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A fasting lipid profile helps evaluate dyslipidemia, one of the most common metabolic complications in childhood obesity. Obese children are at risk of elevated triglycerides, LDL cholesterol, and low HDL cholesterol, contributing to cardiovascular disease. Other useful tests include fasting glucose and liver function tests. Serum ferritin, calcium, and urinalysis are not primary tests for obesity complications.

Thalassemia major is an inherited disorder of hemoglobin synthesis characterized by ineffective erythropoiesis and severe anemia. Children often present in infancy with pallor, poor growth, and hepatosplenomegaly. Regular blood transfusions are required to maintain hemoglobin levels, which can lead to iron overload, necessitating chelation therapy. Iron deficiency anemia and vitamin deficiencies are acquired conditions, not inherited. Scurvy is due to vitamin C deficiency and unrelated to hemoglobin.

The primary carbohydrate in breast milk is lactose, which provides about 40% of the total energy. Lactose enhances calcium absorption and supports the growth of beneficial gut bacteria (e.g., Bifidobacteria). It is present in higher concentrations in human milk than in cow’s milk, reflecting its importance for brain development. Sucrose, maltose, and glucose are not significant components of breast milk.

Cystic fibrosis leads to thick secretions blocking pancreatic ducts, causing enzyme deficiency and fat malabsorption. This results in steatorrhea and deficiencies of vitamins A, D, E, and K. Celiac disease involves gluten sensitivity, galactosemia involves carbohydrate metabolism, and lactose intolerance affects milk sugar digestion.

Although breast milk is nutrient-rich, it is typically low in vitamin D, which is essential for bone mineralization. Exclusively breastfed infants without adequate sunlight exposure are at risk of rickets. For this reason, pediatric guidelines recommend daily vitamin D supplementation for breastfed infants. Vitamin A, K, and B12 are present in sufficient amounts in breast milk under normal maternal nutrition, although K is supplemented at birth for clotting support.