Estudo sugere que pessoas usem máscaras em casa para proteger familiares
Prática já adotada pela população de países asiáticos para se proteger de doenças respiratórias transmitidas principalmente no inverno, o uso de máscaras se mostrou um instrumento eficaz na prevenção ao novo coronavírus. Mas dependendo da faixa etária da criança e da condição clínica, o uso deve ser evitado. Especialistas lembram que para quem tem idade inferior a 2 anos, o uso da máscara facial pode dificultar a respiração e até aumentar o risco de asfixia.
A Associação Pediátrica do Japão fez um apelo aos pais sobre esse perigo em um momento de reabertura da economia no país. O Centro para Controle de Doenças (CDC) dos Estados Unidos e a Academia Americana de Pediatria também já emitiram notas similares. O brasileiro Paulo Henrique Martinez, de 36 anos, que mora no Japão há 30 anos, observa que menores de 2 anos não estão usando máscaras no país por causa da recomendação pediátrica. “Apenas acima dessa idade usam e obrigatoriamente em escolas e hospitais”.
Sua amiga, a japonesa Akira Suzuki, de 27 anos, é mãe da Yua, de 6. Para a filha que está na primeira série, é mais fácil explicar sobre a doença. “Com a retomada das aulas, o uso de máscara será obrigatório mesmo dentro da sala de aula. Mas com essa idade, as crianças já entendem bem e sabem usar corretamente”.
No Brasil, a Sociedade Brasileira de Pediatria (SBP) e a Sociedade de Pediatria de São Paulo (SPSP) concordam com os médicos japoneses sobre a importância de orientar sobre os riscos aos menores de 2 anos e também crianças com doenças pulmonares e portadores de distúrbios neurológicos.
“O sufocamento é o principal risco. Não somente em crianças menores de 2 anos, mas crianças com doenças pulmonares, como asmáticos em crise, ou com distúrbios neurológicos não devem usar máscaras. No último caso, independentemente da idade o uso não é recomendado. A máscara deve ser evitada por aqueles que não conseguem manejar, ou seja, tirar a própria máscara do rosto”, afirma o infectologista Renato Kfouri, presidente do Departamento Científico de Imunizações da SBP.
“Não temos dados de segurança sobre o uso de máscaras em crianças menores de 2 anos. Existe o risco de sufocamento, principalmente em crianças com quadro respiratório. Você colocar a máscara pode piorar o desconforto respiratório e colocá-la em risco”, afirma o pediatra e infectologista Marco Aurélio Safadi, presidente do Departamento de Imunizações da Sociedade de Pediatria da SPSP.
Durante consultas online também chegam muitas dúvidas sobre o uso correto de máscaras em crianças. “Os pais de bebês ficam muito preocupados. Orientamos o uso para maiores de 2 anos de idade e a higienização correta das mãos. As crianças menores não tem autonomia com relação ao controle do uso da máscara. Além disso, como babam muito, elas podem molhar a máscara e perder a efetividade contra a doença”, acrescenta Rafael Placeres, pediatra da clínica de atenção integral à saúde da Central Nacional Unimed (CNU).
O recomendado é ficar em casa, mas caso precise sair com menores de 2 anos, deve-se manter distância de um metro e meio de outras pessoas e lavar as mãos com frequência, medidas de higienização que devem ser redobradas nessas situações. “No caso de crianças menores de 2 anos, precisam ser levadas no colo. Quando retornar da rua, todas as roupas precisam ser retiradas e colocadas para lavar”, orienta Placeres.
“As máscaras são necessárias a todos, mas com certeza com as crianças pequenas temos de ter mais atenção. Estamos cumprindo a quarentena em casa, mas tivemos que sair recentemente. Percebi que minha filha de 1 ano e 11 meses estava com dificuldade para respirar com a máscara de algodão”, constatou o gestor de Facilities Fábio Araújo, pai da Sofia.
A partir dos 2 anos, a criança já começa a ter mais autonomia e fica mais fácil explicar a forma correta de usar a máscara. Mesmo assim, no início desse processo é preciso ter supervisão. “As crianças se adaptam bem. Vão levar a mão ao rosto. Tudo é hábito e treino. No ‘novo normal’ vamos conviver com uso de máscara por muito tempo até tudo ser realmente normalizado. Quanto maior a idade da criança, mais fácil a adaptação para o uso correto”, orienta Kfouri.
No Japão há mais de 20 anos, a brasileira Kalisa Kinoshita, de 34, diz que as próprias escolas enviaram um passo a passo para ensinar as crianças a produzirem as próprias máscaras. Sua filha Sarah, de 10, e a enteada de seu pai Hitomi, de 11, aproveitaram uma máquina de costura que ela tinha em casa para confeccionar máscaras com tecidos de personagens infantis. “As meninas aprenderam a fazer máscaras, pois não encontrávamos mais para comprar. Elas amaram”, diz Kalisa.
Com bastante cautela, a situação está sendo normalizada no Japão. Depois de três meses suspensas, as aulas de Hitomi, Sarah e do irmão, Josué, de 5, serão retomadas na próxima segunda-feira, 1º. “Já fomos avisados que o uso de máscaras na escola será obrigatório. Na rua é opcional, mas os japoneses usam porque são muito obedientes. Como no Japão já é um costume usar máscara no inverno, as crianças também não se incomodam”, completou Kalisa.
No Brasil, as crianças tiveram mais dificuldade em aceitar o uso. Algumas relataram que a máscara aperta as orelhas e dificulta para respirar e enxergar, mas começaram a entender que é preciso se proteger para não ficar doente. Aos poucos, foram se adaptando. “Muitas crianças entre 3 e 5 anos nos surpreenderam e começaram a entender melhor a necessidade de usar máscaras”, diz Safadi.
“A gente não tem saído muito de casa. Mas quando precisamos circular pelo prédio ou retirar comida na portaria, ela vai junto, mas não aceita muito bem. Reclama que não dá para enxergar direito. A gente procura explicar para ela o que é o coronavírus, que a máscara vai mantê-la segura. Falando desta forma, usando coisas mais lúdicas, como uma brincadeira acaba aceitando”, afirma a publicitária Kátia Oliveira, mãe da Laura, de 3 anos.
Para incentivar a criança, vale a criatividade. “Máscaras com personagens têm ajudado bastante e quando elas olham outras pessoas usando, entendem que se tornou uma prática do dia a dia. Existe a dificuldade, mas estão se adaptando. É importante usar máscara que seja bem acomodada ao rosto da criança”, reforça o pediatra e infectologista. As máscaras cirúrgicas feitas para adultos não devem ser usadas, o ideal é adquirir máscaras caseiras (feitas de algodão em duas camadas) que podem ser melhor acomodadas aos rostos infantis.
Desta forma, os pequenos acabam aceitando melhor. “Eu gosto de usar máscara. Tem que usar por causa do vírus”, disse Gabriel Xavier, de 4 anos, que apenas sai de casa com a mãe Cristiana Helena, de 28 anos, eventualmente para ir ao supermercado ou farmácia.
Com a retomada da rotina, o ensinamento de compartilhar objetos entre crianças tão estimulado por adultos dará vez ainda a uma nova realidade. “É preciso explicar que a máscara não deve ser compartilhada entre as crianças, nem mesmo entre irmãos, para a segurança delas”, aconselha o presidente do Departamento de Imunizações da Sociedade de Pediatria da SPSP.
Além de orientação com relação ao uso, a higienização precisa ser mantida. Se a criança usar a máscara por mais de quatro horas, deve ser trocada por outra limpa. Pode ser trocada antes, caso esteja suja ou molhada. Após uso, deve ser lavada com água e sabão. Alguns especialistas recomendam que a máscara de tecido seja colocada de molho em água sanitária (10 ml para meio litro de água) por meia hora antes da lavagem.
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