Backpack? Check. Pencils? Check. COVID masks? Hmm, better check.
Massachusetts issued a statewide indoor mask mandate in K-12 schools last week until at least Oct. 1. Education Commissioner Jeffrey Riley’s mandate was a strong change of heart from Governor Charlie Baker’s earlier commitment to leaving mask regulations in the hands of local school district officials.
While the decision brings an end to weeks of heated debate over whether kids should cover up, the question of how best to mask their children amid rising cases of the Delta variant presents a new anxiety for many parents. Many have taken to Twitter to share gripes and swap tips about best masking practices, aiming to fill the gap left by a continued lack of concrete data on the most effective masks for children. One Twitter user, Aaron Collins (better known as @masknerd), even compiled a spreadsheet with his ratings for all the 12-and-under masks he’s tested on himself and his children.
But Collins was among many parents to note that the availability of many top-rated masks is starting to “dry up everywhere due to the back-to-school shopping,” further exacerbating parents’ worries. The Globe asked four pediatricians and infectious disease experts for tips on masking children effectively, and what the Delta variant means for the back-to-school season.
The Delta variant is highly transmissible among people of all ages. Is a cloth mask still good enough for kids?
If it’s the right kind, yes.
“Fit is more important than fabric,” said Dr. Nina Dadlez, pediatric hospitalist at Tufts Children’s Hospital. Without a snug fit, particles will take the “path of least resistance” and go right around the mask to the child’s nose and mouth. That’s why finding a mask that kids can keep close to the skin is crucial — and often, that means cloth masks.
“Would I rather have my child wear an N-95 mask for two hours and then wear it below their nose for the rest, or wear something that’s pretty effective and more comfortable all day?” asked Dr. Peter Moschovis, pediatric pulmonologist at Massachusetts General Hospital. “Probably the latter.”
That said, surgical masks are also available in children’s sizes, and some doctors are advising their patients to make the switch.
“I’ve been talking to everyone about upgrading their masks to a surgical mask, since there are comfortable, durable surgical masks for children,” said Dr. Cassandra Pierre, infectious disease physician at Boston Medical Center. For her own family, Pierre said she checks the American Society for Testing Materials, or ASTM, rating of every mask before she buys it, to make sure it offers high filtration of respiratory droplets and good breathability.
Regardless of material, Pierre said parents should be sure to look for masks with at least three layers of filtration, ideally with an adjustable nasal clip. Particularly for children who have spent the summer largely unmasked, testing out different masks prior to the first day of school is also essential.
“Better to start early to be sure that your child is ready for the classroom,” Pierre said. She added that parents should focus on “auditioning types of masks that [kids] wear to make sure that they’re comfortable, that they fit, and that they don’t easily get wet or damaged.”
My children don’t like wearing masks. How can I make it fun for them?
“One trick that has seemed to be useful for families is to get the child to pick the type of mask that they all wear, so it’s almost part of their family heritage,” said Dr. Richard Malley, an infectious disease physician at Boston Children’s Hospital. “Some families will all be wearing certain characters from comic books, or Disney characters, . . . [and] color, emblem, all those types of things are an important way to enlist children into the concept of wearing it.”
For younger children, Dadlez also advised parents to associate mask-wearing with other images of safety. For example, toddlers may want to hold their favorite stuffed animal while they put on a mask, or listen to a bedtime story about their favorite masked hero (the pandemic has produced several). “My son loves to pick which superhero mask he’ll wear each day, it’s almost like an accessory for him,” she said.
If children’s books are hard to come by, parents can make up their own stories, like Pierre does for her two kids.
“We found a mask that had a pink elephant on it like the bedtime story character I had created, and they loved that,” she said.
My kids have sensitive skin, and the mask hurts their ears. What can I do to prevent chafing, and make it more comfortable?
“Cloth masks should be relatively benign, even with sensitive skin,” said Dadlez, but recommended purchasing headbands “where the ear loops can hook to a little button on the headband” if the mask straps cause redness behind the ears.
Pierre also advised parents to look for masks with softer ear loops, or to invest in ear-savers for kids with especially sensitive skin. One added benefit of ear-savers is that “for some kids, it might lead to better adherence to the sides of the face,” she said. Parents looking for a DIY-alternative can also fashion their own ear-savers out of ribbon and paperclips.
Everywhere I look, all the ‘good’ masks are sold out. Where can I find ones that my kid will enjoy, and that keep them safe?
For disposable masks, Pierre recommended these from Dr. Talbot’s because they are specially designed for 2- to 5-year-olds. Older kids may want to try the Pac-Dent iMasks, which are rated ASTM Level 3 and have an adjustable nose piece. Parents using these should send their kids to school with extras, she said, in case they get wet or damaged.
Among Collins’s, a.k.a. @masknerd’s, many high-rated suggestions are these child-sized KN-95 masks from Wellbefore that come in three sizes with adjustable ear loops, as well as breathable KF-94s from Korean company GoodDay HappyLife.
I don’t have the money for a fancy mask, but I still want my child to be safe. Are there lower-cost alternatives?
Purchasing a high-end mask like a KN-95 probably isn’t necessary to keep your kid safe, said Pierre, so parents shouldn’t worry if they can’t track one down. Instead, she reiterated that focusing on fit should remain the top priority. In a pinch, adult masks can be adapted for children, too.
“A small adult mask fits probably 70 percent of children” over the age of 2, said Moschovis, and will fit even better if the mask has adjustable ear loops.
Parents in communities with high COVID transmission may also want to consider double-masking if they’re uncertain about the quality of each mask.
“If you are concerned about any given factor happening in your school — physical distancing, ventilation — and you want to be sure that your child is wearing the safest thing possible, you may want to go for double-masking,” said Pierre, but she added two important caveats: Don’t double up on surgical masks (”It can actually be counterproductive and decrease barrier effectiveness”), and test out the two-mask approach before the first day of school. If your child can’t breathe, or fidgets with the masks, it’s better to stick with just one.