Should babies and children wear masks or face coverings?

Kids ages 2 to 6 wearing a mask can be tricky and parents need to use their best judgement. Kids ages 2 to 6 wearing a mask can be tricky and parents need to use their best judgement. Photo: SanyaSM/Getty Images Photo: SanyaSM/Getty Images Image 1 of / 1 Caption Close Should babies and children wear masks or face coverings? 1 / 1 Back to Gallery

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Children age 2 and under should never wear a mask or face covering, according to the U.S. Centers for Disease Control and Prevention.

"The mask can impact their air pathways and obstruct breathing," said UCSF pediatrician Dr. Lee Atkinson-McEvoy.

But what about children 3 and older? Atkinson-McEvoy said for kids ages 3 to 6 wearing a mask can be tricky and parents need to use their best judgement. Some children may not tolerate wearing a mask and may even throw a fit when forced to wear one; crying can release more mucous than simply breathing.

Parents should generally avoid taking their kids to places where masks are necessary, such as grocery stores and on public transit, and especially if their child refuses to wear one, she said.

"Parents should be very thoughtful about why they’re out with their kids," said Atkinson-McEvoy. "If their child can’t tolerate a mask, they need to think about when the right time is to go for a walk. At 2 p.m. when a lot of people are out, or the first time in the morning when there are few people out."

Atkinson-McEvoy said parents can find ways to make wearing a covering fun to encourage kids to use them. "Make it game," she suggested. "Pretend it’s a costume mask. Have your child decorate the mask to make it more tolerable. Cloth masks, which feel more comfortable, will be preferred by younger kids. Practice at home for a shorter time."

The state of California is recommending that residents wear face coverings in situations where social distancing isn't possible, such as inside grocery stores, in taxis, on public transit and when waiting in line to go inside a store.

Alameda, Contra Costa, Marin, San Francisco, San Mateo and Sonoma counties as well as the cities of Fremont and Berkeley have passed orders requiring face coverings. Beginning Wednesday citations and fines may be issued by those who violate the mandate. In all jurisdictions, children 2 and under are prohibited from wearing a covering; children 3 to 12 years old aren't required to wear one and should be supervised by a parent if they do use one. Fremont does suggest children 3 and up wear cloth face coverings in "places where they may not be able to avoid staying 6 feet away from others. For example, if you must take them to the doctor, pharmacy, or grocery store."

Research shows a cloth covering the nose and mouth can help prevent the spread of respiratory droplets, the main way the coronavirus is transmitted between people. The coverings are mainly stopping a person infected with COVID-19 from spreading the virus. Atkinson-McEvoy said it’s possible a child may not show any COVID-19 symptoms, but still have the virus and spread the disease.

Amy Graff is a digital editor with SFGATE. Email her: agraff@sfgate.com.

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