By Elizabeth Valente
STANFORD -- By now, we all know that the novel coronavirus spreads when an infected person speaks, sneezes, or coughs within six feet of others and that wearing a mask or cloth face covering can slow the spread of COVID-19 by limiting the release of virus into the air. As schools get ready to reopen in the fall, many parents are looking for guidance, especially on how to encourage their child to wear a face covering during the pandemic.
Hayden Schwenk, MD, MPH, pediatric infectious diseases physician at Stanford Children's Health, answers some frequently asked questions about face coverings for children: the best types, how to wear them properly, and why they are considered essential barriers.
Why should kids over the age of 2 wear a face covering if COVID-19 seems to be showing up predominantly in adults?
We know that the main way SARS-CoV-2, the virus that causes COVID-19, is spread is by respiratory droplets. Although it appears that children may be less likely to become infected and spread the SARS-CoV-2 virus, if infected, they may still be able to transmit the virus.
People can spread the virus even if they don't have symptoms or are pre-symptomatic, and children are commonly asymptomatic or only mildly symptomatic when infected, so the recommendation is that everyone over 2 years of age wear a mask to prevent the spread of the SARS-CoV-2 virus.
What is the best type of face covering for a child, and do the type of material, the number of layers, and use of a filter matter?
The World Health Organization recommends having a multilayer face covering to stop particles from getting in; however, having a number of layers and a filter may make it difficult for the wearer to breathe. I agree with the CDC recommendations that standard cotton masks (preferably, using tightly woven fabric like that used in a T-shirt) are fine for children.
Can wearing a mask be harmful for a child?
Children under the age of 2 should not wear a mask. Parents of children with special health care needs should speak to their child's pediatrician about face coverings. Also, when a mask impedes a child's ability to breathe normally, or when they are unable to remove the mask on their own if needed, the CDC recommends that a face covering should not be worn.
If the mask resulted in a child constantly touching his or her face, I would consider forgoing its use and focusing on other measures, like frequent hand hygiene, staying home when sick, and social distancing, instead.
What should parents do to encourage their child to wear a mask?
It's important for parents to be open and honest with their child when talking about face masks, and keep the conversation at a level the child can understand. Explain to her why the masks are needed for her safety and the safety of others. Encourage the children to wear face coverings mainly when it is difficult to maintain a distance of six feet from others.
The American Academy of Pediatrics has helpful information for parents about cloth face coverings for children during COVID-19, including:
- Have your child practice wearing the face covering in small increments of time to help him get used to it.
- Put a cloth face covering on a favorite stuffed animal.
- Decorate the masks so that they are more personalized and fun.
- Encourage the child to name the mask and care for it himself.
What is the best way for a child to wear a face covering?
- Have her wear it over her nose and mouth, and make sure that it fits snugly against the sides of her face.
- Show her how to take the mask off by pulling on the ear loops or ties.
- Have her wash her hands before and after handling the mask.
- Teach children not to touch or share their mask.
For more information and guidance on best practices to prevent risk of exposure or transmission of COVID-19, contact your child's physician.
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