The woman’s pre-pregnancy BMI is a factor that the nurse should consider when evaluating the adequacy of the woman’s weight gain.

BMI is a measure of body fat calculated from weight and height.The amount of weight a woman should gain during pregnancy depends on her BMI before pregnancy.For example, a woman with a normal BMI (18.5-24.9) should gain 25-35 pounds, while a woman with an obese BMI (30 or more) should gain 11-20 pounds.

Choice B is wrong because the woman’s age and parity are not factors that affect the recommended weight gain during pregnancy.The weight gain recommendations are the same for all women regardless of their age or how many children they have had.

Choice C is wrong because the woman’s food preferences and cravings are not factors that determine the adequacy of the woman’s weight gain.Food preferences and cravings may influence what and how much a woman eats, but they do not change the amount of weight she should gain for a healthy pregnancy.

Choice D is wrong because the woman’s activity level and lifestyle are not factors that affect the recommended weight gain during pregnancy.Activity level and lifestyle may influence how a woman gains weight, but they do not change the amount of weight she should gain for a healthy pregnancy.Physical activity and healthy eating habits are important for all pregnant women to maintain their health and well-being.

“I should push my baby’s chin down if he doesn’t latch on properly.” This statement indicates a need for further teaching because pushing the baby’s chin down can cause pain and damage to the nipple and interfere with the baby’s ability to suckle effectively.The mother should wait for the baby to open his mouth wide before bringing him to her breast and then gently guide his lower jaw onto the breast.

Choice A is correct because holding the baby close to the body with his nose opposite the nipple helps him to latch on well and stimulates the rooting reflex.

Choice B is correct because supporting the breast with a C-shape below the areola prevents the fingers from compressing the milk ducts and allows the baby to grasp more of the breast tissue.

Choice C is correct because waiting for the baby to open his mouth wide ensures that he takes a large mouthful of breast tissue and forms a good seal around the nipple and areola.

Normal ranges for breastfeeding frequency and duration are 8-12 times in 24 hours and 15-20 minutes on each side.

Applying lanolin cream or hydrogel pads to the nipples after each feeding can help soothe and heal sore nipples that are cracked and bleeding.Lanolin cream is safe for the baby and does not need to be washed off before feeding.Hydrogel pads can also provide cooling relief and create a moist wound healing environment.

Choice B is wrong because washing the nipples with soap and water before and after each feeding can dry out and irritate the skin, making the problem worse.The nipples do not need to be washed more than once a day with plain water.

Choice C is wrong because switching to formula feeding until the nipples heal completely can interfere with the establishment of breastfeeding and reduce the milk supply.Formula feeding can also increase the risk of infections and allergies for the baby.Breastfeeding should be continued as much as possible, even with sore nipples, as long as the baby is latched on correctly.

Choice D is wrong because using a nipple shield or a breast pump for every feeding can also affect the milk supply and the baby’s ability to breastfeed effectively.Nipple shields and breast pumps should only be used temporarily and under the guidance of a lactation consultant.They do not address the underlying cause of sore nipples, which is usually a poor latch.

Sucking on his fingers or fists.This is a feeding readiness cue that indicates that the infant is hungry and ready to eat.

Some possible explanations for the other choices are:

• Choice A is wrong because turning his head away from the breast or bottle is a sign of satiety or fullness, not hunger.

• Choice C is wrong because falling asleep or becoming drowsy is a sign of fatigue or satisfaction, not hunger.

• Choice D is wrong because spitting up or burping is a sign of air swallowing or overfeeding, not hunger.

Normal ranges for infant feeding frequency and duration vary depending on the type of feeding (breastfeeding or formula feeding), the age and weight of the infant, and the individual needs and preferences of the infant and the mother.

However, some general guidelines are:

• Breastfed infants should feed 8 to 12 times in 24 hours, with each feeding lasting 10 to 15 minutes per breast.

• Formula-fed infants should feed 6 to 10 times in 24 hours, with each feeding lasting 15 to 20 minutes and providing about 2 to 3 ounces of formula per pound of body weight per day.

Iron-fortified infant cereal.According to the World Health Organization (WHO), infants should start receiving complementary foods at 6 months of age in addition to breast milk.Iron-fortified infant cereal is a good source of iron, which is essential for the development of the infant’s brain and blood cells.

Choice A is wrong because cow’s milk or juice are not recommended as the first complementary foods for infants.Cow’s milk can cause iron deficiency anemia and allergic reactions, and juice can cause dental caries and diarrhea.

Choice B is wrong because pureed fruits or vegetables are not enough to meet the infant’s iron needs.Fruits and vegetables are rich in vitamins and minerals, but they do not provide enough iron for the growing infant.

Choice D is wrong because yogurt or cheese are not suitable as the first complementary foods for infants.Yogurt or cheese can cause allergic reactions and lactose intolerance, and they do not provide enough iron for the infant.