Face masks guidance for children and adults


Do Masks work? 

  • Masks remain a simple and effective tool to protect against COVID-19, especially for children too young to get the vaccine. 
  • The providers and staff in our office were amazed that close to ZERO cases of colds, croup, bronchiolitis, pneumonia, ear infections, asthma exacerbations, hand foot and mouth, strep throat  from March 2020 until Memorial Day of May 2021. The minute that people stopped wearing masks and social distancing, our office has been inundated with illnesses that are transmitted from our nose and mouth.
  • Here is an article that summarizes 49 scientific studies that explain why face masks work: https://www.kxan.com/news/coro...

Why do we still need to wear face masks for any and all settings where social distancing is difficult (grocery store, school, child care, camp, indoor sports and even some outdoor sports?

  • It is possible to have COVID-19 but not have any symptoms. 
  • Due to the circulating and highly contagious Delta variant, the CDC and the American Academy of Pediatrics recommends universal indoor masking by all students (ages 2 and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.
  • Children under the age of 12 who are not eligible for vaccination at this time. 
  • A significant number of children, teachers and school employees are immunocompromised and are particularly vulnerable to COVID-19, even if they have been vaccinated.

All children age 2 and older should wear a mask at school unless the child has: 

  • Developmental delay
  • Limited physical mobility 
  • Severe autism 
  • Structural abnormalities of the head or neck (some of these children may be able to wear bandanna-style coverings. 

Parents of children who are unable to wear a mask for these reasons may choose remote learning from home.

How do I help my child get used to wearing a mask? 

It is understandable if your child seems afraid of wearing a mask at first. Here are a few ideas that might help make them more comfortable:

  • Look in the mirror with the face mask on and talk about it.
  • Put a mask on a favorite stuffed animal.
  • Decorate them so they're more personalized and fun.
  • Show your child pictures of other children wearing them.
  • Draw one on their favorite book character.
  • Practice wearing the face mask at home to help your child get used to it.

For children under 3, it's best to answer their questions simply in language they understand. For example, you may want to simply explain that people need to wear masks to stay healthy.

For children over 3, try focusing on germs. Explain that some germs are good and some are bad. The bad ones can make you sick. Since we can't always tell which are good or bad, the face masks help make sure you keep all those germs away from your body.

The good news is, children have gotten used to masks and are less likely to feel singled out or strange about wearing them. It has quickly become the "new normal" for all of us.

What kind of face mask is best?

Face masks with multiple layers of fabric are fine for most people to wear. Try to find the right size for your child's face. Adult masks are usually 6x12 inches, and even a child-sized 5x10 inch covering may be too large for small children.

How do I keep my child from touching their face mask?

It may be challenging for very young children not to fidget with their face mask, so expect to give your child plenty of gentle reminders. When mask-wearing is reinforced by adults and peers, they will learn to follow directions. Just like children understand that they must wear bicycle helmets and buckle into their car seats, they will learn to wear masks correctly and routinely when needed.

How do I protect my baby who is too young for a mask?

The best way to protect your baby is to practice physical distancing, and encourage people who are around your baby to wear face masks and take other measures to reduce COVID-19 risk.

Remember: Along with physical distancing, hand washing and vaccination as soon as everyone in your family is eligible, mask wearing is key to reducing SARS-CoV-2 infection and spread. 

Mask guidance for specific conditions

  • Allergies. There is no medical reason that allergies should prevent children from wearing masks. If a child is suffering from allergy-associated nasal congestion, over-the-counter or prescription steroid nasal sprays may provide relief. 
  • Asthma. Children with asthma should not be exempt from wearing masks, nor should masks cause asthma symptoms. It is always important for children to follow their prescribed asthma action plan, including their maintenance medications. Masks should be removed if a child experiences active asthma symptoms. If the asthma symptoms prevent wearing a mask, then the family should see their physician to work together to improve their asthma care. 
  • Anxiety. This is a difficult time for children who suffer from anxiety. Parents can support them by modeling appropriate mask wearing and providing factual, reality-based information about COVID. Anxiety is not a medical reason for not wearing a mask. 
  • Cardiology. There are no cardiology conditions that make wearing a mask unsafe for children who are well enough to attend school. 
  • Developmental Disabilities: Some children with limited physical and/or mental capacity may not be able to wear masks safely. Masks may agitate some children with autism. 
  • ENT. Children who have structural abnormalities of the head, neck or face may not be able to wear a traditional mask safely, but may be able to use a bandanna-style mask. These may also be helpful for children with tracheostomies. 
  • Hematology/oncology. If cancer and blood disorder patients are well enough to attend school in person, they should wear masks. 
  • Neurology. There are no neurological conditions that make wearing a mask unsafe for children who are well enough to attend school. 
  • Physical Medicine and Rehabilitation. Some children with limited physical mobility may not be able to wear masks safely. 
  • Pulmonology. There are no pulmonology conditions that make wearing a mask unsafe for children who are well enough to attend school. 
  • Eye irritation/dry eyes: Eye irritation is not a medical reason for mask exemption. Talk to our doctor about what you can do for this.

Obtaining a Medical Mask Exemption: CHMA providers and staff will work in conjunction with parents, and schools to determine whether children qualify for mask exemptions. 

Disclaimer: Given the ever-changing body of information about COVID 19, the information contained here-in is subject to change on a daily basis. Please call our office to talk to a physician if you have any further questions.

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Children's Healthcare Medical Associates

550 Washington Street

Suite 300

San Diego, CA 92103

(619) 297-5437

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8:30 AM-5:00 PM

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