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QUESTION: My daughter is 4 yr old and weighting 20 kgs. Is it normal?
What food should be given to her and in what quantity?

ANSWER: Hi Neha,

Weight is on the higher side.

She should take normal balanced diet (whatever you all eat at home) with lot of fruits and vegetables, taking care she does not take to much of butter/ ghee/ oil and also avoiding excess of chocolates, toffees etc. Toned milk should be used also should not exceed 500 mL in 24 hours.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

www.KumarChildClinic.com

+91-9818356846

---------- FOLLOW-UP ----------

QUESTION: Hello sir,

    My daughter's food habbits are normal means she has breakfast, carries her lunch box and after coming from school she'll have her lunch, morning she wakes up at 6.30 and she has her cup of milk till 7.00, afterwards she'll  
have her breakfast at 9.00, one chapati, 12.40 she'll have her lunch box and after coming from home at 2 p.m.
she'll have something or just she'll tell i m full, i m very much concerned about her weight as it is herediatery in our house.. Is her weight 20 kgs is ok or i should start to reduce that and in whatd eay? Sometimes i feel i m controlling her very much, i'll not allow her to have food as per her wish, i'll give her limited food, if she feels like eating little more also i'll stop her doing so, is it right? I feel she is overweight but she is very active, she'll be playing and jumping whole day. Please silve my problem.

ANSWER: Hi Neha,

I am happy to see that you are concerned about her being at risk of being overweight. Sadly, it is something that is rare in our society these days: It is said that obesity is most visible, yet most neglected epidemic, globally. This is more relevant in children, as mothers (even mothers of grossly obese kids) usually feel that their child is too thin!!

Actually, it is a bit difficult to interpret single reading of weight. It is more important to see her growth chart to see if she is  GAINING weight rapidly. Let me explain. Normal range of weight at 4 year girl is 11.9-19.4 kg. It is a wide range. I have to know if she has always been on higher side of normal range...or was she at lower side of normal range (or in middle) and she has suddenly gained weight to reach higher side. How aggressive we should be in controlling would largely depend on this information. Secondly, what is her height? We need to know about BMI (Body Mass Index) to manage overweight kids/ adults.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

www.KumarChildClinic.com

+91-9818356846



---------- FOLLOW-UP ----------

QUESTION: Hello sir,
    My daughter's height is 3.6 at present, and she has not gained her weight suddenly , i will be watching her weight frequently.  Whenever we will visit her doctor he will check her weight,each and every time i'll ask him whether she is over weight but he will tell no she is not don't worry.  But i m not satisfied with his answer,so sir please tekl me what should i do?  whenever i see her standing alone i don't fell she is overweight or something of that sort  i see her in group of children in her school i feel worried.  Its not like that, that she is not active and sits   in one place and watch T.V. She'll be playing, jumping whole day and i had not made her practice if eating junk food so much.  What should i do please answer sir.
Thanku very much.

Answer
Hi Neha,

Plot her weight and height on growth charts (actually your pediatrician should be doing it) to monitor weight and height gain.

You can access growth charts at: http://www.who.int/childgrowth/standards/chts_girls_p.pdf

Best wishes,
Dr. Puneet Kumar.

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Dr. Puneet Kumar

Expertise

I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query requiring specific diagnosis of a particular subject.

Experience

I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 15 years of experience in the field.

Organizations
Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (http://www.kumarchildclinic.com)

Publications
(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. http://www.pediatricsciences.com/issue/view/1050000010 (f) Regular column, “How do I treat” in Pediascene (www.pediascene.com) (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 (http://www.pediascene.com/page.php?cid=6&catid=9&id=132 ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

Education/Credentials
After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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