to expect a bit more information from the school nurse?(29 Posts)
DS was weighed and measured at school recently (he's 5). Today we got a standard letter listing his height, weight and BMI.
There was no info on what his BMI meant, no chart or explanation. Initially I thought it seemed very low so I did some googling and checked on the NHS website.
It turns out he's on the 94th centile and is classed as obese. And I only know this because I looked for more information. DH was just saying to me that the school would have flagged up any problems. I'd say this is a problem! How many parents are assuming everything is OK when actually their children are at risk of health problems?
I know DS has a tendency to be chubby so we're fairly careful with his diet and we make sure he walks and cycles to school, and we take him swimming. I'm not surprised he's overweight (but I am shocked by how much). I'm really pissed off that the school measures him then does nothing with the information!
the school did not weigh and measure him, this will have been done by staff from your NHS Trust
the information is used for informing public health planning
I understand that if the child's measurements exceed certain parameters then a letter is included in the record of measurements sent to the child's parents or guardians
I am quite surprised they didn't give you a letter explaining that he was classed as obese and given you links to diet planning and exercise. Only because my mum's DPs daughter is 6 and was sent home with a letter doing just that. Its a bit odd to just expect parents to know what the BMI all means, personally I think BMI is a load of toss but that's another story.
Exactly bon - I genuinely am not concerned about DS because we're aware that this is something we need towatch for anyway. But I'm really amazed that they a) don't explain themselves and b) don't offer any advice!
There was nothing, not an iota of information. I'm phoning the nurse to ask about it tomorrow.
do come back to us, I would like to know if there is a higher parameter than 94% that triggers an intervention letter (for want of a better phrase)
There have been so many cases of parents going batshit crazy when they have received letters stating that their children are obese that I'm not surprised they don't do it any more. It was all over the press for a while that the NHS were "labelling" children as fat and giving them complexes.
Seems they're damned if they do and damned if they don't!
oh yes, good point Coola
All those pics of jumping kids and their sadface parents
I got a letter saying DD was obese and was at risk of diabetes, heart problems and a load of other scary shit. This really upset me as she was not even overweight as she was at that point still a very poor eater. I mentioned it the HV when I took DS for an appointment and she just told me to ignore it. What worried me was how many other kids with healthy weights were labelled as obese and would be put on unecessary diets as a result.
I also got a letter following a school vision test to say DD had a visual impairment the needed immediate action to be taken for this and was directed to a recommended optician. After an appointment here I was told DD had perfect vision!
I got told my DD was obese and she is as skinny as a rake.
I also got told my DS, who has a condition called ptosis, which means he has a droopy eyelid, which causes his eye sight to deteriorate, has impaired vision. No shit Sherlock!!
I had the opposite a few years ago with youngest DD before she left primary. My letter said she was under weight! I wasn't best pleased and rang the nurse at the GPs to ask about it. She said DD was something like 2lbs under the 'normal' range for her age/height, and not to worry. DD was/is tall and skinny.
So they are a bit damned if they do damned if they don't. But they could be sensible about it
I don't see the problem with expecting parents to ask their own questions and do their own research. Parents are supposed to do stuff like that to benefit their children, they can't expect everything to be done for them.
I'm not outraged at finding out he's overweight. I'm outraged at not being told!
In fact, with a BMI of 17.9, I initially thought that was wrong as it seems so low (thinking about normal adult BMI) which was why I googled. If other parents think the same said did at first they could all be trying to feed up their 'low BMI' obese DC!
I get what you're saying, Fred, but it wouldn't be much to ask for them to include a brief explanation or chart. If I'd not been aware enough of DS's weight to think that the BMI looked too low I'd never have given it a second thought - turns out he's much worse off than I thought so thank goodness I did.
When dd had this 2 years ago we got no letter. No explanations.
The study is supposed to inform the national picture not individual parents so I suppose that's why you get no extra details.
They did used to send out a letter of explantion. It just backfired though because people generally have a distorted view of what a healthy weight child should look like and got very upset. It didn't seem to help parents make changes or address issues because so many just argued it must be wrong / BMI isn't reliable / their children play football loads or whatever.
A healthy weight adult is not stick thin whereas, very often, a healthy weight child is like a whippet with ribs on show. So if one third of a whole class are overweight or obese then your child will look totally average but still have a potential problem whereas a healthy weight child suddenly starts to look like one of the thin ones.
I think this explanation is helpful, but I agree it's confusing and more explanation is needed. If adults are aware of BMI they are likely to have the figure of 20-25 for healthy weight in their head. They are very unlikely to be familiar with BMI percentiles. The figure for being obese is 95% and above so maybe you just missed out on an automatic letter.
My son fell in the overweight category and I was a bit upset about it. He's plainly not overweight, you can see every rib. He's quite muscular for his age - my DH pointed out since he'd just happily cycled 10 miles (at 5) then he didn't think we had much to worry about.
I think a lot of parents would struggle to make any sense of it unless they are familiar with statistics. I don't see why it is difficult to tell parents "your child is a cm high and aged 5y bm, a healthy weight range for that age and height is c-d kg. Your child's weight was e kg."
op, a friend of mine has a duaghter who is very very tall for her age and a bit over weight. In her first year at secondary she was weighed and measured and then a letter came home saying she was too tall!!!
As her mum said 'and what exactly am I supposed to do about that - put a book on her head???'
Right, update for anyone who's interested.
I spoke to the nurse. She was a bit taken aback because apparently nobody has ever raised these concerns with her before.
With regard to DS she said unless a child was over the 98th centile line she would not call a parent up. She offered to review him in 6 months and I accepted. She asked if I had any concerns about his diet and we had a brief chat about him but she offered no advice other than that he was growing all the time and things might change.
I also pointed out that I thought a letter with no further information other than a BMI of 17.9 was inadequate. I explained that because most people are familiar with adult normal BMI ranges they would assume that their child is normal, possibly a little too lean, from a standalone letter stating a BMI of 17.9. Some of these parents might try to feed their child more on the basis that they are too slim, when in fact their children are obese. I'm honestly not sure she got my point at all - she seemed a bit bamboozled and surprised that I'd even called at all. Apparently most parents react angrily to any hint of their child being overweight which is why they don't mention it on the letter. I told her I wasn't asking her to write "child is overweight" on it, but to provide parents with some context in order that they can see for themselves what their child's BMI means. I'm not sure she really took that in.
So, that's as clear as mud then.
Maybe she's just surprised that you think parents, looking at a tubby kid, would suddenly believe they were too skinny based on a random number on a letter from the school? I would be.
Presumably other parents can use the magic of google to see what it means, like you did.
Loving the "too tall" letter
My DS is on the 99.6th percentile for weight and height
He is only 1 so no letters yet, but I expect I will get them although IMO BMI is a crock of shite
Miss, my point is that based on adult BMI charts (which I am assuming most parents are familiar with), my DS would be classed as slightly underweight. Purely because I was a little concerned about him being overweight, I googled it and discovered that in fact the charts are entirely different for children.
So a letter simply stating BMI: 17.9 is only helpful if the majority of people are aware that children's BMI is assessed differently to adults. Do you think most people know that? I don't.
Yes I understood your point. However I think people can actually use their eyes. If they look at the letter and think its the same as the adult bmi, they will presumably then look at the child and think, well no, that doesn't add up, and look further into it.
You are suggesting that parents will try and feed up an obese child because they think the BMI number makes them underweight. Which means you think parents are all idiots.
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