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 toddler in this case study had a follow-up visit 6 months later. He weighed 46 lbs (20.86 kg), an increase of 3 lbs (1.36 kg) since the last visit; height was 39 inches (99.06 cm), an increase of 2 inches (5.08 cm), and his BMI was 21.3 (down from 22.1). A thyroid panel was normal; his total cholesterol was borderline high at 182 mg/dL; low-density lipoprotein was also borderline high at 119 mg/dL. Other components of the lipid panel were in the normal range. His parents stated he was no longer taking a bottle, but he continued to eat the same types of foods. They stated that he was more active now because they made an effort to get him "moving." Education was provided again at this visit, and the family was referred to a weight management clinic at the local children's hospital.

PNPs have a role in addressing childhood obesity through management of individuals and families in the clinical setting and on a broader scope by advocating for healthier school environments related to the availability of nutritious foods and physical education programs (NICHQ, 2007). Attention should also be given to the communities where children live. For example, partnerships with community organizations can result in opportunities for more programs and activities that promote healthy behaviors for families who live in all kinds of neighborhoods.