This mother  told me today that she took a home pregnancy test and is
pregnant.  Yes, that will mean four babies under four when this one is
born.  She is focusing on the bright side of this news, which for her means
she must wean.  So that will solve her feelings of nausea and agitation at
MER this time around.  She is planning a gentle weaning and is moving
along. The 4 month old is not taking to a bottle so well.

Any thoughts for next time?
And thanks to all who replied.

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