Face Masks in Child Care Programs

Images used with permission from the National Center on Health, Behavioral Health, and Safety

*This page has been updated to include Summer 2021 guidance from the California Department of Public Health, the Centers for Disease Control, and the American Academy of Pedatrics. 

Wearing a face mask is one of the most effective ways to reduce your risk of getting COVID-19 and spreading it to others.  You can combine masks with other layers of protection such as getting the COVID-19 vaccine, washing your hands frequently with soap and water, staying home when you are 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 mainly spreads between people through the air.  You can spread virus when you talk, laugh, or sing.  You do not have to feel sick or be coughing and sneezing to spread the virus.  When a person with COVID-19 is wearing a mask, most of the virus particles in their breath and saliva get trapped inside their mask.

If you are standing near a person with COVID-19 and 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.

Child Care Program Face Masks

Children and masks

Children in child care programs are not yet eligible for COVID-19 vaccination, and so they need to rely on masks to protect them from getting and spreading COVID-19.  The Centers for Disease Control and Prevention (CDC) recommends that children aged 2 years and older wear masks in child care programs, 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.  If using a cloth mask, choose one made with two or three layers of tightly woven fabric.  Choose a mask material that is comfortable and can be washed frequently.  Some cloth masks have a pocket for a filter that should be changed every day.  Disposable masks like KN95 or surgical masks also work very well, but must be thrown away at the end of each day.  Finding the right mask takes some experimenting.  

When to wear a mask

COVID-19 spreads more easily indoors, especially when people are close together, breathing the same air, for long periods of time.   If you are spending time indoors, masks protect you from getting or spreading COVID-19.  Outdoors, where there is more space for people to spread out and there is plenty of fresh air, COVID-19 does not spread as easily.   Even so, when there is a lot of COVID-19 spreading in your community, you also need to wear a mask outdoors.  You can check the spread of COVID-19 in your county using this website: https://covid.cdc.gov/covid-data-tracker/#county-view .  

Children need to remove their masks for eating and drinking.  Seating them as far apart as possible, facing the same direction, helps them avoid spreading virus.  If the weather is good, eating outdoors is even safer.  Children also need to remove their masks for sleeping.

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.

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.

When masks get wet or dirty

It’s a good idea for staff and children to have two to three extra masks on hand each day in case theirs get wet or dirty.  Put a wet or dirty mask in a sealed plastic bag, label it with the owner’s name, and send it home to be washed .

Wash masks daily with the regular laundry, or by hand with soap and water.  Try to touch only the ear loops or ties before washing, and wash your hands afterwards.

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. 

Getting children and adults used to wearing masks in the child care setting is worth the effort to limit the spread of COVID-19.  We may continue this new health habit in the future when we want to avoid spreading illness, especially during cold and flu season.  

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 (2021) Guidance for Child Care Providers and Programs at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx# 

California Department of Public Health (2021) Face Coverings Q&A at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Face-Coverings-QA.aspx

Centers for Disease Control and Prevention (2020) Use Masks to Slow the Spread of COVID-19 at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

Centers for Disease Control and Prevention (2021) COVID-19 Guidance for Operating Early Care and Education/Child Care Programs  https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/child-care-guidance.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

North Carolina Child Care Health and Safety Resource Center (2021) Face Coverings in Child Care at https://healthychildcare.unc.edu/wp-content/uploads/sites/17234/2021/02/Face-Covering-Use-in-Child-Care-2021.02.04.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

This article was made possible with funding from the Heising-Simons Foundation.

Parents