Infant health supervision 3–6 months — formative SAQs

SAQ 1 (10 marks)

A mother brings her 4-month-old for a routine review. She is tearful. The infant sleeps prone on a pillow “to stop a flat head.” Growth is good. [1] [3] [7]

1. List the core domains you must cover in this health-supervision visit. (3) [5]
2. Correct the sleep advice and explain why. (4) [1] [7]
3. How will you approach maternal mood today? (3) [3]

Model answer

Domains: caregiver concerns and mood; growth (weight, length, OFC); developmental surveillance; focused exam; anticipatory guidance (sleep, feeding, injury); immunisations due; safety-net. [5]

Safe sleep: back to sleep every sleep on a firm flat surface without soft bedding; tummy time only when awake and supervised to address positional head shape — never prone night sleep as treatment. [1] [7]

Mood: screen using local validated tool within the 1-/2-/4-/6-month paediatric framework; explore safety of mother and infant; refer/support dyad; do not ignore because infant is thriving. [3]

SAQ 2 (10 marks)

Parents of a healthy 6-month-old ask when to start solids and what else matters at this visit. [6] [2]

1. Outline complementary feeding timing principles (without inventing brand products). (4) [6]
2. Name two nutrition issues besides solids. (3) [2]
3. Give a concrete safety-net for the family. (3) [15]

Model answer

Introduce complementary foods when developmentally ready; avoid introduction before about 4 months and avoid prolonged delay long after 6 months for most healthy infants; continue milk feeds as the main nutrition early in complementary feeding. Map exact public messages to local guidance. [6]

Vitamin D for at-risk milk-fed infants per guidance; iron risk awareness/prevention strategy age- and risk-based rather than random panels. [2]

Safety-net: specific return triggers (breathing, colour, feeding refusal, fever behaviour change, caregiver crisis), how to access care after hours, and next scheduled visit purpose. [15]