Return to Diagnosis ListShow Learning Points most relevant to Phase 1:

Irritable infant

Clinical Discipline(s)/Organ System(s)
Paediatrics, Emergency Medicine
Progress Test Topic(s)
Child health
A 2 month old NZ European boy is brought to the Emergency Department in the middle of the night by his mother. She is concerned because since about two weeks of age he has been much more irritable than her first child and has been crying for 2 hours tonight. He is gaining weight and feeding well otherwise.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Nutrition and normal physiology of breastfeeding
   - Normal growth and development through the lifespan
Clinical and Communication Skills 
   - Examination of young infants including abdomen and groin, normal growth and development, including plotting height, weight and head circumference
   - Understanding normal feeding, sleeping, crying pattern of infant
   - Assessment of mother's level of understanding and experience
   - Assessment of other potential stressors and support structures
   - Recognition of important 'red flags' (poor growth or feeding, fever, lethargy)
   - Talking with carers of infants; safety in the home including domestic violence and postnatal depression
   - Non pharmacologic management of the crying baby/colic
Personal and Professional Skills 
   - Communicate empathetically, non-judgementally and supportively with child and caregiver
   - Recognise that this presentation can cause significant stress and frustration for the caregivers
   - Assessing for postnatal depression and family violence
Hauora Māori 
   - Recognition of the strengths of extended whānau in support of mothers and newborns
   - Ability to cater for differential health literacy needs of Māori patients and whānau
   - The role of kaupapa Māori health services in health promotion and reducing health inequalities
Population Health 
   - Promotion of breast feeding
   - Knowledge of the “Never Shake A Baby” national campaign
Conditions to be considered relating to this scenario
normal infant/ infantile colic/reflux, acute infectious illness such as urinary tract infection, acute otitis media
Less common but 'important not to miss'
postnatal depression/anxiety, meningitis, other serious infection, intussusception, incarcerated hernia, testicular torsion, non-accidental injury, hair tourniquet