Contraindications
Propranolol may be contraindicated in people with:
Reversible airway diseases, particularly asthma or chronic obstructive pulmonary disease (COPD)
Slow heart rate (bradycardia) (<60 beats/minute)
Sick sinus syndrome
Atrioventricular block (second- or third-degree)
Shock
Severe low blood pressure
Cocaine toxicity

Adverse effects
Propranolol should be used with caution in people with:
Diabetes mellitus or hyperthyroidism, since signs and symptoms of hypoglycaemia may be masked
Peripheral artery disease and Raynauds syndrome, which may be exacerbated
Phaeochromocytoma, as hypertension may be aggravated without prior alpha blocker therapy
Myasthenia gravis, which may be worsened
Other drugs with bradycardic effects

Pregnancy and lactation
Propranolol, like other beta blockers, is classified as pregnancy category C in the United States and ADEC category C in Australia. β-blocking agents in general reduce perfusion of the placenta, which may lead to adverse outcomes for the neonate, including lung or heart complications, or premature birth. The newborn may experience additional adverse effects such as low blood sugar and a slower than normal heart rate.Most β-blocking agents appear in the milk of lactating women. However, propranolol is highly bound to proteins in the bloodstream and is distributed into breast milk at very low levels. These low levels are not expected to pose any risk to the breastfeeding infant, and the American Academy of Pediatrics considers propranolol therapy "generally compatible with breastfeeding". Overdose
In overdose propranolol is associated with seizures. Cardiac arrest may occur in propranolol overdose due to sudden ventricular arrhythmias, or cardiogenic shock which may ultimately culminate in bradycardic PEA.
A meta-analysis of the psychological treatment of obesity in children and adolescents found family-based behavioral treatment (FBT) and Parent-Only Behavior treatment to be the most effective practices in treating obesity in children within a psychological framework. Management
Obesity in children is treated with dietary changes and physical activity. Dieting and missing meals should; however, be discouraged. The benefit of tracking BMI and providing counselling around weight is minimal. Lifestyle
Exclusive breast-feeding is recommended in all newborn infants for its nutritional and other beneficial effects. Parents changing the diet and lifestyle of their offspring by offering appropriate food portions, increasing physical activity, and keeping sedentary behaviors at a minimum may also decrease the obesity levels in children.If children were more mobile and less sedentary, the rate of obesity would decrease. Parents should recognize the signs and encourage their children to be more physically active. By walking or riding a bike, instead of using motorised transport or watching television, will reduce sedentary activity. Medications
There are no medications currently approved for the treatment of obesity in children. The American Academy of Pediatrics recommends medications for obesity be discourage. Orlistat and sibutramine may be helpful in managing moderate obesity in adolescence. Metformin is minimally useful. A Cochrane review in 2016 concluded that medications might reduce BMI and bodyweight to a small extent in obese children and adolescents. This conclusion was based only on low quality evidence.