Paediatrics & Paediatric Endocrinology

Some children are born small, and others seem to grow poorly despite all our attempts to feed them well.

Some kids seem to have recurrent illnesses, asthma, allergies and fevers. Others seem to be remarkably healthy and seldom sick.

Some may just be late developers and others may need specialized assessment and help to help them achieve their full potential.

Some children may have genitals that appear to be smaller than their friends. When is this a part of normal variation within populations and when should parents seek help?

Some children may have been born to mothers with diabetes in pregnancy (gestational diabetes). These children will have an increased risk of diabetes themselves. How do we minimize those risks?

Some children may have been born small for gestational age (SG) or with evidence of intrauterine growth retardation (IUGR). How long should we wait for them to catch up with growth before intervening ? How much is too much when one is trying to feed up these children?

Some children may have Down's Syndrome, Prader Wlli Syndrome, Turner's Syndrome, William's Syndrome, Noonan's Syndrome, Osteogenesis imperfecta, McCune Albright Syndrome, Pseudohypoparathyroidism, Hypochondroplasia, Achondroplasia , Acrodysotosis and other rare conditions.

Which of these will need hormonal assessment and which will or will not respond to growth hormone treatment?

Paediatric endocrinology is the field of medicine which deals with these and other  hormone problems in childhood and adolescence.

Endocrine problems in childhood include hypothyroidism, hyperthyroidism, hypogonadism, precocious puberty, growth hormone deficiency presenting as failure to thrive and short stature, diabetes mellitus and diabetes insipidus  - both of which can present with bedwetting, hypocortisolism, congenital adrenal hyperplasia, acanthosis nigricans, and the treatment of hormone deficiencies resulting from therapy for childhood cancer or brain surgery and radiotherapy. In recent years, the issue of vitamin D deficiency and rickets is making a comeback because of the amount of time children now spend indoors. Asthma and nasal allergies may also cause growth problems if inadequately treated and some parents are unsure if steroids will make their children's condition better or make them worse off.