Your Children Need to Wear Masks During a Pandemic? (Pedcast by Doc Smo and Sonya Corina Williams)

Everyone wants to stop the scourge of Covid-19 as soon as possible. Masks seem to be an important tool to that end. In fact, they seem to be our most potent defense. In today’s pedcast, I am going to pass on what I have learned about making masking as effective as possible and give you some tips on helping your children adjust to wearing them.

Image by Pixabay

Musical Introduction

Goal of Masking Your Children

When SARS-CoV-2 first came on the scene, spread was thought to happen mainly through touch of contaminated surfaces; things like doorknobs, pencil sharpeners, or shared food. Since those early days, many experts now feel that the SARS-CoV-2 germ can get into the air in a very fine form known as an aerosol and travel from person to person, just like smells do. If this is true, even being farther than 6 feet (2 meters) can infect a child or adult, especially if that exposure is in a poorly ventilated closed space like a small room for an extended period of time (currently thought to be 15 minutes or greater). If this is true, masks become an even more important tool to protect your children and family from getting Covid-19 because they reduce the spread outward of contaminated droplets and also impede the mask wearer’s breathing in of aerosol. And masks seem to work. No matter how you feel about having your family wear masks, I think if you look around the world at places where masking is accepted as necessary, the spread of all types of viral respiratory infections is much more manageable and contained.  During sick season, the masks just come out without hesitation.

In the U.S., What Have We Learned About Masking?

So, what have we learned recently about masks with respect to the spread of viral respiratory infections in the U.S.? What does the science show? A recent study found the following when a person coughs;

“With no mask, the aerosol jet extended an average of 8 feet from the head. A handkerchief folded according to instructions from the US Surgeon General reduced that distance to 1 foot 3 inches. A store-bought cone-style mask performed better, with the jet only extending 8 inches. The best result came from a mask stitched out of two layers of quilting cotton (second figure), which permitted only a 2.5-inch jet.”

Still not a mask believer? Consider a large study done in a huge healthcare facility Massachusetts recently where the healthcare workers were at high risk of getting infected. Here they had exponential growth (that’s bad) of cases of Covid-19 until they instituted universal masking at which time, they found the infection rate to plummet. In fact, the director of the CDC recently stated that if everyone in the U.S. would mask appropriately, we could get control of the pandemic in 4- 8 weeks!

And finally let’s look at a study out of Missouri where two hair stylists tested positive and had symptoms but cut the hair of 67 clients. The stylists and clients were masked during the cuttings and guess how many of their clients or their contacts (169 people) came down with Covid-19? None!

But we don’t need to be statisticians to know that masks work, just look overseas to the Asian world to understand how effective they really are. Even though most of these nations are much more densely populated than the U.S., their daily Covid-19 illness counts are typically under 100. The U.S.’s on August 15th at the time I wrote this pedcast was 56,729.

Does the Type of Mask Make a Difference to Its Effectiveness?

Ok, we can see that masks are extremely effective and inexpensive devices to limit the spread of respiratory droplets but does the type of mask make much difference to its effectiveness? The answer is yes, mask construction matters.  One of the best being made of tightly woven cotton with multiple layers and tight fitting to the face. It goes without saying that covering the nose is fundamental to achieving mask effectiveness.

In a study just published last week from Duke University, my alma mater, found that not all masks are equally effective. Here is their rankings from best to worst in decreasing order:

Most to Least Effective:


-3 Layer surgical Mask/Cotton polypropylene

-2-layer Cotton, pleated mask

-One-layer cotton mask/Knitted mask



Cleaning Reusable Masks

Another question about masks is, do reusable masks need care or can I just throw them into my dirty pocket and pull it out whenever I need it? Let’s talk about that. The information that I am about to give you on keeping your family’s masks clean and safe came from a recent Popular Science article called face mask sanitizing sterilizing guide.  The article recommends that you clean your mask after every use and lays out acceptable cleaning methods. Oh, and by the way, sanitizing your and your child’s hands before you put your child’s mask on and after you take it off makes sense. You have to assume that the mask, if used, is full of Covid-19 germs and cleaning your hands will limit spread from the mask to your family.  Ok, now for the cleaning methods:

Acceptable methods of Cleaning

  1. Boiling for 5 minutes (limit 10 boilings)
  2. Washing machine on hot (>140 degrees F) with detergent (ironing may add an extra layer of protection)
  3. Soaking in diluted bleach for 5 minutes
  4. Cleaning and letting it sit in a clean plastic bag for at least a week (the life span of the virus).

Methods of Cleaning Not Recommended

  1. Microwaving-  This method may damage fabric and create holes, the last thing you want to do with a mask.
  2. Exposure to UV light- This method is not recommended because the radiation is likely to fall unevenly across the mask, especially if it is a pleated mask. How do you get the light into the crevices of the mask?

Do My Children Need to Wear Masks?

Do your children need to wear masks and if so, when? My opinion and that of the experts at the AAP is a resounding yes-they need to wear masks anytime their you do. But Doc Smo, we all know that children rarely get seriously ill with Covid-19, even if they get infected, right? Yes, that’s generally true but they are capable of shedding large amounts of virus to others. How contagious they are still remains to be determined but caution is the word of the day. In hindsight, had the CDC recommended universal masking at the onset of this pandemic, I am pretty sure we would not be in the terrible place we are in this country.

I know you are thinking, if masks are so effective, how do I get my children to wear them and how old do they need to be before I expect them to wear them. Here is some guidance from the American Academy of Pediatrics:

  1. Children should wear masks whenever it is appropriate for their parents to wear them.
  2. Children under age 2 years should not be expected to wear masks and it may be dangerous for them to do so.
  3. Getting a properly fitted mask is vital. Amazon has boxes of 50 disposable pediatric multi-layer masks for as little as $17.00. These seem like a good choice for children.
  4. Here are some suggestions for how to get your children used to the idea of masks:
  • Look in the mirror with the face coverings on and talk about it.
  • Put a cloth face covering on a favorite stuffed animal.
  • Decorate them so they’re more personalized and fun.
  • Show your child pictures of other children wearing them.
  • Draw one on their favorite book character.
  • Practice wearing the face covering at home to help your child get used to it.

A Doc Smo Plea

So, here is a Doc Smo.  Please mask yourselves and your children with the best quality mask you can get.

Walmart has high quality reusable cloth masks for about the same cost as a cup of coffee at Starbucks, $2.00.

Now, a word to people who don’t think that masks are necessary during a global pandemic.  Do me a favor. Stand yourself in front of a mirror and talk to your rational objective self, not the self-charged up with excuses.  Admit to yourself that your resistance to masking is just an excuse not to do something that you find uncomfortable and don’t want to do. My advice,  just get over it.

For those worried about their civil liberties, nothing is being taken from you! You are giving the gift of good health to those around you not having something taken away.

But Doc Smo, it is too much to ask of me and my family to get, wear, and keep them clean. My kids don’t like them and whine about wearing them constantly. I just can’t do it. My answer to that is that your face masking predominantly protects the people who sacrificed almost constantly for you when you were young, your parents and grandparents. They are at the greatest risk from Covid-19 and deserve to be protected. I hope you agree.


Well, that was a little longer than usual but I hope you found it informative. I hope I convinced you that masks are our way out of this pandemic mess and that you and your family need to do your part. If you think someone you know might benefit from this pedcast, feel free to pass it on. For it to work, we need everyone on board this train. This is Dr. Paul Smolen, reminding you of an important parenting task, that of getting your family to wear a mask. Until next time.

Thanks to Drs. Monica Miller and Charlotte Rouchouze for their editorial comments.