Masks don’t cause respiratory distress in young children


Many mask mandates don’t require young children to wear masks. A new investigation indicates that young children can wear masks without any respiratory distress.

The pandemic has led to many changes, from school and home merging into one unit, to the proliferation of hand sanitizers and face coverings. Face mask requirements and mandates often do not require children under a certain age to wear them and both the Centers for Disease Control and Prevention as well as the American Academy of Pediatrics recommend the use of a mask by a child aged 3 years and older. An investigation in JAMA Network Open looks into whether the use of surgical masks was linked to oxygen desaturation or other respiratory distress in young children.1

Investigators conducted the cohort student from May 2020 to June 2020 in a secondary-level pediatric unit in Italy. They enrolled healthy children and divided them by age into 2 groups: group A was for children aged ≤24 months and group B was children aged >24 months to ≤144 months. Each participant was monitored for an hour, 30 minutes without wearing a mask and 30 minutes wearing a face mask. Every 15 minutes, the child was monitored for any changes in the respiratory parameters. If the child was aged 24 months and older, he or she also participated in a walking test for 12 minutes.

There were a total of 47 children included in the study with 22 in group A and 25 in group 25. In the first 60 minutes of evaluation, the investigators found no significant change in group A in partial pressure of end-tidal carbon dioxide, oxygen saturation, pulse rate, or respiratory rate. Group B also similarly saw no significant changes in any measurements during the hour of testing. For children in group B who underwent a walking test, the average distance covered in the 12 minutes was 808 meters and none of the children showed respiratory distress during the test.

The investigators concluded that infants and young children can wear face masks without an increased risk of respiratory stress. The findings support including young children in mask mandates to help slow the spread of coronavirus 2019 diseases, particularly in school. They also urge that parents and school personnel educated young children about the importance of face masks and how to use them.


1. Lubrano R, Bloise S, Testa A et al. Assessment of respiratory function in infants and young children wearing face masks during the COVID-19 pandemic. JAMA Netw Open. 2021;4(3):e210414. doi:10.1001/jamanetworkopen.2021.0414

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