Heavy child, out of ideas

[Worriedmummybekind]

My DC is 3.5 and 105cm tall and almost 21kg.

They were 4.6kg at birth (10lbs) and very very chunky. Born early and sure about dates (IVF).

They are a very hungry child. I feed them -
Breakfast - 1 slice of toast with thin layer of ‘healthy’ nut butter or bowl of porridge in child’s bowl

one morning snack - cucumber or apple or rice cake with slices of cheese.

Lunch - sandwich of 2 slices of bread (cheese or ham) and veg sticks

one afternoon snack
Same as morning

Dinner
Home cooked meal with veg.
Pudding usually yoghurt and fruit.

No milk anymore as eat sufficient cheese/yoghurt etc and don’t need the extra calories!

I don’t think the problem is what I am feeding them but the portion sizes. I have tried umpteen times to reduce these but they becomes impossible crying about how hungry they are.

Exercise - they do two sports activities a week and walk about 1mile a day, playpark for 30mins a day. Outdoor play at nursery. They doesn’t eat at nursery.

Is it possible to just be ‘meant’ to be a certain size?! I am so worried about this and not complacent. So please dont tell me I’m a terrible mother! I just don’t what to do next. HV and GP spout usual advice but not much help. Is it too extreme to ask to be referred to paediatrician? They just don’t ever feel full so I have to regulate it entirely. We have child locks on cupboards to avoid food being taken and we also try to model ‘Im so full!’ etc...

Should add that neither DP and I are overweight at all (both on low side of normal).

Think that’s everything. Trying not to drip feed. Please be kind. Real person here!

Academically/developmental all else is fine apart. So don’t think prada -Willis

How active is he? It seems like he eats similar amounts as my 2yo who is a healthy weight.
I don't think it's a bad idea to ask for a referral actually.

I’d look at upping protein and reducing calories from things like rice cakes and fruit. I’m always starving if I eat a shitty rice cake.

And cut portion sizes. And they don’t necessarily need snacks. Introduce a different activity at what it usually snack time.

Reduce portion size and let them have free access to the fruit bowl if they’re still hungry. Pudding needn’t be every day either.
Encourage as much physical activity as possible that is regular - walking/cycling instead of using the car etc. Sports activities and the park may not be that physically active depending on what they are doing. A 30 min swimming lesson for eg generally involves at least half of that listening to instruction and waiting around. Good for learning the skill but you’re not exercising like people who are just lane swimming.

Doesn't seem a lot of food to me and nothing very calorific. Do they eat much protein? Nothing wrong with milk either as even full fat milk is quite low fat.

Maybe asking for a referral might be a good idea. What you've written about his diet sounds fine - the three year old I look after eats quite a bit more than that but is normal weight (he is a lot more active though). He does complain of being hungry all the time though but at that age I think it's difficult to distinguish between hungry/thirsty/bored.

Have you still got the red book with any early weights on them? I'd guess that his birth weight gives a very high centiles.
What happens if you plot current weight on the graphs too. Is it a similar centile?

It does sound heavy for his height, and also very tall for his age.

Is he drinking enough? Is thirst confused with hunger?

Is there anything he isn't fond of? If mine eat bananas, I know they are truly hungry.

I'd up the protein content - try scrambled or poached egg or beans on the toast in the morning, nut butter stirred into porridge. Hummus and veg as snack maybe. Meat in lunchtime sandwich or do something like a turkey roll up and cut the second lot of bread.

It really doesn't seem like he's having a lot of food. My 3.5 DS would still be hungry after what you described and is a normal weight. Think you may need to push for some further medical test etc.

What does a portion size look like? A large dinner could easily add hundreds of calories to their daily intake.

This website has a very useful download for feeding 1-4 year olds, with photographs of appropriate portion sizes for meals and snacks.

My two were at least that weight at that age, possibly more; possibly a little taller. Breakfast time in particular they would both have eaten more much of the time, what you describe sounds like the amount they would have been eating at a time when their appetites were at a low point. I'm looking back as they are now teens. They looked podgy till they were 5 or so and have just grown leaner and leaner since.

Spread food out through the day and try to respond to appetite, if what you are offering is a range and sweet things not becoming dominant I think you should be ok.

It’s definitely portion size that is the issue. HV advised to give healthy smaller dinner portion then give seconds if asked....they always ask!

I just wondered if there is a physiological thing where you don’t feel full?

I tried replacing fruit/veg/rice cake snack with nuts or higher protein but they still want more and I felt it was just adding more calories.

I would say pretty active. They have two siblings a year younger who chase about all day. Will try to increase this though.

If you make them wait about 10 minutes before giving seconds (we make sure everyone has finished) and had some water,you might find they are less likely to want seconds.

On the face of it my 2 average to lean elder ones (7 and 5) eat probably double what you've written! Plus Friday treat sweets and the occasional mid week ice cream with a flake. Plus they have cereal before bed as a "supper" if still hungry
Even my strictly average according to BMI 2yo eats more! Plus still breastfeeding loads. So it must be portions.
My 2yo today had 1 Weetabix with whole milk and adribble of honey for breakfast.
A bourbon and a Clementine for snack.
Slice of cheese, cherry tomatoes and a handful of mini bread sticks for lunch.
Biscuit and 1/3 banana in the afternoon.
Then a hard boiled egg as he couldn't wait for tea
Tea was pasta (maybe 10-15 fusilli) with tomato sauce, carrots and broccoli. Plus half a hard boiled egg.
Pudding was homemade iced fairy cakes, but he left his after having one bite and crumbling the rest.
Supper was about 10 shredded and whole milk.

I don't know what your child looks like, or if the HV has told you they are overweight, but I can give you my experience of a heavy child. My DS was born at over 10lbs and on the 98th centile for weight. He has stayed at this centile his whole life so far and is now 11.

Because I was a chunky child (and am an overweight adult) I was a bit worried about his weight, and he did look plumpish when he was little. However, when I asked the HV about it, she told me he was perfectly healthy. (Some family members had commented on his plumpness.)

My childminder did me a big favour when she told me to give him bigger packed lunches - her theory, based on long experience, was that hungry kids should be given decent sized meals, otherwise they become a bit over-interested in food. FWIW, I think that was probably the case with me as a kid. I doubled his meal sizes and surprise, surprise, he did not get plumper.

So he has stayed on the 98th centile, but is now tall and slim - ribs visible, etc, lovely cheekbones. He still eats a lot, but he doesn't eat rubbish (I think because I didn't restrict him much, so he didn't get obsessed with sweets) and never eats when he's not hungry. He's just really heavy! My dad was really heavy, too, even though he was lean.

I do think some of it is genetics.
My DS has always had a bit of a podgy tummy, despite eating very healthily and lots of exercise. He was checked at the doctors for any underlying causes - all fine.
He is a teenager now and doesn’t eat half the crap that his step brothers do (they are stick thin) and my poor DS only has to look at a donut and put on weight.

Honestly I wouldn't worry. Just keep offering them healthy options and not too much of the crap stuff (sweets, ice cream etc). My DS was very big when he was 8-10 years old (think 99th percentile). I just swopped things for more veg, talked to him about eating sensibly and about being healthy and over time he has grown and now he is slimming out nicely at nearly 12.

I wouldn’t focus on him being full. I wasn’t ever full until I was 21. Absolutely genuinely. I could always have eaten more, never felt full, until 21 (I can vividly remember the occasion!). I wasn’t ever overweight, but Mum gave me tea etc and if I was still hungry, tough. She knew I’d had an appropriate amount of food and wasn’t being neglectful by not giving me more.
I know this is easier said than done though. Our DS is always hungry, and moans that he’s hungry - incessantly. It’s exhausting.

Apologies, I shouldn’t have assumed your DC is a son.

That’s for the supportive comments and tips.

Will try the water break before seconds. They don’t drink as much as I would like so could be confusing hunger/thirst.

Thanks, not that’s... mumsnet needs an edit button!

What sorts of sports activities does a 3yo do?

If your child has a weight issue why are you giving seconds at all? Just give an age appropriate portion and they can have fruit if they’re still hungry. If they don’t want that they aren’t still hungry.
Most kids would be overweight if they regularly had 2 meals at mealtimes instead of one. I know my kids would happily eat seconds, thirds and forths of some of their favourite meals but if offered an apple they will say they’re not hungry!

I would see what the calorie intake should be for a child that age and just give them that - remember to include drinks if its not water and don't underestimate the impact of large portions.

I find that quite a lot of food to be giving a child but can understand its difficult when a child is saying they are hungry. I would probably cut portion sizes back across all meals / snacks and then try to distract if asking for more. I remember reading a book once by Solzhenitsyn and he reckoned your stomach adjusted to whatever its used to after a few days. Don't know if that's true but think cutting calories back is worth a try. You can only really cut calories or increase exercise and that's much harder to lose weight by.

My children were born bug like yours (4 of them) as was my husband and his sisters children. If those who have gone past the age of 5, they are all normal weight. They were all chunky babies, toddler and young children though. So for our family, it is a genetic thing.