Kids health

Kids and masks: The newest info on double masking, disposable vs cloth and more

Just when you thought your kid mask shopping was done, experts have new information to share about the type of mask your child should be wearing.

When we first reported on mask-wearing at Today’s Parent, back when this whole thing started, the question was “Should your kid be wearing a mask in public?” Ten months later, putting on a mask when you go to school or into a store is routine for many kids across Canada—and it might stay that way for a while.

But with new variants of COVID-19 coming to the country and the risk of becoming complacent with mask hygiene use this many months later, we wanted a bit of a refresher on just what’s important when it comes to face masks for kids, so we reached out to a few experts. Here are the answers to our burning questions.

I went for a doctor’s appointment with my kid and they made him take off his cloth mask and change into a disposable mask. Does that mean they are better? 

First thing to know is that there are a few types of disposable face masks.

Disposable non-medical masks, like the kind you can find at pharmacy or grocery store, can sometimes do a good job at protecting against COVID-19, but there aren’t any standards for them and so the quality can vary, says Jane Wang, a member of the University of British Columbia’s faculty of medicine who has studied the effectiveness of different types of masks.

Disposable medical-grade masks, on the other hand—like the ones you might see dentists wear or the kind you put on at a walk-in clinic—do have to meet ASTM International standards. However, even if you wanted to buy a bunch of them, they don’t readily come in kid sizes.

The other thing to consider with disposable masks—both the medical and the non-medical type—is the fit. “They often have a poor wire around the nose, and depending on the size and shape of your face, there could be gaps at the cheeks or the chin,” says Wang. This means that even if the material itself can filter at a certain rate, you’re going to lose a lot of that efficiency out the gaps at the sides.

Wang also points out that disposable masks are not very durable and could soil easily if your kid drools on it or touches it. If they’re wearing a mask at school, you’d likely have to send them with several to get through the day.

I used to read about N95 masks, but now I’m hearing about KF94 masks. What are they?

N95, KN95, KF94. The numbers in all these medical masks refer to the percentage of particles the mask filters out, assuming the mask is fitted well. The letters in front of them refer to the type of certification it has. N is a U.S. standard; KN is a Chinese standard and KF is a Korean standard.

Health Canada recommends non-medical masks for most Canadians, but says that medical masks could be appropriate for people who are at higher risk of exposure and more severe illness. You can find a list of approved medical masks here. However, these are not readily available for kids.

My kids still wear the two-layer cloth face masks that we bought for school. Since then, Health Canada has recommended triple-layer masks. Do I need to buy new masks?

There are many things to consider when it comes to masks, and layers is only one of them. For one, especially when it comes to kids, the mask needs to be comfortable enough that they’ll actually wear it—they need to be able to breathe easily and not get too hot. N95 masks, for example, are very protective but uncomfortable to wear. Disposable masks are very breathable, but not as effective. Cloth masks, especially ones that fit well to the face, lie somewhere in between. Three layers, with the middle layer being a filter, is ideal, but a two-layer well-fitted mask that your kid will wear is still acceptable. “Everything we’re doing is risk reduction. It’s never risk elimination,” says Wang.

What about double-masking? I’ve heard it’s recommended. For kids, too?

Double-masking has come up as a strategy to improve protection now that there are new COVID-19 variants that are more transmissible. The idea is that by wearing two masks you’ll improve filtration and also fit—for example, a disposable mask can act as a filter while a cloth mask over it can create a nice seal around your nose, cheeks and chin. Again, while in an ideal world we would take every precaution possible, Jason Kindrachuk, a University of Manitoba virologist and Canada Research Chair in emerging viruses, says with kids, it makes more sense to focus on mask basics—like proper fit and good mask hygiene—than asking your kid to wear a second mask.

How do I know for sure that my kid’s mask fits well?

It needs to be snug around their nose, cheeks and chin. You can check this with a simple test: Have your kid put on the mask and open their mouth and take a breath in and out. “You should feel that the mask actually has a little negative suction, so that the mask will kind of suction inward. And when you breathe out, the mask will re-expand,” says Wang.

Should my kid’s teachers and daycare workers be wearing N95s? 

N95s are the most effective at protecting against COVID-19, but they are by no means comfortable. “They can cause skin irritations and sores on the face. And even though their oxygenation is not affected, people feel it’s hard to breathe because of the increased airway resistance,” says Wang. She adds that if you’re talking a lot, like teachers normally would be, there’s a higher chance for CO2 to build up in the mask. “We know that CO2 retention for a short period of time is not a problem, but CO2 retention over months, we don’t know,” says Wang. “If there’s an agency that has the money to fit all the teachers with N95 masks and test them, that’s great. But whether the teachers themselves want to wear that day in day out while they’re teaching, that’s a different question.”

Does any of this mask advice change with the new COVID variants we are hearing about?

Since the new COVID variants appear to be more transmissible, the measures we take to avoid infection are even more important. “These variants still rely on being able to get access to our nasal passage and our respiratory tract through our mouth and nose. So if we keep those covered and don’t stay in closed spaces for long periods of time and avoid large groups and large settings—those are the things that we know can still work to be able to reduce transmission of the variants,” says Kindrachuk.