Are N95 masks really safe for kids? Do they make it difficult to breathe? We spoke to medical experts for the best advice on protecting our children.
Wearing a mask is nothing new for adults and kids in Singapore. While the rest of the world is suddenly experiencing a masked society (thanks a bunch, Coronavirus…) here in Singapore, we’re used to masking up. Whether it’s because of the pesky Singapore haze or to protect ourselves (and others) from illnesses, wearing a mask in Singapore is just something we’ve learned to live with. But there is one question we need to ask… are N95 masks safe for children?
It’s one thing to wear a breathable cotton mask, but how about the heavy-duty N95 masks that are used by healthcare workers? Of course, when the Singapore haze reaches hazardous levels (or when we’re panicking from the pandemic), we all want to protect our children. But before you make your child wear any kind of mask, it’s essential to know that not all masks are suitable for kids. They could restrict your child’s breathing – and you must never put a mask on a baby.
To help separate fact from fiction around masks for children, HoneyKids spoke to Dr Michael Lim, Consultant, Paediatric Pulmonary & Sleep Service at National University Hospital, and Dr Natalie Epton, Specialist Paediatrician and Neonatologist at International Medical Clinic for some sound advice.
And psst – don’t miss our guide to surviving the haze for tips on precautions to take, how to understand the PSI and PM2.5 readings, and how to choose an air purifier. And if you need inspiration for places to entertain your kids indoors, check out our guide to Singapore’s best indoor play centres and our list of 100 things to do indoors with kids!
So, are N95 masks safe for kids? Let’s ask the doctors…
We’ve heard that masks can make breathing more difficult. Can kids wear them if we head outdoors during the haze?
Dr Epton: The best advice continues to be that children should minimise prolonged or strenuous outdoors activities if the PSI is above 100, and avoid outdoor activities altogether if the PSI is above 300 (and above 200 for younger children and those with existing heart or respiratory conditions such as asthma).
There are masks being marketed for children, toddlers and even babies, but we’ve also read that N95 masks are not certified for use on children – what is the safe thing to do?
Dr Lim: You are right about the N95 masks not being certified for use on children. The smallest mask that is probably effective is the AIR+ Smart Mask, available in Watsons, but that is designed for children seven years old and up. Below that, Totobobo has been popular in China, but again, only for children aged five years and up.
You do work harder with breathing through these masks, which is why the Air+ Smart masks with the ventilator fans are popular – and they do seem to work (but only for kids seven years upwards). Furthermore, the efficacy is unproven in the very young – getting a good seal is an issue, but the worry of hyperventilating in these masks is there too. So I tend to recommend the more sensible approach, which is staying indoors with windows closed, air conditioning, and a HEPA-grade air purifier. That is safe.
Dr Epton: Although masks for children have been made available through local manufacturers, not all have received US FDA or Singapore HSA approval. If you do choose to use these masks for your children, be aware that they may make breathing more difficult, and you should discontinue their use immediately if your child experiences any dizziness, difficulty breathing or discomfort.
We’ve spotted young children wearing surgical masks. Given that surgical masks don’t offer adequate protection from pm 2.5 particles, is something better than nothing?
Dr Epton: Surgical masks are designed to protect other people from the wearer’s saliva or spit – hence useful during a health outbreak – but not to protect the wearer from particulate matter. Although a surgical mask may provide some barrier against larger particles, thereby reducing some irritation, it will be of no help in reducing exposure to small particulate matter (e.g PM2.5 microns).
What are the best precautions to take for children with respiratory issues?
Dr Epton: Minimise outdoors exposure when the PSI is greater than 100, and avoid any outdoors exposure when the PSI is greater than 200.
How can we protect babies and toddlers who cannot wear masks?
Note that it is not safe to put a mask on an infant, whether they are indoors or outdoors. According to the neonatology unit at KK hospital, when the PSI levels are greater than 100, it is safest to keep your baby indoors, in an air-conditioned room.
Dr Epton: For babies and toddlers, avoid outdoor activities altogether if the PSI is above 200.
What symptoms should parents look out for in kids who are affected by the haze?
Dr Epton: Symptoms range from mild irritation of the eyes, nose and throat, to worsening difficulty with breathing. Minimising exposure is the best strategy; close all windows and doors and use your air conditioner. Consider investing in an air purifier with a HEPA filter, especially for your child’s bedroom. Increase your child’s fluid intake and antioxidant-rich fruits such as blueberries, vitamin C-rich fruits such as oranges; vitamin E-rich foods such as nuts and seeds, and foods rich in omega oils (oily fish). Any child with difficulty in breathing or severe irritation of the eyes, nose or throat should be seen by a doctor to ensure there is no serious illness.
Are there long-term effects for children exposed to the haze at unhealthy levels?
Dr Epton: Although exposure to haze has been linked to a potential increased risk of severe illnesses such as heart disease and lung cancer, the actual risk from short-term exposure is estimated to be extremely low. Most studies looking at long-term risk were evaluating populations with prolonged continuous exposure. Studies in Singapore are ongoing.
To put things in perspective, on a day when PM2.5 levels hit 100 micrograms per cubic metre, a person will take in around 1,100 mcg of these pollutants if he or she stays outdoors throughout the day. For comparison, a smoker will inhale between 10,000 mcg and 40,000 mcg of PM2.5 pollutants for every cigarette consumed.
What are the signs of respiratory distress to look out for in case of an emergency?
Dr Epton: Any child with increased difficulty in breathing should be assessed by a doctor. If your child has asthma or other breathing problems, your doctor may have already given you a plan of action (a written asthma action plan) for you to use in such situations. Follow it, but be prepared to take your child immediately to a doctor if your child deteriorates. Signs such as lethargy and poor feeding in younger children, or inability to speak in full sentences (out of breath) in older children are signs of severe compromise – seek immediate medical attention.
Need more medical advice? Check out these emergency guides and doctor’s lists below: