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Janice and Robert bring Beth in for a 2 week weight check at the pediatrician's office. During the nurse's family

assessment, Janice and Robert appear exhausted and anxious. Janice comments, "I feel like it's my fault that Beth is not gaining weight as she should. I get so frustrated because she is still throwing up after at least two breastfeedings a day.  I try but I don't think I'm a very good mother. Maybe I should give up breastfeeding and give her a bottle". Robert further states that his family has a history of gastric ulcer disease and asked if he "gave this stomach problem to her". The couple comment that they are not sure they are doing the right things for Beth and question how they are going to manage caring for her. At this visit Beth weighs 3.4 kg (7.5 lb.), her posterior fontanel is closed, and her posterior fontanel is closed, and her anterior fontanel remains opened and level with suture lines.



1.    Discuss your impressions about the above situation.

2.    Identify any areas of concern for Beth and her parents.

3.    Discuss the relationship between Beth being preterm, her birth weight, and her current weight.

4.    How would you respond to Janice's concern about breastfeeding and Beth's GER?

During the nurse's assessment of Beth's growth and development, she finds that Beth can put her hand to her mouth, lift her head up from a prone position, turn and look for sounds, focus on the face of the person speaking to her, and that the head lag is present 

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