COVID-19 Protection- Should Children Wear Masks?
Health organizations and authorities around the world are recommending that everyone should wear a mask to protect themselves and to protect others from COVID-19. But what about children? Are face /cloth covering and face masks recommended for children of all ages? This article will address this issue and provide an overview of the universal recommendation on face coverings and masks for children during the COVID-19 pandemic.
Should children of all ages wear masks?
It is important to note that masks can provide the same type of protection in the context of COVID-19 to a child as to an adult. According to the Centre for Disease Control and Prevention(CDC), cloth face coverings should be worn by everyone in public, except for children younger than two, or those who have trouble breathing, the unconscious, the incapacitated, and those unable to remove the cloth face-covering without assistance (1). The American Pediatrics Academy (APA) maintains the same position as CDC, recommending that children should not wear a face covering at home or outside, as long as they have not been exposed to anyone with COVID-19). Outside, they should maintain a physical distance of two meters and avoid touching their faces (2).
Are there any specific types of masks recommended for children?
CDC guidelines specify that general face coverings can be homemade from simple cloth. To encourage children to wear masks, they could be made from material with unique designs, drawings, or cartoons. Parents, caregivers, and teachers should also educate children on the proper use and disposal of the masks.
It is essential to follow the advice of local authorities and international organizations regarding children’s masks in particular. The benefits and risks should always be considered, especially in certain situations.
APA recommends that only children who are considered high-risk, or who are severely immunocompromised, should wear an N95 mask for protection. Their families are encouraged to use a standard surgical mask if they are sick to prevent the spread of illness to others (2).
The Association of Schools of Public Health in the European Region (ASPHER) and the European Academy of Pediatrics (EAP) confirmed, in a joint statement, that they recommend only safe masks (ergonomically designed with elastic bands) for children. A mask that is large and that allows air to pass through the sides will compromise the children’s safety and might expose them to infection. Hat shields, a hat with 360º plastic protection around the child’s head and shoulders, are a good solution for children aged between two and six.
Are there any conditions when masks are not recommended?
There are conditions where the harm caused by the mask may exceed its benefit, especially among children with special education and psychological needs. For example, if a child is admitted to hospital, parents/caregivers should follow the doctor’s advice. Children with severe cognitive or respiratory impairments may have a hard time tolerating a face covering. For these children, special precautions may be required.
A communication plan about the use of the mask, its placement, and disposal, etc., based on the pedagogical needs of children and their age group, is recommended (3).
How can we encourage children to wear masks?
As wearing masks may be uncomfortable for children and may cause fear, the following recommendations and tips may help children accept wearing masks (1, 2, 3):
- Use storytelling, role play, and games.
- Put a face covering on a favorite stuffed animal.
- Help your child to decorate their mask, making it more personalized and fun. Show your child pictures of other children wearing them.
- Draw one on their favorite book character. Practice wearing the face-covering at home to help your child get used to it.
- For children under three, discuss the importance of face masks using simple language. Explain that some people might need to wear a mask if they are sick, for example. It may be useful to discuss with them what good and bad germs are and how the cloth face coverings help keep the harmful germs away from the body.
Finally, staying home and physical distancing are still the best ways to protect yourself and your family from COVID-19. Children who are sick (fever, cough, congestion, runny nose, diarrhea, or vomiting) should stay at home (2).
- World Health Organization (2020). Advice on the use of masks in the context of COVID-19: interim guidance, 6 April 2020. World Health Organization. https://apps.who.int/iris/handle/10665/331693 License: CC BY-NC-SA 3.0 IGO
Dr. Iffat Elbarazi
Assistant Professor in Public Health
College of Health Sciences
Abu Dhabi University