Many countries throughout the world have created face mask mandates since the start of the COVID-19 pandemic. Here in the US, many states have had or currently have face mask requirements for people over the age of two. Many children and adults have become accustomed to the practice of wearing a face mask over the last 15 months. Now that restrictions are easing and people are shedding face masks, research is being performed to determine the long term effects that face mask wearing has on infants and young children.
A large amount of brain development occurs within the first three years of life. In fact, research says that “the brain grows rapidly and has reached half its adult size within three months, doubling in size in the first year. By age three, it has reached 80 percent of its adult volume (Cao et al., 2017). Crazy, right?! The groundwork to set a child up for future development occurs by age three. This really highlights the importance of those first few years of life. Early face to face interactions are crucial for bonding between parents and infants, as well as early language development. When face to face time is interrupted for a prolonged period of time, many potential negative effects have been observed related to infant bonding, language development, and emotional development.
When a face mask is worn, the eyes become a primary method of communication as opposed to the mouth and face as whole. The mouth is crucial for communication because it provides not only the words, but the movements for articulation and can provide emotional cues. Masks create a physical barrier which limits a person’s ability to communicate ‘face to face’. This is concerning since infants develop the emotional understanding behind words as early as five months of age. According to a recent discussion paper that examined research trials and evidence, “for an infant, this (face mask usage) has the potential for long reaching effects in the early stages of neurobehavioral development. A mask covering the face may affect the infant’s ability to develop facial processing and orientating to or focusing on another person’s face” (Green et al., 2020). Newborns learn from looking at faces. Effective communication involves more than just words; it involves facial expressions, tone, and emotion. It is challenging for infants to develop crucial communication skills if repetitively cannot observe the people speaking to them. “For infants and children to feel safe, there is a heavy dependence on facial expressions as they rely on their parents’ emotional cues via facial expression to regulate their responses towards them or to potentially threatening situations (Green et al., 2020).” When this learning process is unable to occur, due to something like a physical barrier on a face, this is linked to possible increased anxiety in infants. (Karz and Hadani, 2020).
Face masks also affect an infant’s ability to imitate speech sounds. Infants acquire speech sounds by first hearing them, and then repeating them. If they cannot hear them correctly because of the sound distortion masks create, then they cannot repeat them correctly. This complication can also affect an infant’s ability to create sounds and cries indicative of specific needs to a parent (happy cry, sad cry, hungry cry). Research indicates that prolonged mask wearing “May interfere with the parent-infant bond and longer-term attachment” (Green et al., 2020). Essentially, when a baby cannot effectively communicate with a caregiver, that baby cannot appropriately bond with the caregiver. When a baby fails to bond with a caregiver, challenges in both the academic setting and in forming relationships throughout life are well documented.
The potential side effects of mask wearing do not stop with infants. Research has been conducted on school age children, and results indicate that there is “evidence for substantial quantitative and qualitative alterations in the processing of masked faces in school-age children.” (Stajduhar et. al., 2020) Children are unable to process the entire message when a teacher is wearing a mask, when compared to material presented by a teacher who’s entire face is visible. Children are demonstrating emotional and educational needs as a result of prolonged face-mask usage.
Am I suggesting to stop wearing a face mask completely? No. I am suggesting that we balance the requirements of wearing a mask while mitigating the negative long term effects this may have on young children. How should we do that? See below for some tips!
- Speak to your baby loudly and with clear pronunciation through a mask
- Reduce mask wearing time as much as possible
- When not wearing a face mask (at home, outside, etc) intentionally set aside face to face time
- Use a clear face mask (teachers especially!!)
- Be dynamic with your facial expressions at home
- Use gestures and hand signs to support your verbal your message
- Play peek-a-boo with your child to target emotions
- Reinforce when you understand your child’s vocalizations (“Oh, I see you are happy!”)
- Read books targeting emotions, daily routine, and family
Cao M., Huang H., He Y. Developmental connectomics from infancy through early childhood. Trends Neurosci. 2017;40(8):494–506. https://doi: 10.1016/j.tins.2017.06.003
Janet Green, Lynette Staff, Patricia Bromley, Linda Jones, Julia Petty. The implications of face masks for babies and families during the COVID-19 pandemic: A discussion paper. J Neonatal Nurs. 2021 Feb; 27(1): 21–25. Published online 2020 Oct 29. doi: 10.1016/j.jnn.2020.10.005 PMCID: PMC7598570
Karz R., Hadani H.S. Education Plus Development; 2020. Are you Happy or Sad? How Wearing Masks Can Impact Children’s Ability to Read Emotions. (accessed 20 October 2020)
Stajduhar, A., Ganel, T., Avidan, G., Rosenbaum, R., & Freud, E. (2021, February 11). Face Masks Disrupt Holistic Processing and Face Perception in School-Age Children. https://doi.org/10.31234/osf.io/fygjq