A group of experts assembled by the World Health Organization examined the evidence on COVID-19 and its transmission in children, as well as the limited evidence available on child use of masks.
Based on that analysis and taking into account other factors, such as psychosocial needs and developmental milestones of children, WHO and the UN Children’s Fund (UNICEF) recommended that the use of a mask should not be mandatory for children under five years of age, for the sake of the safety and general interest of the child and given their inability to properly use a mask with minimal assistance.
The WHO and UNICEF recommend that children from 12 years of age use a mask in the same cases as adults, particularly when a minimum distance of one meter from others cannot be guaranteed and there is widespread transmission in the area.
Organizations advise, however, to always consult and respect the practices recommended by local authorities.
The masks that children should use
Generally healthy children can wear cloth or hygienic masks. In this way, it is possible to control the origin, that is, to avoid transmitting the virus to other people if the child is infected and is not aware that it is.
The adult providing the cloth mask should ensure that it is the correct size and sufficiently covers the child’s nose, mouth and chin.
Children with underlying health problems such as cystic fibrosis, cancer, or immunosuppression should, in consultation with their healthcare providers, wear medical or surgical masks.
Medical masks reduce the spread of the virus and protect the user and are recommended for anyone who is at higher risk of becoming seriously ill from COVID-19.
The correct way to use the mask
Children should follow the same principles as adults regarding the use of masks. This includes cleaning your hands before putting on the mask for at least 20 seconds if using a hydroalcoholic gel or at least 40 seconds if using soap and water.
Make sure that the mask is the right size to cover the nose, mouth, and chin. Children should be taught to use the mask correctly and, among other things, not to touch the front of the mask, not to pull it towards the chin or to put it in their mouth. They should keep the mask in a bag or envelope and not share it with anyone.
Masks for children with COVID-19
All children with symptoms suggestive of COVID-19 should wear a medical mask for as long as they can handle it. The child should be isolated and seek medical help as soon as she begins to feel ill, even if the symptoms are mild. Family members or caregivers who come within a meter of the sick child at home must also wear a mask.
Any household member who is ill or has tested positive for COVID-19 should isolate themselves from everyone else, if possible. If the child comes within one meter of a sick person at home, both the adult and the child should wear a medical mask during that time.
Masks and sports
It is not recommended for children to wear the mask while playing sports or physical activities, such as running, jumping or playing on the playground, so that it does not affect their breathing. When organizing these types of activities for children, it is important to apply the rest of the fundamental public health measures: maintain a minimum distance of one meter from others, limit the number of children who play together, facilitate access to facilities for hand hygiene and encourage their use.
Masks and visors as an alternative option
In the context of COVID-19, some children may not be able to use masks, either due to certain disabilities or in specific situations, such as speech therapy classes, in which the teacher needs to see their mouths.
In these cases, face shields can be considered an alternative to face masks, but they do not provide equivalent protection to avoid transmitting the virus to others.
If you decide to use a mask, it must cover the entire face, surround it on both sides and extend below the chin. In addition, care must be taken when using them to prevent them from breaking and causing injury to the eyes or face.
Adults should use a mask with children
In areas of widespread transmission, all adults under the age of 60 and in general good health should wear a cloth mask when they cannot guarantee a distance of at least one meter from others. This is particularly important for adults who work with children and who may have close contact with children and with each other.
People 60 and older and those with an underlying condition, such as heart disease, diabetes, or lung cancer, should wear a medical or surgical mask, as they are at higher risk of becoming seriously ill from COVID-19.