Many parents are wondering if they should put a mask on their child to protect them from COVID-19. While the American Academy of Pediatrics recommends that children above the age of 2 should wear masks to protect them and others, some parents are wondering how and when it makes sense.
I had an opportunity to talk to a colleague, Dr. Jaime Friedman, a pediatrician at Children’s Primary Care Medical Group in San Diego, for her thoughts on children and masks.
Bhargava: Should your child wear a mask all the time?
Friedman: Like the recommendation for adults, children over the age of 2 should wear a mask or face covering in situations in which they cannot maintain social distancing of 6 feet.
Bhargava: What about special trips such as going to a doctor’s office or hospital?
Friedman: If the nurse or doctor requests the child to wear a mask, it is reasonable to have them wear it to protect the staff and other patients they may be around.
Bhargava: As more states lift shelter in place orders, should kids wear mask in small gatherings or large gatherings?
Friedman: In private, children should wear a mask if they are in a large gathering. Especially if there are elderly people or people in high risk categories. Small gatherings are easier to maintain distance, so whether or not everyone wears a mask should be a mutual decision. In public, children should follow the recommendation of local governments and wear masks when social distancing cannot be maintained, like in a store.
Bhargava: What about biking? Or hiking? Or places where you are not 6 feet apart?
Friedman: When out hiking or biking with the family they are quarantined with, children do not necessarily need to wear a mask. In fact, it might make it harder for them to breathe easily while exerting themselves. Parents should try to stay active in places where staying 6 feet apart is easy. If they must be on a trail or in a location in which they cannot stay 6 feet apart, wearing a mask is recommended if it is safe for the child to do so during their activity.
Bhargava: What if the child has not had symptoms?
Friedman: We know that coronavirus can be spread even before any symptoms occur. Some don’t have any symptoms at all. Because children are more likely to fall in the asymptomatic category, while also being less hygienic, they should wear a mask in any location that requires it, even if without symptoms.
Bhargava: Is there false security by wearing a mask?
Friedman: Definitely! Most people I talk to seem confused. Most people think the mask protects them when, in reality, it protects everyone else. If everyone is wearing a mask, less viral particles are in the air and land on surfaces, so everyone benefits. I have recommended to people that even if they are wearing a mask, they should not have a face-to-face conversation with anyone who isn’t wearing one, especially if that person coughs or sneezes. More importantly, they need to wash their hands before removing the mask and avoid touching the outside of the mask.
Bhargava: At what age should a child start wearing a mask?
Friedman: I never recommend masks for children under 2 years of age, and if they are constantly touching it or playing with it or moving it below their nose, it’s probably best to remove it. For those kids who cannot tolerate wearing the mask, parents should avoid taking them to public places where they can’t maintain social distancing.
Bhargava: What do we do when schools open?
Friedman: If and when schools open in the fall, the use of masks and social distancing in the classroom or staggering hours for different grades and classes, will all depend on where we are with numbers of cases and vaccine development. If schools open but we still have a need for social distancing and masks in public, I would assume the same would be true for schools. The ability to use masks safely and appropriately will definitely vary by age.
Bhargava: What do you do for your own kids?
Friedman: I am wearing a mask in public, as are my children, although they don’t go in public often. I also wear a mask with all patients and office staff.
Bhargava: What if parents don’t follow the mask rule for their kids?
Friedman: I think schools and districts will have to decide on their own policies. If masks are mandatory then everyone has to wear them. Parents will have to comply like they do with vaccines.