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!

If you look at the weight and height on the growth charts they are measuring fairly similar. Birth weight on the 98% percentile and is still there, ( if I’ve worked it out right from what you provided). It’s not like they was born on the 20% percentile and now is on the 98%. We all grow and develop differently. It doesn’t mean they will be a big adult.

I don’t think you should worry too much. You want your DC to have a healthy relarionship with food and eatwhen he is hungry and stop eating when full, making good choices. If you’re providing good “clean” food without hidden sugars and crap in it- which it sounds like you are I think you’re doing all you can.

To be honest I’m worried about my skinny DS who does not eat a good range of clean foods. I struggle to get much beyond bread into him, believe me I’ve tried and he has a fairly sweet tooth. I think he is at much more risk of becoming an overweight adult than yours who will eat anything and all good foods.

Nothing helpful to add I’m afraid but I’m surprised at all the posters saying that is a lot of food. My 2.5yr old DS eats a lot more than that - eg two slices of toast and scrambled egg for breakfast.

He was also born at 4.6kg and has always had a huge appetite but he never keeps still so I guess is burning it all off.

My son is almost that height and weight and not even eighteen months yet. He isn't fat but looks like he bench presses and does some serious squats! My daughter weighs about the same height and weight at that at 5 years old though. Despite age difference my kids almost weigh the same. One gets taller constantly but has no weight on her bones, the other is proportionate but just very heavy. I think it's actually because they are both so physically active, they are both "ripped" and muscly but in different ways.

It's just their build, both born average weights and heights but now on the 90 odd centiles for height...

Are they drinking enough? Not milk I understand but water, squash, diluted juice would help fill them up and it may be they think they're hungry when actually they're thirsty. But you need to pre-empt and not wait until they're saying they're hungry.

Activity levels aren't enough, sorry but they aren't. I'd up park to 1 hour and avoid the swings!

Portion control - but add extra veg which is v low cal

IF after genuinely reducing calories in and increasing calories out for a few months there's no significant/acceptable difference then I think you do have to consider a metabolic disorder and need a referral to an endocrinologist.

Prader willi is one but there are others, and with PW the intellectual development issues vary and may not necessarily be obvious at this age.

@graphista do you have any health qualifications? Your recommendations do not sound very evidenced based.

They just don’t ever feel full so I have to regulate it entirely.

My DS is like this. He is much better at aged 9, but it took until he was about 7 before he ever refused food. He would (and still would, if there's no promise of screen time after) eat until he is sick. It is wearing, nobody quite believes you. But you get used to it. What worries me is what will happen when I am not there to say "no, you've had enough."

I've found breaking the meal up, waiting until everyone has finished for seconds because DD is a slow eater. The other thing I do is serve a (usually green) salad as first course for every evening meal. They get served a plate of salad and it has to go before getting the next part of the meal. It means that he fills up on salad first and is then more reasonable on the rest of the meal. We also know if he's really hungry because he will ask for seconds of the salad!

Are there any other issues (following instructions, sensory)? My son has a slow auditive processing speed and we have been told it could be related and simply be that his brain isn't getting they "full" signal and this should improve with age.

They need to drink more water, and milk should always be offered before other fatty dense foods.

My nearly 4 yo eats about that and he's 3/4 of the weight of yours. Same height. It really doesn't sound like an excessive amount of food.

Starstruck I'm an ex nurse and childminder and I've done a couple of courses in nutrition one for children one for elderly care which relate to those. I had experience of a child with prader-will I during nurse training and also used to mind a child with LD that meant he had an oral fixation and would always ask for food. He didn't like fluids (didn't like the feel) so didn't drink enough so the thinking was he was probably unconsciously trying to get more fluid from his food so we went down squash frozen into "ice lollies" route for some of it. But he wasn't even overly keen on that.

It's tough and I hadn't the emotional pull of being his mum!!

OP you are getting a lot of advice from many posters. A lot of it is quite concerning.. milk before meals, diluted juice, regulating and structuring play times.

Honestly talk to your GP and health visitor again and follow their lead. If they are not concerned then try not to be. You sound like you are offering a well balanced diet to your child. Yes they are big, but it sounds like they are proportionately big, and without seeing your child or taking a proper history no one here really can advise you.

Honestly talk to your GP and health visitor again and follow their lead.
It's likely rare that a HV comes across this issue though. Ours told us it was because I'd done BLW with him and he'd had too much practice eating and if I'd weaned him on purées it wouldn't be an issue.

If I hadn't have listened to the GP's oh he's a late developer don't worry then he might have been diagnosed and sent to physio earlier.

Listen to your instincts, you know your child best. See if you can get a referral to a paediatrician or dietician.

In the mean time there are tricks:
Snack food you know they don't like.
Go and have a drink, then go and play. If you still want something in 30 minutes ask again.
Get used to saying no.
Asking if they're hungry or thirsty or saying "I think you're probably thirsty. Here have a drink." Or just the plain mean "when you've finished your water, then you can have something."

I’m leaving this thread.. the only advice I think you should be following is “listen to your instincts”. If you think you need a referral get one. Don’t follow dangerous tips from strangers on the internet until you actually know you have a problem.

I’m sorry Aviana you have had a bad experience with your health visitor that’s terrible information.

Op already states hv and gp weren't much help- sadly not uncommon now. It's luck if you get someone experienced/knowledgable in the issue at hand. Don't expect all hv's or GP's to know everything but if they don't know they should admit it and pass patient on to someone who DOES know

The NHS recommend children under 5 years who are old enough to move should be getting at least 3 hours of 'light exercise' per day. That seems to be anything that isn't sitting down

www.nhs.uk/live-well/exercise/physical-activity-guidelines-children-under-five-years/

A lot of varied replies! They would definitely eat fruit continuously if I allowed it or veg. Very happy to eat ‘healthy’ food. So limiting to that doesn’t help and I worry about the sugar of allowing unlimited fruit.

They get well over 3 hours of moving about (constantly running at home for a start, currently playing a racing game with their sibling!). Although that’s a minimum and certainly wouldn’t hurt to increase.

I think it’s the absolute constant limiting and tears and how hungry they are when they have eaten enough that I would feel full! I have to limit it but that’s going against what the GP and HV say. Whose advice is don’t limit just offer healthy foods. That doesn’t work when your child will happily munch through 6 apples or 10 carrots if you let them! So I don’t feel confident with their advice.

Think I will keep doing what I’m doing, offering veg and fruit for snack but limiting it when they say they are hungry. Try to keep them as active as possible. Then reassess in a year to see if it’s improved.

I wouldn't leave it as long as a year!

I would find something healthy they like but not that much and offer that for snacks if you think they are eating when they’re not hungry. My kids were the same - would eat a whole celery, whole bunch of bananas etc. Apples are what I offer now. They both like them but not much! If they want an apple I know they’re hungry.

This was Dd's height and weight almost exactly last year now 4 1/2 She's the average height of a 6-7 year and only 1 lb heavier at 124 cm ish last measured 4 months ago

Up the protein but otherwise youve got great healthy meals

Not always a popular opinion but with both dds I give unlimited food sweets included within a month they lernt to self regulate and don't often ask for treats or seconds the fruit bowl is however emptied daily

My dm obsesivly policed our puddings treats and I'm 6st over the top range of a healthy bmi for my height as I can't control myself around treats