Paeds Cases · preventive-and-community-paediatrics
Infant health supervision OSCE — early weight check and 2-month counselling
Observed structured encounter testing day-5 feeding and jaundice decisions plus 2-month safe-sleep and maternal mental-health counselling with teach-back.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a day-5 exclusively breastfed neonate with weight loss and jaundice. Station B is a 2-month well visit with bed-sharing and maternal low mood; vaccines are due.
Station A — Day-5 neonate (10 minutes)
Candidate instructions: Take a focused history from the parent, outline examination priorities, and explain your management plan for weight loss and jaundice. [1]
Parent script (key facts if asked):
- Term birth, home day 2, exclusive breastfeeding.
- Birth weight 3500 g; today 3120 g.
- Painful latch; feeds 45 minutes each side.
- 4 wet nappies yesterday; stools present.
- Yellow face and chest noticed this morning.
- Baby wakes for feeds but is sleepier today.
- No fever reported; no bilious vomiting. [1]
Examiner checklist — must hit:
- Assesses wellbeing / red flags for sepsis
- Interprets ~11% weight loss with output
- Plans feed observation and lactation support ± temporary supplementation criteria
- Measures bilirubin and plots by age in hours (local AAP-aligned pathway)
- Gives timed reweigh and clear safety-net
- Mentions full exam including eyes, hips, femorals if time [1]
Domain marks: clinical reasoning 4 · management 4 · communication 2 [1]
References7ShowHide
- [1]Moon RY, Carlin RF, Hand I Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 2022.PMID 35726558
- [5]Kemper AR, Newman TB, Slaughter JL, et al. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 2022.PMID 35927462
- [6]Flaherman VJ, Schaefer EW, Kuzniewicz MW, et al. Early weight loss nomograms for exclusively breastfed newborns. Pediatrics, 2015.PMID 25554815
- [7]Rafferty J, Mattson G, Earls MF, et al. Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics, 2019.PMID 30559118
- [3]Meek JY, Noble L Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 2022.PMID 35921640
- [12]Shane AL, Sánchez PJ, Stoll BJ Neonatal sepsis. Lancet (London, England), 2017.PMID 28434651
- [9]Mahle WT, Martin GR, Beekman RH 3rd, et al. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics, 2012.PMID 22201143