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Facemasks during COVID-19 and the importance of smiles in developmental assessment
  1. Lynn Snow
  1. Community Paediatrics, Leicester Partnership Trust, Leicester LE3 9DZ, UK
  1. Correspondence to Dr Lynn Snow, Community Paediatrics, Leicester Partnership Trust, Leicester LE3 9DZ, UK; lynn.snow{at}

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Wearing Personal Protective Equipment (PPE) including a mask, I try to elicit a social smile from a 7-week-old baby. Despite exaggerated cooing and wide smiley eyes on my part, it is unsuccessful. The carer reports that the baby has just started smiling at home with her. I step back, allow the carer to remove her mask and smile at the baby … the baby responds with a grin happily!

There are parts of a developmental history and examination that we are used to taking on report from a child’s carers—can they feed themselves with a spoon, for example. The social smile is not one of these. I would normally try to elicit it to be reassured that a baby was responding normally.

I am needing to change so many of my practices as a result of COVID-19. I have had to change the whole clinic setting—no toys, PPE, limited people in the room; the way I examine—social distance until physical contact is needed; the way I communicate to work round the face covering—increased body language, increased checking verbally back with people. Things we did automatically from years of practice all now have to be risk assessed and possibly altered. Eliciting that smile is one of them!

Does the fact that the baby cannot see our mouths behind a mask matter and will it affect their …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.