Problem
"Mary is just here for her shots. What should we be giving her for formula?" Mother looks very young, petite, less than 5 ft., about 100 lbs., is Filipino. HPI: Mary is a 20 week old female in your clinic for a 4 month well child check. Mom states, "She was getting constipated, so I switched her to low iron Similac. Is that ok? Also, she is still up twice a night. How much longer will THAT last?" PMH: Normal spontaneous vaginal delivery (NSVD). Apgar scores 9 and 10. Milestones all WNL on previous visit. Has started to try to turn over. Received all required immunizations at 2 month visit. Mary's physical growth: Plot her growth and fill in her percentiles. Parameter Age Measurement Percentile Length 2 wks. 20" 2 mos. 21 ¾" 4 mos. 23 ½" Weight Birth 6 lb., 15 oz. 2 wks. 6 lb. 14 oz. 2 mos. 8 lb. 8 oz. 4 mos. 11 lb. 1 oz. Head circ. 2 wks. 34 cm 2 mos. 37 cm 4 mos. 39 cm Allergies: None Current medications: None Family Hex: MGM: 44 yrs. A&W MGF: 46 yrs. A&W PGM: 53 yrs. HTN, NIDDM PGF: 58 yrs., deceased, colon.