Teacher concerned DS is too skinny

[confusedofengland]

Today after school, the Senco/deputy head, who works closely with my SEN DS, came up to me & said she & class TA thought DS2 had lost weight.

He is & looks very skinny & always has been. Even when he had toddler chub he looked like an average-sized child & not chubby iyswim. He is 10 & 2 months. Is 140cm (measured him last week). I have just put away 8-9 tshirts as they were getting too short. Shorts he is in 8-9/9-10, trousers 9-10. We have to pull the waist right in on most things. Haven't weighed him in ages. I'm pretty sure he grew 5cm in the last couple of weeks as he was shorter than friend's daughter but now bit taller. Even his feet are small & skinny, he has just gone into size 2 & is a D/E width.

He did have one day in the week before half term where he was sent home from school because he was so tired he kept bursting into tears. This was following a long bike ride & later than usual bedtime with Cubs & also everybody was tired as end of half term. Also it takes him a lot of effort to settle into things as he has autism. Since then he has been fine & teacher said he has been full of beans since going back.

His diet is very good. He eats absolutely everything except about 5 things (lettuce, gherkins, olives, raw carrots & brussel sprouts) & always has. He has what I consider to be decent portions. For school lunch I give him slightly less at the teacher's request because he takes a long time to eat it. But he eats plenty at home. He will often choose fruit as a treat rather than cake/biscuit/sweets etc.

I have also noticed that he has started to grow a few hairs in the pubic region, so don't know if this is the start of puberty & if so would that have an effect? Ds1 was a bit later, about 11 for the same thing.

DH (his dad) is also on the skinny side & always has been. He is 6'2 & about 11.5 stone, just gone into 32" waist trousers (at age 44) as his 30" are too tight to sit down comfortably in (he has noticeably developed a little paunch, he is studying FT & not moving about much).

So, bearing all that in mind, which is a lot, I know, what should I do? Should I start giving him more food in his lunchbox? Offer extra snacks or more fattening snacks? Something else? He has a multivitamin with Omega 3 daily. I'm wary of feeding too many unhealthy (especially processed) foods unnecessarily because I believe that they are not good for you & weight isn't the only indicator of health. But maybe I'm mistaken.

Sorry for rambling on but it has been an emotional day & this has really worried me.

In puberty growth spurts can cause anemia. It is more obvious that girls will need iron as they start their periods. However not so much in boys and low iron can cause diminished appetite and lethargy, low mood and so on.

I have an autistic DS who has scared along the bottom of BMI for years. I do things like make cakes with butter icing, give him full fat milk (loads more vitamins as well as more fat), milkshakes and allow snacking between meals. He's not remotely interested in food though so I have to make an effort to tempt him.

You could give him all juice for breakfast rather than dilute?

I think often it's about tweaking.

Echoing what riotlady said, tired and losing weight could be type 1 diabetes (coincidentally
my DS, who also has autism, was diagnosed with T1 diabetes at exactly your DS's age.) It's worth checking out with the GP if only to rule it out. It can be detected pretty much instantly with a fingerprick or urine test.

Check his bmi as advised before worrying.
One thing you should cut out is semi skimmed milk. Children and teenagers need the small bit of fat in full fat milk to process the calcium in the milk and turn it into strong and healthy bones. Children and teenagers should always drink full fat milk - especially as yours are on the small side. A big glass of full fat milk a day is something many teenagers crave as they go through big growth spurts. Also of course plenty of protein to lay down muscle and brain density.
Maybe speaking to a dietician would be helpful. Schools have to report these things and it is most probably nothing. Maybe your child is one of those skinny types who will be a long distance runner or cyclist, however they will need a balanced diet and lots of it in the teen years.

Just get him weighed op, focus on that right now.

Honestly OP, he sounds fine and what you're feeding him sounds fine too - I presume he would tell you if he was hungry and you would obviously feed him if he was?

I have a very skinny 11yr old, he takes after his skinny father and grandfather. He's incredibly fit (competitive swimmer, runner and plays rugby), but looks tiny when compared to his larger friends (many of whom are actually overweight). It would be worth checking his BMI but if you think he's fit and healthy the chances are that he is.

He has taken a stretch recently so looks slimmer, as he is slim anyway he will look skinny. He has always been slim, his dad is slim and he eats well. If he has enough energy I would not worry about it.

Maybe note how his school trousers fit at the waist and if any further weight loss think about doctors but just after a growth spurt I wouldn't be worried.

He has no hesitation in telling me or anybody else when he is hungry His version of autism = no filter. Close friends and family are accustomed to him marching into their house & asking what snacks he can have He is very lovable & loving so always gets it, too!

Oh and to add, DS has always been 'right size' in clothes, as I think your DS is? He's now in age 10 clothes, aged 10? We've always had to put DS's trousers on the tightest waist band setting too - it's not a bad thing that he is wearing the right size clothes, as opposed to the next age up.

I think we've actually lost sight of what a healthy weight looks like. So many Y6s today are larger than Y6s were 20 years ago. This year lockdown hasn't helped and some children have chubbed up more than they might have done- get him weighed, and see what the NHS BMI calculator says. My DD was aways in the low amber range on the calculator as she was thin, but she always had enough energy so I tried not to worry.

You need to weigh him op, if you need to pull the wait in on his clothes then they are far too big for him on the waist.

I don't agree with this. My child was bang on average on the weight charts when they measured them at school but the waists are enormous on most children's clothes and that's why they have the pull in elastic things - they are catering for the more than averagely large child as the slimmer ones can adjust them down. This by itself is no cause for worry.

People often thought my older daughter was too skinny and at secondary school other pupils thought she was anorexic.

Fact is, she was born on the 25th centile and has pretty much stayed there all her life! (She’s 20 now.) One health visitor raised her eyebrows until I asked her to plot it on the chart and see for herself that DD was within ‘her’ range.

She ate well and had good energy levels and, at one point, was doing 10 hours of dance a week!

It does seem that some people find it hard to understand that to have an average you will always have people either side of it 🙄

Ds1 has always been tall and skinny. He was 160cm at 11 and was like a beanpole. He still is and eats more than anyone else I’ve ever met for his size. His dad was the same.

Full fat milk, full fat yogurt, peanut butter on toast, etc.

At one point I couldn’t get trousers to fit as he was so skinny as a teen.

@Minezatea

You need to weigh him op, if you need to pull the wait in on his clothes then they are far too big for him on the waist.

I don't agree with this. My child was bang on average on the weight charts when they measured them at school but the waists are enormous on most children's clothes and that's why they have the pull in elastic things - they are catering for the more than averagely large child as the slimmer ones can adjust them down. This by itself is no cause for worry.

Totally agree with this. DS3 has autism but also adhd- lots of activity keeps him slim and meds affect his appetite- and he looks very slim/ skinny. Surprisingly at weigh on today at Cahms he's on the 70th centile for weight . He's 90th for height - taller than your 10 Yr old OP- so I reckon the height can make them appear very thin. I've been assured he's very healthy despite looking thin. I've always had to pull clothes right in in every brand. He needs 10-11 for his height so that's even more pulling in.

I reckon we have, indeed, lost sight of what's healthy.

If you're concerned, like PP, cheese added to meals/ hidden, full fat milk, nut-butters and nuts if you can (mine loves pistachios), avocado etc

Give him full fat versions, so full fat milk, real butter, full fat mayo etc the evidence that fat is bad has largely been disproven and I agree you don't want to give him processed food. My eldest had to have full fat for the same reason. He is still at the bottom end of healthy bmi but was underweight when he had semi milk etc

Apologies, missed the above posters. They talk sense

I agree waists seem enormous on clothes. My DS always struggles with this as they are always huge on him. At aged 16 we still have to get jeans with an adjustable waist band. I also agree we’ve lost sight of what an average size is. When I look back at old school photos now we would all have been considered skinny by today’s standards. I would really judge on how much energy he has or whether he seems pale and tired rather than how much he weighs, although if he is losing weight then that’s more of an issue.

You need to weigh him.
My 10y 1 month DS is 1.39m (had to see if he was tall enough for an activity at half term), and no idea on weight, but usually around 50th centile. So the WHO charts I found put him around 31kg. He is in age 7 shorts. Age 8 school trousers, with the waists pulled in tight. Age 8-10 H&M teeshirts.
He is totally average according to growth charts, eats most things, and looks really skinny compared to much of his class. Waists hands on clothes are usually generous, and trousers sit low on him because of that.
If ye really yas grown a lit in a short space of time, he will likely look skinny, and that's what school are commenting on. But without weighing him you have no idea if he is a healthy weight or not.

There is no reliable BMI for children. What is used are their growth charts. If there is any concern, take him to his GP for checkup and they will plot his growth from infancy to now on a child growth chart and that will show if it is just genetics or if anything to be concerned about.

My DS2 went through a crazy growth spurt last year (aged 13) and was so thin that he looked physically ill. Went from a 4 1/2 half shoe size to an 8 in 5 months.

I did the BMI measurement and he was dangerously underweight. This was in lockdown, impossible to reach a gp etc.

Anyway, I changed his diet so more fattening foods, increased his meals (he didn't snack unless I reminded him, so I added in extra "meals" mid morning and afternoon. Gave him a snack box just for him with his snacks.

He was back within normal range within 6 weeks.

if you need to pull the wait in on his clothes then they are far too big for him on the waist

In my experience it's completely normal for a healthy weight child to have to take the waist in. We routinely do it for all 3DC (DS8, DD11 and DD13), they are all tiny (but healthy), DH and I are also petite. DD1 was under a consultant for a while and she didn't put on any weight on between two consultation, the only thing that seemed to have caused it was that she'd had a bug a month before the second consultation. That was enough to knock her weight back.

Get your DS weighed and check his BMI. Consultation with GP in case of diabetes good idea. If there is a problem high calorie lunches for school is a good idea. Oh, and his tea sounds great.

Our DS has a heart condition so found it really difficult to keep weight on (he uses more calories just sitting still than the average kid because the heart uses more energy). So we were told to keep the calories up by adding a little butter to baked beans, potatoes, veg like carrots when they're cooked. He's now 14, almost 5'10" tall but still very slim. Eats like a horse (doesn't now like butter on anything but toast - what can you do). But he can cram more in than he could as a young child.

Have a chat with the GP or nurse. If there's a problem they can put you in touch with a dietician who can come up with ways to help.

So I had a very similar situation with my son. Everything in terms of height and weight/build was very ‘normal’ as in didn’t stand out from his classmates at all. Maybe around age 10 he suddenly shot up in height and appeared incredibly skinny. He was a lot taller than all his classmates and people would comment on how thin he was.
I did take him to Dr who immediately asked about height and build f dad (husband is perhaps not really tall but very slender and when young yes was very skinny). Dr was able to do a height/weight comparison with UK averages and my son was right In top section eg amongst tallest group for his age.
Due more to my worry Dr did refer to Children’s hospital and we got a consultation there. Consultant was brilliant and quickly confirmed son was going through puberty, not unusual, growth spurt etc. Consultant arranged for a ‘hand scan’ which confirmed how far through puberty son was. Consultant stressed that at some point soon sons growth in height would slow down and his weight may catch up eg he would fill out a bit or it could just be that he’s going to have a skinny build.

Son is now 15, yes not growing at same rate but he hasn’t put on weight. He is so conscious and anxious about his weight and kids can be horrible with their comments (as can adults).

I so understand your emotions, I was horrendously upset and sometimes still really worry and wish we had the magic wand. We are careful with clothing as some clothes can make his frame look a lot worse.

I hope this helps, try to keep it in context and arrange to see your GP just to make sure all ok. X

I've just checked DS's pants OP, he's 12 in August, but wearing aged 8-9 pants. I should probably buy him some new ones as they are looking a bit tatty, but they fit him perfectly well. He's a county level, nationally ranked runner - so slim yes, but you'd struggle to catch him on the track .