Masks for Kids: What You Need to Know

With a changing virus comes a change in guidance: The omicron variant is even more infectious than earlier variants, so the CDC now recommends using a more protective mask. In areas where transmission is high, everyone, regardless of vaccination status, should continue to wear a mask to stay healthy and help prevent the spread of the virus.  The key is to monitor spread in your community so you know when it’s important to ramp up precautions and when it’s OK to loosen them.

Check out the CDC's COVID-19 County Check widget to quickly find transmission levels in your county.

As of mid-February 2022, for instance, many places had lifted mask mandates as cases began to fall. During times of low spread, the decision to have your child wear a mask is more nuanced and depends on several key factors:

• Your child’s vaccination status (vaccinated children are at much less risk for severe COVID, long COVID and other complications)
• Whether your child or a family member in the household is immunocompromised or at higher risk for severe COVID-19 if they were to get sick
• Your family’s general risk tolerance for having a child with active COVID

The choice to mask or not to mask during times of low community transmission varies depending on your family’s situation and risk tolerance. Every family’s situation and risk tolerance is going to be different, and that’s OK.

Yes. While the omicron variant has been found to be less likely to cause severe disease (meaning it’s less likely for people to need care in the hospital), experts estimate that it’s at least three times as contagious as delta. That means that even though on an individual level you and your child are less likely to be hospitalized with omicron, even individuals that are fully vaccinated can still get sick. Because the variant is so contagious, using effective prevention measures that work for your family is important.

Masks remain a key prevention tool for:

• People who are not fully vaccinated (including children under age 5)
• Individuals with conditions that make it harder for them to fight infection
• Everyone, when local transmission is high

When you are in an area with high transmission, the risk of getting sick also increases and wearing a mask indoors is more important. So, even if mask mandates have been lifted in your area, it’s a good idea to monitor the level of risk in your nearby community and to follow the recommendations of your local public health agency.

Technically speaking, transmission is considered high when there have been more than 100 new cases of COVID reported per 100,000 people over the past 7 days. This is called incidence.

To monitor transmission levels in your community, visit the CDC COVID Data Tracker. If when you enter your state and county, the map appears red, then transmission is high and masking indoors is recommended.

Again, risk tolerance, health status (individually and by family) and local transmission all vary. Even doctors will have differing opinions based on their personal situation.

Take our Chief Medical Officer David Brumbaugh, MD, for example. Here’s how he is weighing his decision.

“My kids are fully vaccinated and no one in my family is immunocompromised; by the time our school district lifts its mask mandate, community spread is expected to be low,” says Dr. Brumbaugh. “When community spread is low, the risk for my family is also lower, and I won’t require my kids to mask at school.

“Masks are no big deal for kids to wear,” Dr. Brumbaugh says. “But, when local viral transmission is relatively low we should strive to get life back to normal for the well-being and mental health of our kids.”

Other individuals, including doctors, may come to a different answer for their families. There are no easy answers, and context matters. Each family needs to consider the entire equation and then make a decision that works for them.

With the omicron variant, which is more contagious, people who have been vaccinated can still get sick with COVID-19 and have the potential to spread it. While the risk of vaccinated individuals getting sick and developing severe disease is very low, transmission is still possible. If your local area is seeing an increase in community spread of the coronavirus, wearing a mask while indoors becomes more important.

In areas and at times of high community transmission, yes, especially indoors. Wearing a mask is also important outside when in crowded group settings where social distancing isn't possible.

COVID-19 still poses a risk to children, especially those who are not vaccinated. Public health guidelines recommend that all kids and adults, regardless of vaccine status, mask while indoors when transmission is high in the community. That includes school.

“We know that COVID-19 still poses a risk to kids, which is why we recommend that children attend school with precautions in-place to protect them,” says pediatric infectious disease expert Jessica Cataldi, MD. “Of those precautions, vaccinations are our most important tools for success, along with masks, hand-washing, testing, distancing, improving ventilation, and quarantine and isolation, when needed.”

Children under 2 should not wear a mask because they may not be able to remove the mask themselves when needed. Because they cannot be protected with masks or vaccines, parents should continue taking other precautions, including distancing when possible and getting all eligible family members vaccinated, to help protect toddlers and babies.

When it comes to which type of mask to have your child wear, all well-fitted masks offer some protection, but some are better than others. Remember these general pointers:

• Disposable medical-grade masks (called surgical or procedure masks) offer more protection than cloth face coverings.
• Respirators (like the KN95 and N95) offer more protection than medical masks.
• Even when it comes to cloth face coverings, some are better than others.
• The “ideal” mask for your child can depend on many factors, including their personal risk if they got sick, how much virus is circulating in your community, cost, convenience and more.

Respirators filter the air and form a seal around the nose and mouth. They offer the highest level of protection against airborne particles, including the coronavirus that causes COVID-19.

When it comes to types of respirators you will see, most are either N95 or KN95:

• N95 respirators are designed for healthcare professionals and are federally regulated to ensure high standards. In healthcare settings, workers are fit-tested to ensure proper fit and protection.
• Respirators that are widely available to the general public, including children, are KN95 respirators. KN95s meet an international standard for quality, but they are not as tightly regulated as the N95. Some KN95s have been found to be poor quality, meaning that they do not provide the level of protection advertised, so it’s important to watch out for counterfeit products.

While K95 respirators do come in children’s sizes and are available at this point in the pandemic, they may not be the most affordable option, especially for daily use at school.

“Disposable surgical masks are a great middle option because they offer more protection than cloth and aren’t as expensive as KN95 respirators,” Dr. Dominguez says. “And, you can always place a cloth mask over a surgical one to increase protection.”

Respirators will not work as intended unless they also fit well and are worn as intended. Even touching or taking a respirator on and off frequently can make them less effective. Any gaps around a respirator, including from facial hair, also inhibit their effectiveness.

Check out this guide from the CDC on how to identify counterfeit respirators.

It depends. It’s true that a respirator offers the best protection, says Dr. Dominguez. “We’ve known all along that a medical mask is better than a cloth mask and a respirator is better than a medical mask. That’s not news. What’s changed is that the omicron variant is more contagious and medical masks and respirators are much more widely available than at the start of the pandemic.”

Each family is different. What’s most important is that you choose the most protective option you can access that:

• Fits your child well and comfortably
• Will be worn consistently
• Is realistic for your budget and situation

If you do opt for KN95s, make sure to:

• Look for gaps and make sure the mask seals correctly
• Choose a size that fits over the child’s nose and under the chin but does not impair vision
• Follow the user instructions for the mask or respirator

In one study published by CDC in February 2022, people who reported always wearing a mask in indoor public settings were less likely to test positive for COVID-19 than people who didn’t. A respirator offered the best protection, followed by surgical masks and then cloth face coverings. Read more about the effectiveness of face mask or respirator use in indoor public settings.

While a mask is better than no mask, context matters. What is most important is that your children wear the most protective mask you can find (and afford) that also fits well and that they will wear consistently.

And remember: Comfort is key. If the mask isn’t comfortable, your kid won’t wear it anyway.

Learn about the types of face coverings from the FDA.

No matter the type, to work well all face coverings for kids should:

• Fully cover their nose, mouth and chin
• Fit comfortably – but snugly – against their face
• Allow them to breathe easily
• Be clean and in good shape (no holes or wear and tear)

Face coverings – of any type – should not:

• Be see-through or thin enough to allow light through (translucent); hold your child’s mask up to the light to check for holes where light is coming through
• Be uncomfortable, forcing your child to fidget or adjust their mask, potentially with dirty hands
• Be difficult to breathe in
• Have exhalation valves or vents; these vents do not contain the germs within the mask, making it possible for someone without symptoms to spread COVID-19

Overall, finding a good face covering for your child involves finding a balance: You want a mask that doesn’t allow droplets to pass through while ensuring that they can still breathe easily and wear it consistently.

Additional tips:

• Instruct (and help) your child wash their hands before they put their face covering on
• Remind them that they shouldn’t touch the mask again until they’re ready to remove it
• Have your child wash their hands after they remove their mask, too
• If their mask gets dirty or becomes hard to breathe through, make sure that they take it off and do not wear it again until it’s been washed in the laundry (or thrown out)
• Do not share or trade masks
• Keep dirty and clean masks separate

That depends. Every family’s situation is different, and there are pros and cons for each option. After proper fit, here’s what else to keep in mind:

Medical masks are a good “middle-ground” option for many families. Even Dr. Dominguez typically chooses to wear a medical mask in his day-to-day activities. Wearing a cloth mask is better than no mask at all.

When to upgrade

Wearing a more protective mask is most important in situations that present a higher risk. While a mask is better than no mask, there are a few situations where you might consider a more protective option like double masking or a respirator:

• If transmission is high in your community
• If your child is immunocompromised or at a higher risk of complications from COVID-19
• If family members in the household are at a higher risk of complications from COVID-19
• During travel or in very crowded places, especially at times of high community transmission

If you have questions about the type of mask your child should wear based on health conditions, talk to your pediatrician. For examples of what to wear and when, consult the CDC’s chart to different masks for different situations.

If KN95s aren’t realistic for your family, consider medical masks. And if a new medical mask each day is also unrealistic, consider having your child wear their cloth mask over a medical mask; this allows your medical mask to last longer, and it can also help snug the medical mask up against smaller faces.

No; every family’s situation is different. While some parents feel more comfortable having their child in a respirator or medical mask, replacing them every one to two days may not be an option for every family due to access and/or cost.

If you're wearing cloth masks, this is a good time for the whole family to look at options to improve your mask’s fit and protection: Check that your mask is in good condition, fits snugly against the face and has multiple layers.

No matter the type, don’t reuse masks that are visibly dirty or wet.

It’s best to use a new surgical mask each day. Respirators can be reused as long as they’re not dirty or wet, according to the CDC.

Again, context matters. If you know you have been exposed to someone with COVID-19 or are caring for a family member with the virus, it’s best to start fresh with a new disposable mask or a freshly laundered cloth face covering.

While children as a group have been shown to be at lower risk for becoming seriously ill from COVID-19, they can get sick and still spread the virus. Most kids over age 2 – and especially those that are not fully vaccinated – should wear face coverings in indoor public settings to help keep themselves and their family and friends safe. This is even more important when community transmission is high.

The more we wear face coverings around others the more effective they are. That’s because fewer droplets are moving freely within an area. When combined with the additional protective measures of vaccination, good ventilation and proper hand-washing, face coverings are even more effective at limiting the spread of the coronavirus.

As additional studies are completed, we have even more scientific evidence that community use of masks helps prevent transmission of the coronavirus by both blocking exhaled virus and helping to filter inhaled air. A large randomized control trial in Bangladesh showed the benefit of masks in the real world and on an enormous scale.

New evidence from early 2022 shows that, in addition to being up to date with recommended COVID-19 vaccinations, consistently wearing a comfortable, well-fitting face mask or respirator in indoor public settings protects individuals from COVID-19. Out of all the options for face coverings, a respirator offers the best protection.

The New York Times has a helpful interactive guide about masks that explains the evidence. (Note: A free account may be required to read the article.)

COVID-19, the disease caused by the novel coronavirus, is a new condition, and scientists and doctors are still learning about the virus and how it spreads.

As medical experts learn more about COVID-19 and its variants, we update our guidance accordingly. Basing our recommendations on the latest data and science is the best and safest way to respond to an evolving virus.

We understand that keeping up with guidelines has been challenging for parents, but what we do know is that wearing masks, especially well-fitting masks in indoor public settings, has been proven to reduce the spread of COVID-19.

Nearly everyone, anytime you’re in public or with people outside of your household indoors during times of high community transmission. There are a few exceptions: kids under age 2 and those with medical exemptions, like sensory sensitivities or significant issues that limit their ability to remove their own mask in case of an emergency.

If your child is over the age of 2, they should wear a mask or face covering during times of high community transmission whenever they’re out in public or with people outside of their household, especially indoors or if it will be challenging to keep your distance from others. Keeping your distance from others is more difficult in places like grocery stores, classrooms and public transportation, so wearing face coverings at these times is even more important.

During the COVID-19 pandemic, people – including most kids – can and should wear face coverings during times of high transmission when going out in public or socializing with people outside of their household. Even kids with asthma. (More on that below.) Of course, there are some exceptions.

The following people (including kids) should not wear face coverings:

• Babies and children under age 2
• Anyone who would need help taking off their mask in an emergency, such as someone who has cognitive impairment or is unconscious or incapacitated

Remember, check in with your pediatrician for their advice on your specific situation.

There’s definitely a balance, and parents should help their child wear their face coverings properly but without expecting perfection. Do your best to follow the recommendations for masking and be sure your child is wearing their face covering as one of several precautions including getting vaccinated, staying home when they’re sick, washing their hands frequently, maintaining physical distancing of 6 feet from people outside your home, and socializing outside whenever possible.

Treat your mask like you would your underwear. Make sure to:

• Cover the important parts, in this case your nose, mouth and chin
• Avoid fidgeting with it, especially in public
• Keep a stash of clean masks on hand so you don’t get caught unprepared
• Find patterns and colors you like, maybe even one to match your outfit
• If your face covering is cloth, wash it after each use

If the virus is spreading in your area, it becomes more important to wear a mask indoors even if some facilities may have eased their mask requirements. If you’re traveling, everyone is required to wear masks while riding on public transportation, as well as at airports or train or bus stations. If you have a child with an underlying medical condition, consider continuing to mask yourself to set an example and enhance protection.

When community transmission is high, masks are strongly recommended for children over 2. Even outdoors, during times of high transmission they should wear masks while playing contact sports or whenever it’s not possible to maintain 6 feet of distance from others not in their households. The only exceptions are when your child is swimming or participating in activities where their mask could get caught and injure them, such as:

• Aquatics, where a wet mask would be a choking hazard
• Wrestling, where a mask could easily be caught or dislodged
• Spirit or cheerleading, only during high-intensity maneuvers where the mask might get caught or dislodged

Find mask guidance for organized sports from CDPHE or read up on the CDC’s advice for activities and gatherings.

No. You can continue to wear the same face covering if it’s not soiled or dirty. Remember to wash your hands before and after you put your mask on, to keep it apart from dirty masks, and, if it’s cloth, to wash it after daily use.

Wash your kiddo’s face covering after each day of wear using laundry detergent and hot water. A regular dryer cycle is sufficient. (No need for a high temperature option.) In a pinch, you can hand launder your face coverings. Make sure they’re fully dry before wearing.

Yes, but the exemptions are for babies, who could suffocate in a cloth face covering, and for children with significant medical issues that make it impossible for them to remove their face covering independently if they were to have trouble breathing. Another instance is children with significant sensory sensitivities. This is more common for children with conditions like autism spectrum disorders.

The scientific data clearly show that face coverings play a crucial role in limiting the spread of COVID-19. We recommend that anyone over the age of 2 who can remove their mask in an emergency wear it in public when indoors. Especially in situations where it’s more challenging to maintain distance from others or in poorly-ventilated areas.

There are no valid reports or scientific studies linking masks to mental health problems in children or any other group. In fact, early research data show no clear evidence that masking impairs emotional or language development in children.

“There is currently no scientific evidence to support this potential concern,” says Jenna Glover, PhD, a child and adolescent psychologist. “We’re encouraging all families and children to follow mask guidelines so kids can continue to enjoy safe in-person learning and activities. Masking helps kids and teens safely socialize with friends, teachers, coaches and other support systems, which is critical for their mental health.”

The mental health challenges that many children are experiencing are due to multiple factors, namely disruptions to routine, family life and schooling coupled with isolation, stress and anxiety due to the pandemic. “In general, kids are feeling more stressed and distressed than ever before,” Dr. Glover says. “The major activities in their lives have been constantly changing during the pandemic and youth have been faced with prolonged periods of trying to cope with the unknown. Masks are not harmful to children’s mental health. They need to be in school and have connections with other kids and adults to improve their mental health. Right now, wearing masks is the best way to ensure that happens.”

Kids' and teens’ mental health challenges existed before the pandemic. What’s changed is that many of the activities that helped them cope with these challenges – like school, sports and extracurricular activities – changed significantly. Maintaining in-person learning – by wearing masks and getting kids vaccinated as soon as they are eligible, along with other protective measures – is a beacon of hope for communities. Masks are a key step on the road to getting back to normal and providing kids the support systems they need to thrive mentally, emotionally and physically.

Pediatric experts at Children’s Colorado support safe in-person learning (with masks) because of its benefits for child health overall.

Learn how to support children’s mental health throughout the pandemic.

"100% yes,” says Dr. Dominguez. In fact, people with underlying medical conditions may be more vulnerable to catching or experiencing a more severe case of COVID-19, so it’s especially important for this group – and those nearby – to wear face coverings, especially indoors. Talk to your child’s pediatrician, who knows them best, if you have medical questions.

See what underlying conditions may put people at higher risk for COVID-19.

For the typical healthy person, not at all. Just think of the healthcare workers who have been wearing masks and PPE for their shifts for years now; there are no reports or valid scientific studies demonstrating that these workers have experienced health problems from continued mask wearing.

Additionally, people with chronic lung conditions (like cystic fibrosis) and patients taking immunocompromising medications (like transplant recipients) have worn face coverings to protect themselves during respiratory season long before this pandemic. They have not suffered any harm from face coverings either.

And, accumulating research demonstrates that there are no significant adverse health effects from mask wearing.

In rare instances, existing medical conditions can make mask wearing more uncomfortable and even dangerous. That’s why the CDC guidelines include exceptions for face coverings for people with cognitive issues who cannot take the masks on and off by themselves. But this is uncommon, and exemptions should be rare.

Until they are fully vaccinated and community transmission is very low, yes: Children with asthma should wear masks.

From what we know about the disease so far, kids with asthma might be at an increased risk of being hospitalized for respiratory support due to COVID-19 if they’re infected. Kids with asthma should wear face coverings when transmission is high to help protect themselves and others.

What if my child with asthma has a difficult time wearing masks?

“If kids with asthma are having a hard time breathing with a mask on it may be because their asthma isn’t well controlled,” Monica Federico, MD, the medical director of Children’s Colorado’s Asthma Program, says. “They can try their quick relief (inhaler), and if that doesn’t work in relieving their asthma symptoms then they should talk to their doctor about better controlling their asthma. It doesn’t have anything to do with wearing a mask. We think that all children over the age of 2 with asthma should wear a mask. They should wear one when they’re going to school and whenever they are indoors with people outside of their household.”

If your child has significant issues wearing a face covering, it’s worth working with their pediatrician, a mental health professional or even an occupational therapist to help them succeed.

• First practice wearing face coverings in a safe environment, like home.
• Model the behavior yourself; kids and teens are more likely to wear their face coverings if their family and friends wear them consistently, too.
• Help them get used to face coverings gradually.

Additional tips by age group

Preschoolers and young children

• Set expectations: If they want to be able to leave the house, they need to wear a mask.
• Be consistent: If they refuse to wear their face covering and still get to join in an activity, they’ll be more likely to continue to refuse one. Though it may be hard for parents to cut an activity short, consistency is key to young kids’ cooperation.
• Make it fun: Allow your child to decorate their mask or choose the pattern. Encourage them to incorporate masks into everyday play, such as putting their stuffed animal or doll in a mask, too. They could also pretend to be a doctor or nurse taking care of a patient. Or a superhero. Incorporate other toys like a doctor’s kit or a superhero cape to add to their play.

School-age kids and adolescents

• Explain the why: Make sure you talk to your child about why wearing masks is so important for the health of the family and people around them. You might say, “Because of the coronavirus that is going around, we have to do extra things to stop the virus from spreading. Wearing masks is one of the best ways we can stop the virus and make sure we don’t get sick or get someone else sick.”

Teens

• Emphasize the impact to others: Teenagers may not be as concerned about catching the virus themselves. Help them understand that their cooperation is important for ensuring others like their sibling or vulnerable people in the community stay safe and healthy during the pandemic.

Adjusting to what’s different and new during a pandemic can be difficult, especially for young kids. If you’re struggling with getting a younger child to wear a face covering, our child life specialists have the following tips:

• Comfort your child and help them feel safe: Ask them what about the mask they don’t like. Having a better understanding of what they don’t like can help you figure out how best to address their refusal.
• Start slowly: Begin by having your child practice wearing their face covering for short spurts of time during an activity they enjoy. For example, have your child wear a mask for 10 minutes while they play with their favorite toy as a distraction.
• Keep it up: Gradually increase the amount of time that your child wears their face covering, again during preferred activities when they have something more fun to focus on.
• Try different designs and styles: Cloth face coverings vary significantly, so you might have more success with a different type of mask (style, material, fit, tie style, size, etc.) over another. Here are a few ideas:
  • Some masks have adjustable elastic which can help ensure a better fit for your child. If the mask secures around their ears, putting a thick lotion or Vaseline behind the ears can prevent the ears from getting irritated.
  • Many kids don’t like the feeling of the elastic pulling on their ears, so it may help to find a style that ties behind their head. Alternatively, you can find ear protector clips or use a plastic S hook to secure the elastic ear loops at the back of the head. You can also sew buttons onto a head band to secure the elastic loops around the buttons instead of the child’s ear.
• Give your child some control back: Often children refuse to cooperate simply because they feel like they don’t have a say and they want to demonstrate their independence from you. Giving them options, like the ability to choose their mask, can help increase their sense of control and their likelihood of cooperating.
• Let them be helpful: Kids generally want to be helpful. Keeping it fun and focusing on how they can help can sometimes be enough to increase a child’s cooperation. At Children’s Colorado, our child life specialists often ask children, “Do you want to be a medical superhero to help stop the spread of the virus? To be a medical superhero you have to wear a mask to help stop the virus.”

Some kids with developmental and behavioral challenges or sensory disorders may also have trouble wearing face coverings. If this is the case for your child, these tips may help:

• Be simple and direct when explaining what you want them to do: You might say, “First put on your mask; then we can go in the store.” If your child understands information best when it is presented visually, using pictures might help increase their understanding and cooperation. To help your child understand the expectations clearly, reading a social story about wearing a mask can also be helpful for some children. There are great resources for social stories online, such as parent training and support resources for COVID-19 from Autism Speaks, about wearing masks and social distancing. Or you can create your own.
• Slowly work wearing a mask into your child’s daily routine: Begin by having your child wear their mask when they are doing activities they are enjoying doing, like watching their favorite show, so they start to have a positive association with the mask. Praise and offer small rewards when your child cooperates with wearing their mask. Keep your first outing out with a mask short and build off the success.
• Get them interested: Help increase your child’s interest in wearing the mask by choosing masks with colors, patterns or characters that you know they like, or let them choose the mask they want to wear.
• Try to find out what’s bothering them: If your child refuses to wear their mask, try to figure out what exactly about the mask is bothering them. Try different styles; for example, wearing a tie-on face covering instead of one with elastic loops may help relieve some of the pressure on their ears and cheeks.
• Get help: Speak to your child’s pediatrician or therapist if you have specific questions about your child or options for face coverings.

For some kids with special needs, wearing a face covering may just not be possible, and that’s OK. If your child does have a medical exemption that means they can’t wear a mask, it also means that it’s likely safer for them to stay home until they can get vaccinated. If they must go out without a face covering, like to school or to get medical care, it’s critical that they stay 6 feet apart from others and wash their hands with soap and water or an alcohol-based hand sanitizer frequently.

• If your child is attending in-person school, daycare or another in-person activity, send multiple face coverings with them in case any get dirty, lost or damaged.
• Designate one spot for clean, ready-to-wear masks and one for soiled masks that need to be washed or disposed of. Some tips and ideas include:
  • Send your child to school with two containers: one marked clean and the other marked dirty.
    • Clean, unused coverings can be placed in a clean bag or bin.
    • Soiled and used coverings can go in a separate container to be washed or disposed of.
  • Note: Paper bags allow for airflow and drying between uses. But, plastic bags or containers are OK for used masks that are heading straight to the washing machine or the wastebasket. (Remember to toss the used plastic bag and wash any reusable containers, too.)