Paediatric Endocrinology Clinic

At Gertrude’s Children Hospital we care for children and teenagers up to 21 years with type 1 and type 2 diabetes. We also treat various endocrine disorders. These are disorders related to various hormones in the body and may include abnormal or delayed puberty, thyroid diseases, pituitary diseases and various growth hormone disorders.

Common disorders may include diabetes, obesity, etc.

We are proud to have:-

  1. Paediatric endocrinologists on board
  2. Laboratory services that test various hormone levels
  3. A pharmacy that is well stocked for any hormonal/ non-hormonal treatments that may be required
  4. Nutritionists that will take you through the dietary measures required with Diabetes
  5. Various professionals in the team to assist the child, teen, family and caregivers understand, manage and come to terms with any chronic diagnosis. Education is power and we are keen on giving our patients and families this power. You will be taught how to regularly check your blood glucose, use insulin if prescribed, plan your meals among many other details.

Overweight and Obesity 

How are overweight and obesity defined?

These are defined using a formulae known as the Body mass index (BMI). It uses height and weight measurements to estimate a person’s body fat. Calculating BMI on your own can be complicated. An easier way is to use a BMI calculator.  

On a standard BMI chart, kids ages 2 to 19 fall into one of four categories: 

  • underweight: BMI below the 5th percentile 
  • normal weight: BMI at the 5th and less than the 85th percentile
  • overweight: BMI at the 85th and below 95th percentiles 
  • obese: BMI at or above 95th percentile 

For children younger than two years old, doctors use weight-for-length charts instead of BMI to determine how a baby’s weight compares with his or her length. Any child under 2 who falls at or above the 95th percentile may be considered overweight. You can refer to the national maternal and child health card.

BMI is not a perfect measure of body fat and can be misleading in some cases. For example, a muscular person may have a high BMI without being overweight (extra muscle adds to body weight — but not fatness). Also, BMI might be hard to interpret during puberty when kids have periods of fast growth. Remember, BMI is usually a good indicator of body fat, but it’s not a direct measurement. 

Preventing kids from becoming overweight means making choices in the way your family eats and exercises, and how you spend time together. Helping children lead healthy lifestyles begins with parents who lead by example.

What health problems can obesity cause?

Obesity puts children at risk for medical problems that can affect their health now and in the future. These include serious conditions that were once considered adult diseases like:-  

  • Type 2 diabetes,  
  • High blood pressure  
  • High cholesterol  
  • Bone and joint problems 
  • Shortness of breath that makes exercise, sports, or any physical activity more difficult. This also can make asthma (link) symptoms worse or lead kids to develop asthma. 
  • Restless sleep or breathing problems at night 
  • A tendency to mature earlier. Overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are. Overweight girls may have irregular menstrual cycles and fertility problems in adulthood. 
  • Liver and gallbladder disease 
  • Obese kids also might have emotional issues to deal with (such as low self-esteem, and may be teased, bullied or rejected by peers. Kids who are unhappy with their weight can be at risk of unhealthy diets, eating disorders (link), depression (link) and substance use (link)  

If you’re worried, take your child or teen to see the doctor. The doctor will ask about eating and activity habits and make suggestions on how to make positive changes. The doctor also may order blood tests to look for some of the medical problems associated with obesity. 

Depending on your child’s BMI (or weight-for-length measurement) and health, the doctor may refer you to a nutritionist for a weight management program. Self-instituted diets without professional help may be dangerous especially for children who are still developing.  

Why do children become overweight or obese?

Diet and Lifestyle 

Fast foods, over processed foods that are high in direct sugars and unhealthy fat are the main culprit. Large portions of food also contribute.  

An irregular feeding pattern especially on weekends and holidays.  

Modern life is also quite sedentary. Kids spend more time playing with electronic devices than actively playing outside. Kids who watch TV more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. And kids who have a TV in the bedroom also are more likely to be overweight. 

Exercise and Physical Activity 

Many kids don’t get enough physical activity. Older kids and teens should get 1 hour or more of moderate to vigorous exercise every day, including aerobic and muscle- and bone-strengthening activities. Kid’s ages 2 to 5 years should play actively several times each day. 

Genetics 

Genetics can play a role in what kids weigh. Our genes help determine body type and how the body stores and burns fat. But genes alone can’t explain the current obesity crisis. Because both genes and habits are passed down from one generation to the next, multiple members of a family may struggle with weight. 

People in the same family tend to have similar eating patterns, levels of physical activity, and attitudes toward being overweight. A child’s chances of being overweight increase if one or both parent is overweight or obese. 

How can we prevent overweight and obesity?

The key to keeping kids of all ages at a healthy weight is taking a whole-family approach by making healthy eating and exercise a family affair.  

Get your kids involved by letting them help you plan and prepare healthy meals.  

Take them along when you go to the market or grocery shopping.  

Teach them how to make good food choices. (The new Kenyan curriculum has the subject health & nutrition).

Serve healthy foods most of the time with treats once in a while.   

Try to avoid these common traps:

  • Don’t reward kids for good behaviour or try to stop bad behaviour with sweets or treats. Find other ways to change behaviour. 
  • Don’t have a clean-plate policy. Even babies turn away from the bottle or breast to send signals that they’re full.  
  • If kids are satisfied, don’t force them to keep eating. Reinforce the idea that they should only eat when they’re hungry. 
  • Don’t talk about “bad foods” or completely ban all sweets and favourite snacks. Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own. 

Additional recommendations for kids of all ages:

Birth to age 1: Besides its many health benefits, breastfeeding may help prevent excessive weight gain. 

Ages 1 to 5: Start good habits early. Help shape food preferences by offering a variety of healthy foods. Encourage kids’ natural tendency to be active and help them build on developing skills. 

Ages 6 to 12: Encourage kids to be physically active every day, whether through an organized sports team or a pick-up game of soccer during school breaks.  Keep your kids active at home with everyday activities like playing outside. Have family plans that involve activities like a walk, jog, cycling in Karura or Arboretum forest.  Let them be more involved in making good food choices, such as packing lunch. 

Ages 13 to 18: Teach teens how to prepare healthy meals and snacks at home. Encourage them to make healthy choices when outside the home and to be active every day. 

All ages 

  • Cut down on TV, phone, computer, and video game time and discourage eating in front of a screen (TV or otherwise).  
  • Serve a variety of healthy foods and eat family meals together as often as possible. Have a written down meal plan including snacks. ( breakfast, morning snack, lunch, evening snack, dinner)  
  • Encourage kids to eat breakfast every day.  
  • Have at least five servings of fruits and vegetables daily. 
  • Limit sugar-sweetened beverages in form of sodas and juices, sweets and candy.   
  • Talk to kids about the importance of eating well and being active.  

Be a role model by eating well, exercising regularly, and building healthy habits into your own daily life. Make it a family affair that will become second nature for everyone. 

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