After the arrival of the highly contagious Omicron variant, authorities urged Americans to shelve their cloth masks and replace them with medical-grade N95s for better protection against COVID-19. That’s easy for grown-ups, but more complicated for kids—the Centers for Disease Control and Prevention doesn’t recommend N95s for children, as these masks were never tested on them.
Zachary Hoy, a specialist at Pediatrix Nashville Pediatric Infectious Disease, says authorities will likely reevaluate mask wearing for children in the spring, but only if and when vaccines become available for them and Omicron rates decline. Until then, he recommends kids keep masking in enclosed spaces and in large groups where social distancing isn’t possible.
Both the CDC and the American Academy of Pediatrics (which also recommends children over 2 wear masks in public) have guidelines on what to look for in a kids’ mask, but these have only added to the confusion of parents, who still don’t know what kind of face covering to get their little ones. The issue has become more pressing lately, as the CDC recently labeled school settings as low-risk.
Why children can’t just get an N95 mask
Medical-grade respirators such as N95s are pieces of engineering whose effectiveness at filtering at least 95 percent of airborne particles depends mostly on one thing—proper fit.
N95s are implemented in health care settings following a rigorous fit test, explains Anita Patel, an attending physician in pediatric critical care at Washington D.C.’s Children’s National Medical Center. The objective is to find the correct size to ensure no air leaks between the mask and the wearer’s face, which would render the mask less effective.
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Adult faces are pretty similar in size, and N95s were designed to fit that standard. Replace that grown-up visage with the much smaller face of a child, and achieving that necessary perfect fit becomes impossible.
You may think that solving this problem is only a matter of making smaller N95s, but unfortunately, it’s not just about scale. Prior to the pandemic, there was no need for respirators for small faces, so nobody bothered researching, designing, testing, or manufacturing them. Testing on children would also be quite challenging, as this process requires “participation, cooperation, and following clear directions,” Patel explains Anyone who has ever wrangled anything other than a Peppa Pig mask onto the face of a 3-year-old can attest to why that might not work out.
This has left parents doomed to scroll online in search of a more efficient mask without any easily accessible guidance. And this is not only concerning, but also alienating—it makes a lot of them feel forgotten as the rest of the world moves on.
“Now suddenly you have people saying ‘Hey, everyone’s had the chance to get the shot, so let’s return to normal, right?’ Guess what—as a parent of a child under 5, I, of course, feel gaslit and unseen,” says Patel.
No, it’s not dangerous for your child to wear a respirator
Some parents may worry that putting a medical-grade respirator like a KN95 or a KF94 on their child is harmful, as their kid would be forced to breathe their own exhaled air. That concern is unfounded.
“This is completely false and a product of targeted disinformation to attempt to convince parents that they shouldn’t put masks on kids,” says Patel, pointing to research proving that oxygen levels remain constant in children wearing high-end respirators.
Still, parents of children with developmental challenges should forgo this type of face covering, especially if their kid can’t reliably remove a mask by themselves, or if they suck on it or persistently touch their face. Moreover, children with sensory disorders may also forgo masking, as it might “exacerbate underlying problems,” Patel says.
It’s all in the fit
Parents can study data and shop for the best mask until their fingers can’t scroll anymore. But it won’t matter if their child has a poorly-fitting face covering. Just like adult respirators, children’s masks should have multiple layers of non-woven material and a nose wire. Parents should also ensure the mask actually fits by checking for gaps around the nose and mouth.
There’s not a lot of science to back up their filtering efficiency on small children, but at the moment, Patel and other pediatricians and specialists recommend KN95s and KF94s as the best alternative to non-existent children’s N95s. These two types of mask are pretty similar—KN95s are Chinese and block 95 percent of particles, while KF94s are manufactured in South Korea and block 94 percent. Patel opted for a KF94 for her young daughter, because she thinks they have a better fit for her particularly, but the appropriate respirator for your kid is whichever fits their face best.
But above all, both Patel and Hoy say that the best mask for your child is the one they’ll actually wear. That Peppa Pig face covering may not be an N95, but it’s truly better than nothing if they refuse to wear anything else. And if your child is willing, you may still be able to level up that piece of fabric—double masking with a surgical mask first, followed by a well-fitted cloth mask can reduce cough particles up to 85 percent.
Choosing a reputable kids’ mask
A quick search online will reveal endless possibilities for kid-sized KF94s and KN95s, so the first goal of parents is to avoid counterfeits by purchasing from reputable brands.
If you are shopping on an online marketplace, make sure you buy directly from the manufacturer. Patel warns that on Amazon, skipping the results page and going to a specific brand’s store can lead to more expensive products, but this is still one of the most effective ways to avoid counterfeits.
An alternative to Amazon is Project N95, which carries adult and kids’ masks from reputable sources such as Dr. Puri, and provides clearly outlined details on best age groups for each product. At the time of publishing, Project N95 had five masks listed for children, two of which were labeled KN95s.
Individuals have also stepped in to fill the informational void. Aaron Collins, a former mechanical engineer with a background in aerosol science, has made a name for himself by independently testing the efficacy levels of various brands of kids’ masks and posting them to social media. He also helps parents understand how to choose the best kids’ masks on YouTube, and has found these specific models to be the safest:
Red flags your kids’ mask might be low-quality
Low-quality and counterfeit masks have been a concern for adults seeking true N95 masks, and the same is true for kids’ masks. As N95s aren’t available in small sizes, don’t expect to see a kids’ model approved by the National Institute for Occupational Safety and Health—they just don’t exist and the CDC says claims like that are a red flag.
[Related: When are two masks better than one for preventing COVID-19?]
The Emergency Care Research Institute suggests you check out the models listed by the National Personal Protective Technology Laboratory for credibility. When purchasing KN95s, ECRI also recommends parents check for expiration dates and make sure the masks meet manufacturing standards in China by looking for the codes GB2626-2019 or GB2626-2006 on the packaging. If you’re opting for KF94 masks, ECRI says to make sure they’re manufactured in South Korea, and have an expiration date as well.
If masks aren’t working for your child, Hoy says to continue other precautionary measures, such as good old hand-washing. And as the weather eases up and spring arrives, you can kick kids back out to the great outdoors to breathe mask- and COVID-free air as much as possible.
