Images used with permission from the National Center on Health, Behavioral Health, and Safety
Wearing a face mask was recommended when COVID-19 was present in the community or child care program. Face masks are one of the most effective ways to reduce the risk of getting COVID-19 and spreading it to others, especially when local COVID-19 hospital admission levels are medium or high.
Face masks help reduce the spread of any respiratory illness, such as the flu, respiratory syncytial virus (RSV), or colds. Combine masks with other layers of protection such as getting vaccines, washing hands frequently with soap and water, staying home when sick, and avoiding crowds. In your child care program, wearing a mask helps protect you, your coworkers, and the children you care for from COVID-19.
How masks work
COVID-19 and other respiratory illnesses spread when a sick person shares the air with others. Viruses spread when people talk, laugh, or sing. People do not have to feel sick or be coughing and sneezing to spread the virus. When a person with COVID-19 or other respiratory illness is wearing a mask, most of the virus particles in their breath and saliva get trapped inside their mask.
If you are near a person with a respiratory illness and you are wearing a mask, most of the virus particles that escape their mask will be trapped by the outside of your mask. Their mask and your mask work together so that only a very small amount of virus—or none at all—reaches your nose or mouth.
Children and masks
Now that children 6 months and older are eligible for COVID-19 vaccination, masks are not the only way to protect them from getting and spreading COVID-19. Masks give children extra protection during times when there is a lot of COVID-19 or other respiratory illness spreading in the community. Masks especially protect children who have not been vaccinated or have factors that affect their risk of getting a severe respiratory infection.
Children can wear masks safely as long as they are able to: breathe safely, avoid touching the mask or their face too often, keep the mask from getting wet with drool, and remove it without assistance. Children under 2 years of age should not wear a mask because of the danger of suffocation. Families of children with special health care needs should consult their health care provider about the best type of face covering to wear.
What kind of face mask works best?
A mask works best when it fits snugly against the face, without large gaps on the sides. It must cover both the mouth and nose. It can fasten around the ears or the back of the head, as long as it stays in place when the wearer talks and moves. Finding the right mask takes some experimenting. Choose one from the following that is most comfortable for you or your child:
Best protection:
- Medical grade masks called N95. N95 masks are not usually made for children.
- Medical grade masks called KN95 or KF94.
- A cloth mask layered on top of a disposable surgical mask.
Fair protection:
- A disposable surgical mask.
No longer recommended:
- Most washable cloth masks are no longer recommended by the California Department of Public Health. However, cloth masks that meet specific standards (ASTM F3502-21 Standard Specification for Barrier Face Coverings) provide better protection than common cloth masks.
When to wear a mask
COVID-19 and other respiratory viruses spread more easily indoors, especially when people are close together, breathing the same air, for long periods of time. Outdoors, where there is more space for people to spread out and there is plenty of fresh air, these viruses do not spread as easily.
Check with your local health department to see what is being required in your county or jurisdiction. The Centers for Disease Control and Prevention (CDC) recommends wearing a mask when local COVID-19 hospital admission levels are medium or high. Check the spread of COVID-19 in your county using this website: https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county.
Children need to remove their masks for eating and drinking. During meals and snacks, it is best to seat children as far apart as possible, facing the same direction, to help them avoid spreading virus. If the weather is good, eating outdoors is even safer. Children also need to remove their masks for sleeping.
Wearing masks safely
Everyone should wash their hands with soap and water before and after touching their mask—when putting it on, or when taking it off. Teachers should wash their hands before and after helping a child with their mask. Try to touch only the ear loops or ties, because the part of the mask that touches the mouth and nose may have virus particles on it. When putting a mask on, make sure the correct side is facing out.
To avoid mask mix-ups, each adult and child should have a paper bag or plastic container, labeled with their name, where they can store their mask during mealtimes and naptimes.
When masks get wet or dirty
It’s a good idea for staff and children wearing masks to have extra ones in case theirs get wet or dirty. Disposable masks are meant to be worn once. N95, KN95, and KF94 masks are not designed to be washed, but they can be worn more than one day. Throw them away when they look dirty or worn.
Helping children get used to masks
If children have not been wearing masks regularly, they may need time to adjust. Families can practice wearing masks together when leaving the house. Putting a mask on a child’s stuffed animal may help a child get used to how it looks on others. Parents and guardians can purchase face masks in their child’s favorite color or pattern or give their child a chance to choose their own mask. Smaller, child-sized masks will fit better.
Face masks can interfere with your ability to express and model emotions to the children in your care. Practice showing emotion in other ways, for example by exaggerating your eyes and eyebrows, using more body language, using emotion cue cards, and making a habit of describing your emotions in words.
Resources
American Academy of Pediatrics (2020) Masks or Cloth Face Coverings for Children during COVID-19 at https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx
California Department of Public Health (2023) Get the Most Out of Masking: Tips and Resources at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Get-the-Most-out-of-Masking.aspx
Centers for Disease Control and Prevention (2023) Protect yourself from COVID-19, Flu, and RSV https://www.cdc.gov/respiratory-viruses/index.html
The National Center for Pyramid Model Innovations (2020) Helping Children Understand Emotions When Wearing Masks at https://challengingbehavior.cbcs.usf.edu/docs/Wearing-Masks_Tipsheet.pdf
Strong Center for Developmental Disabilities (2020) A Toolkit for Helping Your Child Wear a Mask During COVID-19 at https://www.urmc.rochester.edu/strong-center-developmental-disabilities/resources/masks-toolkit.aspx
Updated August 2023, UCSF California Childcare Health Program
This article was made possible with funding from the Heising-Simons Foundation.
