Ask Nana

Dear Nana,

have two little ones – a 3 year old and a 4 year old. We are struggling with keeping a mask on our 3 year old. He refuses to wear it – screams and fights me. If I do succeed in getting him to put it on, he pulls it off after a few minutes. We can’t take him anywhere because he won’t keep his mask on! The 4 year old is better but she sometimes pulls hers off when he takes his off. At this point, I’m tag-teaming with my partner -- one of us stays home with the kids while the other one goes grocery shopping or to Target. But as winter approaches, we will be inside more and more and we just can’t keep avoiding taking them out. I know a 3 year old isn’t always required to wear a mask but I don’t want him to get sick. Help! -

-- signed, Battle Weary Mom

Dear Battle Weary Mom,

I know it probably doesn’t help but this is my most frequently asked question these days. It comes in all forms but always starts with, “how do I get my 2 or 3-year-old to…?” Insert – “sit at the table,” “help with clean-up,” “wear their shirt, shoes, pants, bathing suit” – and now – “wear a mask.” The toddler years can test the patience and resolve of even the toughest among us.

First – it is important to recognize that children this age are undergoing many, many developmental changes, including recognizing that they are their own person and can act independently of their caregivers. They learn through cause and effect and by trial and error and they are naturally curious about the world and want to explore; however, they don’t realize that they lack the physical and cognitive skills to do everything they desire. This doesn’t mean that there’s anything wrong with them or your parenting skills, this autonomy is actually something to be celebrated! AND – I recognize that the ensuing power struggles can be frustrating and exhausting.

It should help to keep in mind some simple principles when dealing with toddlers – about masking up and any other request that has the potential for resistance. You’ve likely heard some of these before but they bear repeating.

1) Pick your battles. Save your energy for the critical things. Instead of always saying, “no” or “don’t” try to phrase things in the positive, for example: “please walk” instead of “no running.”

2) Routines are important. Most parents follow a bedtime routine but things like leaving the house, or meal time can also be easier if there are set patterns and expectations. “Put on your shoes, put on your jacket, put on your mask. Can you turn off the light for me? Ok, let’s go.”

3) Give your child a choice when you can, ideally between 2 things. This works both as a distraction from the thing itself (Which shirt would you like to wear: green or purple? Not: Do you want to get dressed?) This also helps your child feel a sense of control.

4) Don’t keep negotiating (especially in a non-negotiable situations.) Keep your tone even, keep your words simple and then just wait. “We’re not going to do anything until you get in your car seat.”

5) Don’t give in. It’s tempting to meet your child’s demands when they are screaming (especially if the meltdown is in public), but it’s crucial to compassionately but firmly stand your ground. You don’t want your child to learn that a tantrum will get them what they want. If it happens in public, you need to wait it out or cut your losses and leave.

I know some of you are thinking, “if only it was that easy. You haven’t met MY child!” None of this works all the time – and some children are simply more sensitive and/or more likely to tantrum than others. The good news is that the older children get, typically the easier it is to introduce new requests or smooth out day-to-day activities.

So about masking specifically…

Your expectations matter. You should treat masking up as a non-negotiable item, like wearing shoes or a jacket when it is cold. Keep your voice neutral when you ask your child to put their mask on – don’t make it sound like something hard to do. Keep masks where you keep other items that are put on when you leave the house –establish mask wearing as part of your leaving the house routine.

Just like shoes, your child needs a mask that fits well and one they recognize as their own. The better a mask fits, the less likely a child is to keep pulling at it. Try letting them pick out which one they want to wear. Children like see characters on their mask – or animals or certain colors. Children will feel some sense of control over the situation when the mask is something they picked or created themselves.

Many children need to practice with their masks. Some children resist anything on their face, so it might help to start with some child-size sunglasses when in the car seat. You can have your child put a mask on their favorite stuffed animal or doll and then wear a matching one themselves. Parents tell me that they have created costumes that include masks for dress up and pretend play. One mom made a superhero mask to go with her child’s superhero outfit and she lets them dress up for their trip out of the house. Enlist your older child’s help by having them dress up too. You can also let your child practice by putting a mask on you – make it fun with a game of peek-a-boo!

Let your children know when mask wearing will be required. It is always a good idea to outline the expectations of an outing, as well as the probable schedule and sequence of events. “We are going to go to the grocery store where we will buy milk and other stuff. We need to keep our masks on the whole time at the store. When we are done, we will go to the park to play. You can take your mask off outside at the park.”

Plan practice session out in the real world. Start out with simple trip and be prepared to cut it short. Going out with your mask on is a lot different than keeping your mask on at home. Children will see others with masks on, there are built in distractions when out and about, and most of all – they will see YOU with YOUR mask on. Children look to their parents for appropriate social cues, so modeling mask-wearing is the single most important thing you can do.

Finally – focus on positive reinforcements. Be enthusiastic about mask wearing, give tons of praise when your child keeps their mask on (no matter how little on lasts) and praise others (within ear-shot of your child) for keeping their mask on too. “Wow, Nana, cool mask. Good for you for keeping it over your nose.” You may want to set up a reward/incentive system. If you do this, it is important to keep is super simple so your toddler understands – “you must keep your mask on while we are at the store and then you will get a sticker.” I’ve seen a variety of social media posts about using sweets (M&Ms seem to be a favorite) as especially effective but that would be an individual family choice. (I’ll discuss the pros/cons of the use of rewards/incentives for young children in another blog.) But what I will say here is if you decide you want to try a reward system with your child, it is critical to set it up ahead of time -- prior to any opportunity to practice mask wearing. Resist the urge to suddenly offer a reward in the middle of an outing that is not going well (a

momentary bribe) because that trains children to use their behavior as a way to negotiate a reward.

No matter how much you practice, adjust your expectations for “mask fails.” Toddlers and preschoolers just don’t have the same self-control as we (adults) do. They pull their masks down to talk, their masks fall off, or they just get bored or frustrated with having a face covering on. All of this is normal. Rather than getting upset, stay focused on setting the routine: “We have to wear our mask in the store to stay healthy.” Point out your own mask and gently replace the mask on your child’s face. If your child shares that their mask is uncomfortable, it’s okay to validate that “yup, sometimes masks feel itchy or hot.” Reassure them that you will be done soon and they can take it off in the car. Then try re-direct your child’s attention to something else, for example is the store decorated for the Holidays?

Wearing masks are now a part of life for all of us. Fortunately, children respond well to the consistency of daily routines, including mask-wearing. By always making masks a part of your family’s “going out” routine, your children will learn to wear theirs with little or no protest. As always, don't hesitate to talk with your child's pediatrician if you have any questions specific to your child wearing face mask.

Ask Nana is published with permission. ©2021, M. Rogers, All right reserved