A child should see a paediatric endocrinologist when their growth, puberty or body weight departs from what the growth charts show, and when there are symptoms suggesting a thyroid disorder or diabetes. Many of these signs develop slowly and are easily put down to “just how the child is” — which is why regular measurements and comparison with the charts matter. The symptoms of type 1 diabetes are the exception: they call for quick action.
Growth problems
A child’s growth is one of the most sensitive indicators of their health. What counts is not a single measurement but the rate — whether the child is keeping to their line on the growth chart.
Worth a consultation:
- short stature — below the 3rd centile for age and sex, or clearly below what the parents’ heights would predict,
- slowing growth — the child “drops” between chart lines, for example from the 50th to the 10th centile within a year or two; after age 3, growth of less than about 4–5 cm a year,
- tall stature — above the 97th centile, especially when combined with early puberty or other symptoms,
- disproportionate build — for example short limbs relative to the trunk.
The causes vary: from growth hormone deficiency and thyroid disease, through coeliac disease and chronic illness, to so-called constitutional delay, which needs no treatment. Examination, bone age and, if needed, hormone tests settle the question.
Puberty — too early or too late
Early (precocious) puberty means the appearance of sexual characteristics:
- in girls before age 8 — breast development, pubic hair, a growth spurt, a first period before age 10,
- in boys before age 9 — testicular enlargement, pubic hair, voice change, acne.
Delayed puberty means no sexual characteristics:
- in girls after age 13 (no breast development) or no first period by age 15–16,
- in boys after age 14 (no testicular enlargement).
In both cases a paediatric endocrinologist should be consulted — some causes need treatment, and early puberty can affect final adult height.
Thyroid
Thyroid disorders in children often cause non-specific symptoms. Consult if you notice:
- slowing growth, weight gain, drowsiness, feeling cold, constipation, dry skin (possible underactive thyroid),
- weight loss despite a good appetite, restlessness, trembling hands, palpitations, sweating, poor sleep (possible overactive thyroid),
- swelling of the neck or a palpable lump,
- an abnormal TSH result in blood tests done for another reason,
- thyroid disease in the immediate family combined with any of the above.
Diagnosis uses blood tests (TSH, thyroid hormones, antibodies) and a thyroid ultrasound.
Overweight and obesity
If a child’s weight is above the 90th centile (overweight) or the 97th centile (obesity) for age and sex, it is worth checking for accompanying hormonal or metabolic problems: insulin resistance, abnormal blood glucose, lipid abnormalities, dark patches of skin on the neck and under the arms (acanthosis nigricans). A consultation is particularly advisable when weight gain is rapid, when the child is at the same time growing more slowly than peers, or when type 2 diabetes runs in the family.
Treating obesity in children is a multidisciplinary process — it includes medical assessment, changes to eating habits and activity and, where needed, working with a dietitian and psychologist.
Symptoms of type 1 diabetes — when it is urgent
Type 1 diabetes in children develops quickly, often over a few weeks. Do not wait for a routine appointment if your child:
- drinks far more than usual and is constantly thirsty,
- urinates frequently, wakes at night to go to the toilet, or starts wetting the bed again after having stopped,
- loses weight despite a normal or increased appetite,
- is weak, drowsy or listless,
- has a smell of acetone on the breath, abdominal pain, vomiting or rapid breathing.
The first three symptoms together need a blood glucose test the same day — at your GP, paediatrician or a sample collection point. The symptoms in the last point may mean ketoacidosis, a life-threatening condition: in that case go to a hospital emergency department.
What the visit at Sonar Clinic looks like
Paediatric endocrinology and diabetology consultations for children and adolescents are provided by Monika Seifert, MD, PhD, paediatric endocrinologist and diabetologist, who has worked at the Department of Paediatrics, Endocrinology, Diabetology and Metabolic Diseases in Wrocław since 2013. The visit includes a history (including family history), measurements plotted on growth charts, examination of the child and, where needed, a thyroid ultrasound on site. The doctor decides which laboratory tests are needed; these can be done at the clinic’s sample collection point.
The scope is described on the paediatric endocrinology page. A paediatric endocrinology or diabetology consultation costs 290 zł — the current price list is on the pricing page. You can book by phone on +48 880 018 703 or online on the specialist’s profile.
What to bring to the visit
- The child’s health record book with measurements from check-ups — it allows the growth curve to be reconstructed from birth.
- Growth charts or your own dated height and weight measurements, if you keep them (from home, nursery or the paediatrician).
- The parents’ heights — needed to calculate the child’s predicted adult height.
- Test results — all previous blood tests, ultrasounds, hospital discharge letters.
- Information about puberty — when the first signs appeared; for girls, the date of the first period; it also helps to know at what age the parents went through puberty.
- A list of medicines and supplements the child takes.
- Family history — thyroid disease, diabetes, obesity, short stature in relatives.
Dress your child in comfortable clothes that are easy to remove for measurements and examination. If your child is older, tell them what the examination involves — a calm conversation with the doctor is part of the visit.
This content is for information only and does not replace a medical consultation. If symptoms are sudden or getting worse, contact a doctor or call 112.