Is your child struggling with their face mask? Tips from a pediatrician to address mask challenges

Sep. 9--Face masks are the newest feature of most school uniforms this year, but unlike a new pair of tennis shoes or a school polo, face masks can come with a learning curve for children.

Lafayette Parish public school students return to class this week, with pre-K to fifth grade students attending classes full-time after staggered orientation periods. Meanwhile, sixth through 12th grade students will attend classes on an alternating in-class and virtual learning schedule.

Regardless how often students attend classes, face masks are a cornerstone of the school system's plan for a safe return. The American Academy of Pediatrics endorses the use of masks for children ages 2 and older, with some exceptions for certain health conditions or children who cannot handle a mask without assistance.

In LPSS schools, third through 12th grade students are required to wear face coverings, while pre-K through second grade students must wear them on the bus, during arrival and dismissal and during transitions during the day. Early childhood educators have discretion about mask use in the classroom to accommodate the possible need to remove masks for language development work, the plan said.

"Having teachers and students return to a safe and engaging learning environment is our ultimate goal. Please join us in doing your part in slowing the spread of COVID-19," Superintendent Irma Trosclair wrote in a summer letter to families.

Dr. Lauren Bailey, a pediatrician with Lourdes Physician Group, said masks should cover the child's nose above the nostrils, below the chin and fit close to the child's cheeks without being tight to prevent respiratory droplets from the mouth and nose from becoming aerosolized and spreading nearby.

While cloth masks can't filter out particles, the idea is that if everyone is masked it will reduce likelihood of the novel coronavirus entering the air and limit transmission. By preventing the spread of your germs you're protecting other people, and vice versa, she said.

Bailey said she's heard concerns from parents about children playing with masks in school or refusing to wear them, thus reducing the usefulness of the mask or even making the mask a possible transmission concern. While the first few days or weeks may be difficult, the novelty of the mask will wear off and children will adapt to their new uniform piece, she said.

"I think kids will get used to the idea of wearing a mask. When I had to start wearing my mask all the time, I was constantly pulling on it, messing with it. ... Now I'll wear it and not even realize I still have it on. It's become part of my daily attire like my clothes and my shoes. I don't even realize it's there. I think kids will get to that point if we have to continue to wear masks consistently," Bailey said.

The pediatrician said repetition is key for parents working to break bad mask habits with their children and train them to wear the mask properly.

Parents should walk their child through the steps of putting the mask on properly, teach the child about always washing or sanitizing their hands before and after handling their mask, and how to safely remove it without touching the front of the mask. It's like teaching them any other skill or habit, she said.

The pediatrician said children may find mask wearing stressful if they haven't worn masks frequently over the summer and are suddenly expected to wear them for six or more hours at school. Practicing at home for progressively longer periods can help build children's tolerance. Start with a set increment of time, like 20 minutes, then scale up, she said.

Parents also need to remember that children take cues from their parents, even if we think they're not watching, Bailey said. Modeling good mask behavior is important.

"I think that despite what some of us think, I think our children do watch us and see our reaction to things. They're taking note. If you're sitting there and saying, 'Why do we have to wear this mask? I don't want to wear this mask,' or you're not taking it seriously, you're not wearing it when you go into the store, the child is going to see that and think, 'Why do I have to wear this mask? Mom and dad think it's silly,'" the pediatrician said.

Some children may struggle with their face mask out of anxiety or other strong emotions about returning to a school year with a different look and feel. Children are intuitive and the extended absence from school because something bad prevented them from being there isn't lost on youngsters, she said.

"We've been having to modify things based on the virus and I think that gives kids lots of anxiety," she said.

Bailey recommended acknowledging and validating the child's feelings and developing a plan to overcome anxiety and other emotions. Having an honest conversation at the child's level about the virus and the positive steps they can take to protect themselves and their friends, like wearing a mask, can help build their confidence, she said.

Having an open line of communication between student, parent and teacher will also be important to know how the child is adapting to the new procedures and address any problems as a team, the pediatrician said.

To make wearing a mask more fun, Bailey recommended dressing a child's favorite stuffed animals in masks, letting the child pick out their own face masks, decorating the mask or selecting a themed face mask if school guidelines allow, or coordinating the mask with the child's outfit.

If those efforts don't work, providing behavioral incentives or turning proper mask wearing into a game could spur the child to properly wear their mask. Bailey suggested having a sticker chart and awarding one sticker each day the child's teacher doesn't send home a note or reach out about the child having mask issues. After a certain number of stickers, the child could get an ice cream or other prize, she said.

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