How Much Milk Is Too Much?

A Case Study of an Obese Toddler

Barbara Gray, PhD, RN, CPNP; Maria C. Reyes, MS, FNP-C, APRN; Lori L. Conners, RN, BSN; Jo Ann Serota, DNP, RN, CPNP; Beverly Giordano, MS, RN, ARNP, PMHS; Donna Hallas, PhD, PNP-BC, CPNP


J Pediatr Health Care. 2013;27(2):148-154. 

In This Article


The patient weighs 43 lbs (19.5 kg; > 95% percentile), his height is 37 inches (93.98 cm; 75% percentile), and his body mass index (BMI) is 22.1 (> 95% percentile). This toddler is playful, alert, and although quiet, makes eye contact with the examiner. His skin is pink, warm, and dry without any lesions or rashes; no acanthosis nigricans is noted. His lungs are clear to auscultation, and the cardiac exam reveals S1 and S2 heart sounds with no murmurs and a regular rate and rhythm. The abdomen is soft and nontender without organomegaly. He has symmetrical movement of extremities with full muscle strength, and normal male genitalia with testes descended bilaterally. A complete blood count (including a hemoglobin level of 12.5 mg/dL) and comprehensive metabolic panel for this child yielded results in the normal range. His fasting glucose level was 70 mg/dl. The child's lead level was < 1 μg/dL, also within the normal range.