Children and BMI(12 Posts)
So there is a female child who is about eight years old. Height approximately 121cm (9th centile), weight approximately 32kg (91st).
Child has visibly increased in size, particularly around the middle, so that they have rolls of fat where eczema is making itself happily at home, and thighs meeting together rub to the point of causing a painful rash. Child is becoming unhappy with running around like children do because they are getting puffed out or tired quickly.
WHO BMI charts say that this child is on the 99.6th centile line for BMI, this is the line between very overweight/obese and very obese.
One parent says this is normal for kids to get a bit of podge and a growth spurt will sort it out. This parent continues to feed child calorific diet of processed foods and not increase activity levels via sports clubs or time outside doing physical activities. Their opinion is this is a stage kids go through and the child will level out eventually. This has been their opinion almost six months with no change except weight gain of around a kilo or two.
One parent wants to have it managed via doctors, one to rule out any medical causes for this weight gain (like thyroid issues) and where there is a programme that encourages healthy choices with eating and increased exercise in a child friendly way.
This is partially because this parent's side of the family have had obesity issues and some health problems exacerbated by weight issues. They want to limit unhealthy food options and reduce snacking, educate the child about perceived healthy foods and actual healthy foods (like checking the traffic light system on foods, and understanding that whilst cheese is healthy for calcium needs, it's also unhealthy in large amounts sort of education), and significantly increase activity levels with things like swimming club, karate and dance classes, alongside outside play like walks and bike rides.
Parents are separated and child is resident with the parent who believes this is a phase.
Who is being unreasonable? What middle ground is there? How would you deal with this situation?
The middle ground is to understand that a lot of children do go through a chubby phase, and to not think about it too much, but to make an effort to include healthier meals in the house and possibly take up more activity.
If it was my child (i'm assuming you are the NRP or NRP partner) i would have them at the GP, if RP refused to engage with HCP on this issue i would be applying for residency.
It's a total myth that anyone needs to bulk up in weight before growing in height. Yes the trajectory of height and weight growth can get a little out of kilter in May, but it is a) brief and b) nowhere near pronounced enough to put an adolescent into the 99.6th BMI centile.
How to deal with one parent in denial needs someone far wiser than me though.
That was meant to be 'in many' (nothing whatsoever to do with May) . Sorry.
I'm not a journalist, no. I'm a NRP trying really hard to understand how to deal with a situation out of my control that concerns me, I'm just trying to be factual and as unbiased as I can in my OP.
It's difficult because children do go through phases of putting weight on then shooting up and seeming to stretch out again. DS1 is 10 and does that exact thing.
However, I'm a big believer that as a parent you have a responsibility to give your DCs as nutritious a diet as possible, and to encourage an active lifestyle. Not doing so sets them up for a lifetime of possible ailments (I know there are always exceptions to this, for various reasons, so I'm discussing healthy children only). If you're not prepared to provide that for your child, you're letting them down a little and need to be educated about it.
Regardless of whichever one is RP/NRP the one who feels action needs to be taken needs to push this. BMI isn't the only indicator of health and fitness by any means, but when a child is physically restricted because of their size something needs to be done.
Do you have PR? If so you can make GP appointments for this child. If possible make them for a time the child is with you. If child is only with you at the weekend then make the appointment for during school time and take her out for it. This is too important not to act on.
There are some complications in that the parents do not reside in the same place, there is a good hour by car between them.
Parent with concerns has contacted school and asked for school nurse to do BMI check and recommend further action. They have ongoing contact with schools wellbeing/safeguarding officer due to concerns about other areas of child's life.
They have travelled to the RPs area and given GP surgery information to show they have PR (birth certificate, ID, Court Oder etc) to try and access medical records and make appointments but this is currently in progress as GP surgery very anti sharing information with NRP and it's been sent to higher up person. Child has been taken to OOH locally due to concerns about a rash and eczema where height and weight were measured when situation was explained.
They are unable to mediate with RP due to domestic abuse situation. They are currently in the process of applying for residence due to concerns about neglect.
Is there anything else they can do?
Well as youre already in the process of applying for residency and in touch with school nurse and GP there isnt much more you can do other than stick to this course of action. I would instruct your solicitor to issue a letter directly to the child's GP stating that you have PR and should be provided with full access to the child's medical records and have authority to make appointments for the child.
Record and report all concerns as you become aware of them. Keep your own records of dates, times, who you contacted, their response, etc.
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