Pediatrician weighs in on masking small kids | News

Children in the Commonwealth are going back to school and other childcare facilities with a newly instituted mask mandate.

The latest news from Governor Andy Beshear’s office now includes children ages 2 through 5. Previously, children in that age group were not included in the mandate, although organizations have recommended them for the age group.

As the coronavirus makes another wave across the state, the mask mandate expanded to toddlers and preschoolers.

According to a local pediatrician, there are two main reasons why the new mandate includes these young children.

Ishmael Stevens is a clinician at Ashland Children’s Clinic who survived the pandemic. He shared that because of last year’s lockdowns, people – and especially children – didn’t go many places.

“Schools were closed…so they couldn’t infect each other,” Stevens says.

The first kind was not so problematic for children.

“At that time, the new coronavirus, the first round of this, it didn’t seem to bother kids much, it didn’t seem to infect them much,” Stevens said. “If they were, they had a very mild form of it. This Delta variant, which is currently on the rise, seems to be a bit rougher for children.”

Stevens emphatically acknowledged that the mask required for young children is challenging for parents and caregivers, but offered some practical advice based on developmental milestones to help.

First, Stevens shared that because these kids have seen the masks on others in the past year, they are used to seeing them.

“It’s not something that’s just completely new,” the pediatrician said.

At age 2, children begin to understand cause and effect, he said. They can understand that they get a sticker or reward for doing something good and that they lose if they do something bad.

“We can try to have a developmental discussion with them, which is difficult,” Stevens said. “I fully recognize that it is a real challenge in (ages) 2 to 3; 3 to 5 is not so bad to explain them.”

Kids in the older part of the age range have started washing their hands, and “most of them go to the bathroom alone, they can participate in their hygiene,” Stevens said. “So we kind of explain it to them like that’s another part of hygiene. It’s part of staying clean, staying healthy and staying safe.”

Stevens shared that a basic rule is to use about as many words in a sentence as the child does in years. It is not hard and fast, but it provides a foundation to build with the child.

“You can’t make it too complicated for the smaller kids,” Stevens says.

The pediatrician explained that children up to the age of 2 are just learning to cope with their environment, and so many will bite or bump their heads at that age in frustration.

“You just have to keep them safe and redirect them because it’s very hard to reason with them,” Stevens said.

Once a child turns 2, they begin to undergo a developmental shift that allows for the concept of cause and effect as they grow older.

“We want to encourage positive behavior and provide positive reinforcements, and minimize negative behavior a little bit and you can start doing that a little bit with 3-year-olds more and then it’s just progressive from there,” the clinician said.

Stevens said children are naturally nervous most of the time, through no fault of their own. This leads to the challenge of getting children to wear a mask. His advice is to keep it simple and positive.

Giving friendly reminders when a child wants to move their mask and positive reinforcements when they’ve done a good job is the best way. Stevens also added that being a good role model as a parent or caregiver by wearing a mask properly can go a long way.

Stevens said it’s best to keep these kids away from situations where they could be exposed when possible. It is not always possible, and keeping a mask on a small child can be a challenge, he repeatedly acknowledged the achievement for parents and teachers, especially for the 2 and 3 year olds.

There are ways to put on the masks, put masks on favorite stuffed animals, put them on pictures of princesses or a favorite cartoon. Stevens recommended healthychildren.org for more practical ways to familiarize children with the idea.

It’s not just about the masks, though.

“Most importantly, the big picture is, don’t send your kids to school or daycare if they’re sick,” Stevens said. “If they have a fever or a cough, they really don’t need to go to a school setting because no, no level of protection is perfect. So they really should stay at home if they are sick.”

He also added that it is important that people wear their masks correctly.

“It should be about your mouth and nose,” Stevens said. “It has to be a good fit that you want to be quiet, even if you’re wearing a mask, you want to wash your hands often and try to maintain social distancing if you can. You have to wear them properly and you have to take some of the other precautions as well.”

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