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 2y.o obese or?  



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Author14 Posts
  #1

A mother brings her 2-year-old toddler to you because he does not eat. Pregnancy and delivery were normal and his birth weight was 4 kg. He was breastfed up to 6 months of age. He is now drinking 1.5 L of milk a day, and loves juices. His height (91 cm) is in the 90th percentile and his weight 16.5 kg) is over the 97th percentile for his age. Which one of the following measures is most appropriate in the initial management of this problem?

1) Admit the child to hospital for adrenal, pituitary and thyroid function tests.
2) Refer the mother and her son to a child psychiatrist.
3) Plan an appropriate diet for his age.
4) Reassure the mother and check his weight in 3 months.
5) Add vitamin supplements to his regular diet.





  #2

3? Plan an appropriate diet for his age?


  #3

3.


  #4

3


  #5

what is the exact percentile to assume an infant as obese?


  #6

The weight scale just changed ! WHO change the weight scale for infants and toddles becasue it is a biased research study based on white American babies instead of world-wide babies.


  #7

Yes indeed. They've changed the scales, admitting that the previous ones were wrong and have contributed to obesity. But the reason they gave is that the previous scales were based on birth weights of infants who received supplemental feeds and not breast-feed.



  #8

so does anybody know the new sacles to assume an infant as obese?



  #9

ITS ALWAYS 2 SDs THAT IS ??


  #10

The new recommendation is if the child fells behind in weight on breast feeding, forumla, supplemental oral nutritional feeding may be recommendated


  #11

i'll go for 3 too - plan an apt diet for the child.




  #12

ya i read it too....WHO admitted that the chart that doc's all over the world had been following for the last 40 yrs had some calculation mistakes. it did not consider the brith weight of a child only on breast feed. they have now lowered the ideal weight gain so that the child may not be wrongly diagnosed as underweight. i am pasting below a news article i read on the topic.

"Due to the faulty chart, mothers were wrongly told their babies were underweight. This led to overfeeding of newborns, making them obese.

WHO experts had erred in formulating the chart on the basis of growth rates of infants fed on bottled milk. Babies fed on formula milk put on weight much faster. So, normal weighing newborns fed on breast milk were found to be underweight. "

"The new chart is based on data from breast-fed babies. It was decided following a 15-year study involving more than 8,000 children from six nations, including India. The new chart says a one-year-old boy should weigh between 7.7 kg and 12 kg. The old chart said the weight should be between 8.1 kg and 12.4 kg. A oneyear-old girl's weight should be 7-11.5 kg against 7.4 to 11.6 kg of the old chart. "





  #13

what a disaster that we, doctors, cause!


  #14

Wrong, the doctors did not cause the msitakes.

It is the American Professors who designed those research projects 40 years ago without thinking about 80% of the population are in Asia and Africa and not in America.






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