Infant health supervision 3–6 months — branching viva

Stem

You are in a general paediatric / primary care clinic with a 4-month-old and mother. ^[5]

Examiner: How do you structure this visit? ^[5]

Strong answer: Confirm stability; open concerns; maternal mood; plot weight, length, OFC; developmental surveillance; focused exam; anticipatory guidance; immunisations; safety-net. ^{[5] [3]}

Examiner: Mother sleeps the baby on the tummy for a flat head. Your counsel? ^{[1] [7]}

Strong answer: Supine for every sleep; firm flat surface; no soft bedding; supervised tummy time only when awake to help head shape and motor skills. ^{[1] [7]}

Examiner: Why ask about maternal mood if the infant looks well? ^[3]

Strong answer: Perinatal depression is common, under-treated, and harms the dyad; AAP framework includes screening at 1-, 2-, 4- and 6-month visits with a path for positives. ^[3]

Examiner: What developmental approach do you use? ^{[4] [5]}

Strong answer: Surveillance each visit with evidence-informed milestones; document domains; act on red flags; do not wait for a later birthday screen if concern is high. ^{[4] [5]}

Examiner: Family needs an interpreter. ^[10]

Strong answer: Professional interpreter for mood screening and safety counselling; not child interpreters. ^[10]