Child Health, Growth and Development
Growth
Use WHO growth charts; know failure to thrive (weight faltering, causes: inadequate intake, malabsorption, increased demand, psychosocial). Understand short stature (familial, constitutional, GH deficiency, coeliac, hypothyroidism) and obesity in children.
Development
Know milestones by domain (gross motor, fine motor, language, social) and red flags (no social smile by 6–8 weeks, no sitting by 9 months, no words by 18 months, no walking by 18 months). Understand autism spectrum disorder early signs and ADHD criteria.
Common paediatric issues
- Vaccination schedule and catch-up.
- Fever: red flags (age <3 months, lethargy, poor feeding, non-blanching rash).
- Respiratory: bronchiolitis, croup, asthma.
- Gastro: gastroenteritis and ORS, reflux.
- Newborn: jaundice, feeding, screening (heel prick, hearing).
Traps
- Reassuring a parent without plotting growth on a chart.
- Missing developmental regression (a red flag for neurodegenerative or epileptic encephalopathy).
- Attributing fever in an infant <3 months to a viral illness without investigation.
- Ignoring non-blanching rash (meningococcal disease).
Worked rule
A 2-month-old with fever ≥38°C: full sepsis work-up and empirical antibiotics - age is the red flag, not the examination.
Safeguarding
Consider non-accidental injury when history and injury pattern are inconsistent; document and escalate.