I have a request from a colleague at WIC to see if anyone has had a similar experience or concern.  She is seeing a mom who has Type 1 Diabetes (poorly controlled...does not regularly see MD due to lack of insurance) and her 8 month old female infant.  Birth weight was 6-4, current weight 31-1.  This infant has "exceeded" the 100% of growth (weight) by the first 3 months of life to where now she is so far over the curve, her weight is being plotted in the length section!  She is in the 75% for length and 95% for head circumference.

The baby has been followed by a pediatrician who is not concerned about the wait and is taking a "wait and see approach".  She has minimal, if any, other intake beyond exclusive breastmilk.  My colleague has a concern that there may be an endocrine problem.  She has practiced for over 20 years as a dietician and is an IBCLC, but has never run into anything like this in all that time!

I am thinking that perhaps since mother has uncontrolled DM, the baby is getting additional levels of glucose and is able to metabolize it and the growth reflects that phenomenon (as in utero when babies are macrosomic).  Could this be?  Have you run across similar situations and do you think this should be followed more closely?

I am no-mail right now, so if you could copy your response to me personally, I'd appreciate it and pass it on!

Thanks,
Cindy Anderson, IBCLC
UND
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