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Obesity


Question

My daughter is 5-years-old, is 3' 3" tall and she weighs 49 lbs. I’m concerned because her pediatrician feels she is overweight and wants to put her on the Atkins' diet. Our charts on weight by years place her above the 95th percentile for children with CdLS, so she would appear to fall within normal limits for weight. Do you think her doctor's recommendation for a diet for a child with CdLS at this height and weight is warranted?

Answer of our experts

This girl is at the 95th percentile for 5-year-old girls, let alone for CdLS girls. Her height is below the 5th percentile for regular girls. It sounds like she is overweight no matter what. I would make sure that she has a correct diagnosis. I would recommend checking thyroid function studies and think about other reasons for obesity, if diet and lack of exercise alone cannot explain this. If all is negative, she may need to have limitations on intake (I cannot comment on an Atkins diet in 5 year olds although would not normally be recommended in a pediatric population); typically you decrease intake and increase exercise in overweight children and wait until children grow in height. A dietician should be involved

TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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