Should children wear a face mask?

Text and Photos by Henrylito D. Tacio

Natalia Lapinig is only three years old.  When the coronavirus disease 2019 (COVID-19) started, she and her parents were staying at home.  The father, Normel, went out to the market only when they needed food and medicines.

Two weeks ago, her mother, Meryl, brought her outside the house to mingle with her cousins and some relatives.  Every time she goes out of home, her mother places a loose-fitting mask that covers her nose and mouth as one of the health protocols to avoid being infected with the dreaded virus.

Natalia doesn’t complain at all or shows tantrum whenever Meryl puts on her a face mask.  She knows that whenever her mother does it, they would be coming out from home.

It may be alright to keep the baby safe but the question is: should children wear a mask?  What do health experts say about this?

“People should always consult and abide by local authorities on recommended practices in their area,” said the Geneva-based World Health Organization (WHO) in a press statement.

The WHO brought together recently an international and multidisciplinary expert group to review evidence on COVID-19 disease and transmission in children and the limited evidence on the use of masks by children.

Based on this and other factors such as childrens’ psychosocial needs and developmental milestones, the United Nations health agency and UN Children’s Emergency Fund (UNICEF) issued this advisory:

“Children aged 5 years and under should not be required to wear masks.  This is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance.”

The two UN agencies advise the decision to use masks for children aged six to eleven should be based on the following factors:

  • Whether there is widespread transmission in the area where the child resides;
  • The ability of the child to safely and appropriately use a mask;
  • Access to masks, as well as laundering and replacement of masks in certain settings (such as schools and childcare services);
  • Adequate adult supervision and instructions to the child on how to put on, take off and safely wear masks;
  • Potential impact of wearing a mask on learning and psychosocial development, in consultation with teachers, parents/caregivers and/or medical providers; and
  • Specific settings and interactions the child has with other people who are at high risk of developing serious illness, such as the elderly and those with other underlying health conditions.

Are there any situations where children aged 5 years and under may wear or not be required to wear a mask?

As stated earlier, children aged 5 and under should not be required to wear masks.  “This advice is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance,” the WHO explained.  “There may be local requirements for children aged 5 years and under to wear masks, or specific needs in some settings, such as being physically close to someone who is ill.  In these circumstances, if the child wears a mask, a parent or other guardian should be within direct line or sight to supervise the safe use of the mask.”

Children with underlying health conditions – such as cystic fibrosis or cancer – should wear a medical mask in consultation with their medical providers.  “A medical mask provides protection to the person wearing the mask and prevents transmission to others,” the WHO stated.  “It is recommended for anyone who has underlying health conditions that put them at greater risk of serious illness.”

Children who are in general good health can wear a non-medical or fabric mask.  “This provides source control, meaning it keeps the virus from being transmitted to others if they are infected and are not aware that they are infected,” the WHO said.  “The adult who is providing the mask should ensure the fabric mask is the correct size and sufficiently covers the nose, mouth and chin of the child.”

Like adults, children must follow the same principles when wearing face masks.  This includes cleaning hands at least 20 seconds if using an alcohol-based hand rub, or at least 40 seconds if using soap and water, before putting on the mask.

“Make sure the mask is the right size to cover the nose, mouth and chin,” the WHO urged.  “Children should be taught how to wear the mask properly, including not touching the front of the mask and not pulling it under the chin or into their mouth.  They should store the mask in a bag or container, and not share the mask with others.”

When children are playing sports or doing physical activities, they are not obliged to wear face masks.  Examples include running, jumping or playing on the playground.  Children are not advised to wear face masks when doing these activities so that their breathing isn’t compromised.

“When organizing these activities for children, it is important to encourage all other critical health public health measures: maintaining at least a 1-meter distance from others, limiting the number of children playing together, providing access to hand hygiene facilities and encouraging their use.” – ###

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