Editor’s note:This guidance was updated on March 8, 2021. Please visit https://bit.ly/3kJhHm0. AAP interim guidance is based on current evidence and best data at the time of publication. Updates are provided to reflect changes in knowledge about the impact of the disease on children and adolescents. For the latest news on COVID-19, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
Children ages 2 years and older can and should wear cloth face coverings when not able to physically distance, including while in schools, child care and other group settings, according to AAP interim guidance. The guidance also indicates that cloth face coverings should be considered in the home to protect at-risk and medically fragile family members.
“Cloth face coverings can be safely worn by all children 2 years of age and older, including the vast majority of children with underlying health conditions, with rare exception,” the AAP said.
Children under age 2 years and anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove a face covering without assistance should not wear them.
The AAP guidance also “strongly endorses” safe and effective infection-control procedures to protect children.
“This virus is going to be with us for some time, and face coverings are a proven, effective way to prevent the spread of COVID-19,” said AAP President Sara “Sally” Goza, M.D., FAAP. “As parents prepare to send their children to school and into child care settings, cloth face coverings should be part of their new normal.”
For COVID-19, effective infection control and prevention includes wearing a cloth face covering, washing hands and physical distancing. These three basic skills can be implemented easily by children and adults to help reduce the spread of SARS-CoV-2.
“During the COVID-19 pandemic, plans for the safe return of children to school, child care, and other group settings must include the universal use of cloth face coverings by children 2 years of age and older and the adults with whom they interact,” according to the guidance.
Pediatricians should remind parents to keep children at home if they have a fever, cough, congestion, runny nose, diarrhea or vomiting.
Pediatricians may be receiving questions from parents about young children and cloth face coverings. Even children as young as 2 years have demonstrated that they can be taught basic infection-control skills, the AAP says.
To help make a habit of wearing cloth face coverings, pediatricians can encourage families to have children practice wearing them at home. Use of cloth face coverings at home may be valuable to help protect at-risk or medically fragile family members.
The AAP guidance does not specify types of material or styles to wear. It does state that many cloth face coverings have infection-control performance comparable to standard medical facemasks used in health care settings.
Surgical masks and N-95 respirators should be reserved for doctors, nurses and other people at risk of being exposed to a sick person, according to AAP guidance on personal protective equipment.
