Writing an OET Nursing letter about a child: ages, parents, growth and immunisations

By medEmu team · Published 24 Oct 2026 · Updated 25 Oct 2026

Short answer

When the patient in an OET Nursing letter is a child, write about the child by name (not 'the baby' or 'the kid'), give their age in the form the notes use (weeks or months for infants, years for older children), and make clear who reported what: 'his mother reports that…'. Include parents or carers only where they affect care, such as who gives medication or who needs teaching, and report growth, feeding and immunisation details only when they matter to the reader's task.

What changes when the patient is a child

OET Nursing case notes sometimes describe a baby, toddler or school-age child. The letter structure stays the same as for an adult (purpose, background, current situation, request), but four things need extra care:

How you name and describe the child.
Who reported each piece of information.
Which family details matter.
Growth, feeding, development and immunisations, which appear in many paediatric notes but are not always relevant.

For the general referral structure, see the OET Nursing referral letter guide.

Naming the child and giving their age

Case-note style	Letter style
"Baby O., 6/52"	"Oliver Grant, a 6-week-old baby"
"Pt 9/12 F"	"Amira Saleh, aged 9 months"
"4yo M"	"Leo Baptiste, a 4-year-old boy"
"Kid c asthma"	"a 7-year-old girl with asthma"

Tips:

Use the child's name after the first mention, or "he/she". Avoid "the baby" repeatedly, and never "the kid".
Hyphenate an age used before a noun ("a 4-year-old boy") but not after it ("he is 4 years old").
Keep infant ages in weeks or months; "0.75 years" is hard to read.

Who said what

Much of a child's history comes from parents or carers. If you write it as fact, the reader cannot tell what was observed by staff and what was reported. Use reporting verbs:

"His mother reports that he has had fewer wet nappies over the past two days."
"According to his father, he has been waking at night with a cough."
"On examination, he was alert and well hydrated." (observed by staff)

This also helps Content accuracy: you report the notes as they were written, without upgrading a parent's concern into a diagnosis. See the Content criterion guide.

Which family details to include

Parents and carers belong in the letter when they affect what the reader does. Use this test:

Family detail	Include?
Mother gives the inhaler and needs technique reviewed	Yes
Parents separated; child lives with father on weekdays	Yes, if it affects who receives teaching or follow-up
Older sibling recently had chickenpox	Yes, if relevant to the illness or risk
Father works as an engineer	Usually no
Mother anxious about feeding	Yes, if the reader is asked to support feeding
Grandmother lives overseas	Usually no

If the reader is a parent, a teacher or a social worker, see writing to a non-clinical reader for plain-language swaps.

Growth, feeding, development and immunisations

Paediatric notes often include a block of routine information. Decide line by line:

Weight and growth: usually key if the referral is about feeding, weight loss, dehydration or failure to thrive. Quote figures and the change.
Feeding: key for infants with feeding problems, reflux or dehydration; give type and pattern ("breastfed every 3 hours, with formula top-ups at night").
Development: include only if a delay or regression is part of the concern.
Immunisations: include if overdue and the reader can act, or if relevant to the illness. "Up to date" can usually be left out, or added in a few words if the reader is a child health nurse.
Birth history: include if it affects the current problem (for example, prematurity in a baby with poor weight gain).

Every line you leave out saves words for what matters; see Conciseness & Clarity.

Worked example

These case notes are invented for this guide.

Patient: Amira Saleh, 9 months. Lives with parents and brother (4 yrs). Presenting: referred by child health nurse; weight static for 4 weeks. Weight: 7.4 kg (3 wks ago 7.9 kg); 25th centile (previously 50th). Feeding: breastfed 4–5 times/day; solids twice daily, eats small amounts. Mother reports refuses lumpy food. Birth: term, normal delivery, 3.3 kg. Immunisations: up to date. Other: 2 episodes vomiting last week, no diarrhoea. Afebrile. Alert, active. Mother: concerned; first language Arabic, good English. Father works long shifts. Plan: refer to paediatric dietitian for feeding assessment; review weight in 2 weeks. Writing task: As the ward nurse in the children's assessment unit, write to Ms Helen Ford, Paediatric Dietitian, referring Amira for assessment.

Sample opening and body:

I am writing to refer Amira Saleh, a 9-month-old girl, for a feeding assessment, as her weight has fallen over the past three weeks.

Amira's weight has dropped from 7.9 kg to 7.4 kg, and she has moved from the 50th to the 25th centile. She is breastfed four to five times a day and has solids twice daily, but eats only small amounts, and her mother reports that she refuses lumpy food. She vomited twice last week but has had no diarrhoea or fever, and on examination she was alert and active.

I would be grateful if you could assess Amira's diet and advise her mother on increasing her intake. Her weight will be reviewed again in two weeks.

What was left out: the brother's age, the father's work pattern, the birth history (term, normal weight, so not relevant here) and the immunisations (up to date and unrelated to the referral). The mother's language was left out too, because the notes say her English is good; if the notes had said an interpreter was needed, that would be key.

Checklist for paediatric letters

Child named, with age in weeks, months or years as appropriate.
Reported information attributed ("his mother reports").
Weight and feeding figures copied exactly, with the change.
Family details included only when they affect care.
Immunisations and birth history included only when relevant.
Tone stays formal and respectful about parents' concerns; see formal tone in OET Writing.

Practise and check your letter

Choose a case from the medEmu practice case notes, or paste your own paediatric case notes and letter on the check your letter page. medEmu marks all six OET criteria, checks which case notes you included or missed, and marks problems on your own sentences with the fix and the reason. Your first letter is graded free without an account, and you get 5 more when you sign up. Grades are estimates for practice, not official OET results, and medEmu is not affiliated with OET.

Sources

This guide is medEmu's writing advice, not official OET guidance; all patients and case notes are invented. For OET's own description of the Writing sub-test for Nursing, see oet.com.

Frequently asked questions

How should I write a baby's age in an OET letter?

Follow the notes and be consistent: '6-week-old', 'aged 9 months', 'a 4-year-old boy'. Weeks or months are clearer than years for infants. Write it in words the reader can't misread; avoid case-note shorthand such as '9/12'.

Should the letter be addressed to the parents?

Only if the writing task tells you to write to them. Most tasks name a health professional, such as a paediatrician, a child health nurse or a school nurse. Then the parents appear in the letter as people who report information, give care or need support.

Do I need to include the child's immunisation history?

Only if it is relevant to the reader's task, for example if vaccinations are overdue and the reader can arrange them, or the illness is vaccine-preventable. 'Immunisations up to date' in the notes is often safe to leave out.

How do I report weight for a child?

Quote the weight and, if the notes give it, the change or the centile: 'Her weight has fallen from 7.9 kg to 7.4 kg over three weeks (from the 50th to the 25th centile).' Weight changes are often the reason for a paediatric referral, so they are usually key content.