Back-To-School Week: 5 Things I Want Every Family To Know

The best masks, immune-boosters, and mental health.

Kids need to be in school. Period. For this to happen safely and successfully, children need to have all the adults around them do their very best.

For back-to-school week 2021, here are a few things I want families to know. 

1. Until all children have the opportunity to be vaccinated against Covid, universal masking is the easiest and most effective mitigation measure to keep our kids in school.

Although mask fit and material matter, two people wearing relatively crappy masks work better to limit transmission than when only one person is masked up. That’s why masking everyone, regardless of vaccination status, is the way to go. (Thank you, Blue Valley.)

With the highly contagious Delta variant circulating, making better mask choices may help in certain situations, especially if your child is headed into a masks-optional environment. Although masks are primarily source control, masks also protect the wearer. Masks will catch any large respiratory droplets carrying the virus while limiting the number of infectious particles a wearer may inhale.

The best masks for kids: 

1. The one that is comfortable and fits correctly.

2. See #1

3. For the littles, it’s about comfort. I see many Jaanuu, HappyMasks, Old Navy, and kid-sized surgical masks in the office. Choose a mask with a flexible nose bridge and adjustable ear loops to get the fit as tight as possible. Don't forget the simple knot-and-tuck to get any mask snugger.

4. For unvaccinated elementary/middle kids, they need both source control and wearer protection. This is the job for child-sized KN95/M95. (Vita, Lutema) or 3-layer, well-fitting masks. (MASKC, Athleta) Put a few extra masks in the backpack in case a mask gets wet or dirty during the day. And mask lanyards can be helpful to prevent masks from getting lost or shared. 

5. For vaccinated kids, source control is the goal. Both disposable surgical masks and comfy cloth masks should easily accomplish this, especially if everyone at school is masked. Masks not required in your district? See #4. 

6. For athletes, keeping the mask away from the face during play is important. Many of my kids like the Athleta or UA masks for wearability and comfort. 

7. For kids with glasses, masks with adjustable nose wires are best. Pull the mask up higher on the nose before crimping down the bridge wire and place the glasses on top of the mask to limit fogging. 

8. For teachers and staff, get vaccinated first. And I’d wear a KN95 or a triple-layer mask. 

9. For teachers working with special needs children, there are clear masks. I’d only recommend face shields if you are in a room of fully vaccinated students. 

2. We can’t forget the basics! Quality nutrition, routine exercise, and restorative sleep are mental health and immune system boosters.

Working to gain healthy habits is good for everyone in the house. A few details: 

• Get sweaty every day. Exercise is a stress-reducing immune builder and desperately needed for most of us after months of working from home and school. Generally speaking, exercising outdoors (including school recess) without a mask is a lower risk activity, but be sure to check your local community rates. Start small, strive for consistency, and encourage everyone in your family to reach this goal. 

• Pre-K through middle schoolers need 10-12 hours of sleep per night. Teens need at least 8 hours. These hours are really hard to get without some effort. To get back into a better sleep routine, mindfulness exercises may help with the wake to sleep transition and increase the quality of sleep. (Apps that help: Headspace Kids, Calm and Peloton sleep meditations.) If things are really off the rails, talk to your pediatrician about the use of melatonin or other sleep supplements until the routine of sleep is better established. 

• Get around the family table most nights of the week. Eye contact with those we love, genuine interest in our daily experience, and tech-free eating time is a restorative respite from the chaos of the day. I cannot stress enough the global value of family meals for every family—and it doesn’t have to happen every night for your children to reap the benefits. If you feel your child has a diet deficient in certain micronutrients, consider a cheap multivitamin. I’d think about vitamin D, zinc, B-vitamins, and iron support to fill in the micro gaps that may exist — but talk to your child’s doc first. 

3. No one knows the vaccine timeline.

I know we were promised Covid vaccines for 5-11 yo by early fall, but I’ve been telling my patient families to lower that expectation. The FDA has called for a larger sample group to be able to fully evaluate for rare side effects. By default, this extends the research time.

Although the AAP has approached the FDA to expedite the process due to Delta, it's my opinion that parental confidence and uptake of this vaccine will require an exceptional level of diligence that cannot be rushed. In turn, I will not be able to recommend the vaccine until this information is released. However, I will rely on the trusted experts who are helping us to make this decision. I hope you will, too. 

4. Anxiety is high. And treatable.

Many kids have not been in school for over a year. Some kids are heading into situations they have learned are unsafe (crowds, unmasked, etc.) or navigating new social situations. Even more will be rebuilding after academic decline. Parents are equally stressed as we send our precious forward into this chaotic world. Deep breaths, everyone! 

Anxiety is a normal response for any and all of these situations, and it’s okay if your child needs additional support during this time. Reach out to your school counselor first. Your pediatrician will have recommendations, too. You can also find tips for managing childhood anxiety in this piece I wrote for Forbes Health. And for a crowd-sourced list of recommended books for child anxiety, check out this link.

5. This will end.

I know many of you are frustrated/overwhelmed/disheartened by vaccine uptake and mask mandates. I hear you. I also know that many of you are pissed off that we’ve got to mask up again. I hear you, too. We share these frustrations. This many months into the pandemic, we are NOT where I thought we would be. But, here we are. 

For the sake of our kids and community, we need to react to our current reality while retaining belief that we will get through this next hurdle. We have to maintain our faith that one day the pandemic will end. Because it will. Until then, it’s in all of our best interests to work together, offer grace to one another, and believe we are all trying our best. Because we are. 

Pediatricians all over the country are masked and ready to help your student this year. Please, reach out to us and we’ll try to help. We need kids to have a fun and full academic year, and I’m looking forward to seeing it happen. 

Have a memorable and fun week, 

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Other Stuff: 

• If you missed it, my partner-in-pandemic came to KC for a special anniversary edition of Masks Off Live. It was so fun to be eyeball-to-eyeball with such a dear friend, and I already miss her. We talked about masks, Delta and all the things — take a look. We’ll be back later this month for a Masks Off Live and keep you updated on the back-to-school transition. Follow on Insta for the deets.

• Need a few more tips to keep kids Covid-safe from KC experts? Find them (and a super-old photo of me) in this KC Star article.