Mrs. Kimberly Franklin, a 26 year old mother of one, is now well into the second trimester of her second pregnancy.

• She weighs 180 pounds and is 5'6" tall.
• She is very concerned about weight gain, and
• Indicates the 'morning sickness' still bothers her.
• Mrs. Franklin is very conscious of her body image.
• She emphasizes it's important to have a healthy weight.
• She was referred by her obstetrician because of low weight gain, although Mrs. Franklin feels she's 'fat' enough.
• She gained 35 pounds with her first pregnancy, and did not loose it all after the birth.
  • She is determined that that not happen again.

Mrs. Franklin's SGA form indicates she would benefit from nutrition counseling.

• Mrs. Franklin says she's concerned for her baby's health because the excessive vomiting may have resulted in a nutrient deficiency for her baby.
• When pressed on the matter, she says she is making herself vomit after eating in attempt to prevent the kind of weight gain she experienced in her first pregnancy.
• If her reported change of weight is accurate, she has gained only 5 pounds so far.
• Examination of her oral cavity reveals extensive loss of enamel on the lingual surface of her teeth.
  • Click the image to see the changes.

Can this all be morning sickness?