We to make sure you keep those germs away from your own body.
  • One of the biggest challenges with having children wear masks relates to them “feeling different” or stereotyping them as being sick. If this becomes more of a norm, it will help children not to feel singled out or isolated, and they may feel strange not wearing something.

What kind of material is best for a mask for the average person to wear? 

  • Homemade or purchased cloth masks are suitable for the average person to wear. For a child, especially a small child, ensuring the right fit is important.
  • Pleated masks with elastic are likely to work best for children, but the right size is important. Adult masks are usually 6×12 inches, and even a child-sized 5×10 inch mask may be too large for young children. Try to find the right size for your child’s face and be sure to adjust it for a secure fit.

Due to very limited supply now, professional grade masks like N-95 masks should be reserved for medical professionals on the front lines who have increased risk of exposure to coronavirus in close proximity.

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