PROBLEM SOLVING IN CLINICAL PRACTICE
A picture is worth a thousand words
Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, USA
Correspondence to:
Caroline Kistin, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, USA; caroline.kistin@bmc.org
| The first 150 words of the full text of this article appear below. |
JB is a 5-month-old infant who is referred to a growth and nutrition clinic for poor weight gain. He was born full term with a birth weight of 6 pounds 10 ounces (3000 g), and there were no complications during the pregnancy or delivery. He has a history of spitting up (mild vomiting) after feeds and has been tried on a number of different formulas. He is currently taking seven or more bottles per day of 6–8 ounces (177–236 ml) of formula. He has no history of diarrhoea and no recent infections. There is no family history of growth problems or other illnesses. In the clinic, his height, weight and head circumference are measured and plotted on growth charts along with his prior measurements (
figs 1 and 2). Based on these data he is diagnosed with weight faltering, with moderate malnutrition. In addition to seeing the doctor, JB
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Childhood nutrition (paediatrics)
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