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.

DS2 has always been very slim. Always had to pull the waists in on trousers. He still fitted in age 2-3 pants at 7/8. Ribs and spine are visible. The dr has never been worried though as he's always been slight. He can just about get away with mens 28" waist trousers now at 14. 26" is a better fit but not always available and in budget.

If he's always been slim, and is otherwise healthy, isn't lethargic etc, I wouldn't worry.

My DC are pretty skinny & school never said anything about it.
Maybe with his SEN they just think OP's DS needs extra attention to make sure he's doing well.

13.5yo DS is only just wearing trousers for age 11-12 yrs.
We need firm numbers to get a picture on OP's DS, though.

I am wondering why he has semi skimmed milk? I agree with another poster you need to go full fat on dairy, also increase portion sizes. Is he having supper before bed?

Just to say, my DD sounds the same sort of proportions and I just weighed her last week and was horrified to find she's slipped right down the weight charts and is now very underweight for her height. Currently waiting to see the GP as so worried. She had some other concerning symptoms as well (getting anxious about eating, not herself, very cold over the winter etc). Have started feeding her up and she seems happier already but will still be following it up with tests and medical advice. I didn't think she looked that skinny, but the scales said otherwise.

Why are people talking about pants? What has the fitting of underwear got to do with anything? Is this a measure some people use? Just confused.

My DS is the same age and sounds about the same, he eats loads.

Will get some full fat milk tonight. In the past he hasn't liked it & said it is too creamy but will try again. Thanks for all the reassurances.

I read it that the school have said they think he’s lost weight, which is different to raising a concern that he’s skinny?

I would probably start tracking to see if he is losing weight, because that’s important.

They did say they thought he had lost weight, whereas I think he has put some on (see earlier post about non-drawsting/button trousers no longer falling down).

It does also occur to me that this is the first time they've seen him in shorts since Year 3 (he is at the end of Year 5). As he only wears them in the summer term & was obviously not there last summer due to Covid. So as they are used to him in trousers & jumper, they wouldn't realise what is normal for him.

Teachers raised my DS as being underweight when he was in primary. I said I was not concerned (he looked perfectly healthy to me, DH and I have always been slim as has DD) but they were welcome to get the school nurse to check him when they were in doing the health and weight checks on other year groups. The nursing team duly checked his height and weight and said he was just under 50th centile and a lovely healthy weight, they pointed out that the issue is that a healthy weight child often looks underweight theses days because more and more of the children they see are actually overweight.

My DS always had to have his trousers pulled in as much as possible because children’s clothes are made too big these days. When I bought his Y7 trousers the only ones long enough had a 32” waist which is the size my then 41yo old DH was wearing.

I have lean built DCs (as were DH and I at their age so no concern). They have tracked the low end of normal range from early on (DS1 was under dieticians for allergies and they were always happy)
People do think they look thin because it is a rarer body shape these days and we've lost sight of how lean healthy can be.

I do weigh and measure them 2-3 times a year and just say that it's to check how well they're growing. Plus it helps with things like car seat status.

Pants are relevant as they are a garment bought entirely for width with no compromise for waist. Mine have always worn significantly underaged pants/ trunks and have adjystable waists yanked right in and often being a bit short on length in order for waists not to lose a battle with gravity.

They are statistically healthy range, have large appetites, eat a good range of food and very fit and active. I'm now jealous of DS2's 2k running pace as he trounces me (I still win on HM though )

In OP's case, I'd get his measurements to confirm all is in order. Slightly tweak to full fats (more satisfying to a slow eater too) I find that mine often need a light tea after school to keep them going until dinner. Before school we tend to have breakfasts involving thingslike porridge/ eggs/ beans to give a filling start to the day. They take little longer than doing the toast anyway.

He does usually have a snack after school if time allows but usually something like a couple of biscuits or an ice cream, with hot chocolate or milkshake to drink. Then we have dinner about an hour later. I could try adding peanut butter to his banana milkshake & see if he likes that. Or maybe a bigger snack.

Children who are autistic may find it hard to always recognise their hunger cues, especially if they are "busy" or distracted with a different activity. When hyperfocusing autistic people may forget to eat entirely...

For example you mention "if time allows." I would perhaps make sure you have a snack available and offer it, rather than wait to see if there is time or he asks. Similarly him eating less at lunch because he eats slowly may mean he isn't really eating enough then? A snack for after school might help this.

My very thin son turned out to have coeliac disease. Worth testing for.

This was my brother always comments made about his weight by school and people in general. My mother became so concerned that she took him to a pediatrician, who kindly told her that he was a healthy and strong child and just had a fantastic metabolism. He is in his late 20s now and he is still the same , eats all round him and barely puts on a pound. Peoples bodies are all different!

If I were you I’d probably book a GP appointment just to be sure and so that I could reassure the school but if he’s just had a growth spurt recently it’s likely he’s just looking skinny as he’s grown taller and him being slim is more noticeable.

Both my DDs are naturally very slim and tall like DH and I get people comment all the time. But they’re a healthy centile and the health visitor has no concerns. But recently DD1 had a growth spurt and even I thought she looked really skinny all of a sudden, but her clothes still fit her the same around the waist so she hasn’t lost weight, just grown.

I think you need to do a weight check. There are several conditions that affect children's growth that have nothing to do with parental feeding strategies and that need to be treated with medication or with supervised diet changes (such as elimination of specific food items). When someone makes a comment that your child seems thin, it could be that they are just having a growth spurt or it could be that the person is noticing something that you, as a parent, wouldn't notice because you are observing your child from a different perspective. If this were me, I would just give the doctor a call and say a teacher mentioned she thought he might have lost weight, and do they want you to come in for a quick weight check.

I think it would be better to have a current official weight before you start messing around with full fat milk and adding butter and so on, otherwise it just extends the process of determining if he's just having a growth spurt or has a food intolerance or silent reflux or something. But it's up to your child's doctor.

My 10 year old is very slim, about 29kg and 50c height. He eats plenty but is also very active. He has also just had a recent growth spurt.
Also, lots of children now are very well covered and so, although he is on the skinny side, it’s a bit more noticeable when he’s with a couple of his friends who are larger build and much taller already.
I figure if they eat a well balanced diet, aren’t going hungry and are active and sleep well, it’s probably fine.

Just adding an update. We went to see the paediatrician yesterday - mainly for ASD/ADHD assessment & DS also got measured while we were there. He is currently 140cm tall & weighs 24.5kg. This puts him on the 2nd centile, according to their calculations. This is in line with what I thought really.

The paediatrician said she has never seen a skinnier child & that because of his weight & his delayed development, she wants to run some blood tests. I still believe it is just a case of DS taking after his father, but I am happy to have any tests done. She has also put him on medication for inattentive ADHD, which will increase his concentration. We are to start this as he goes back to school. The trouble is that it can suppress the appetite, so I'm hoping that won't happen with DS.

For now, we have switched to whole milk & I am making sure to give him extra & larger portions. I am also trying to introduce extra calories where I can, so thinking of trying peanut butter or honey in milkshakes, cream in sauces etc. Plus I am keeping a careful eye on what he eats. Today has been:

B - 2 crumpets with butter & marmite. Bowlful (approx 2 serving spoons) raspberries, blueberries & strawberries. Banana milkshake ( 1/2 banana & small cup whole milk)

S - milk. Small hm sausage roll.

L- 2 slices tiger baguette with Clover, 1/4 yellow pepper, 4 small slices cheese, 1 large slice ham, 2 slices courgette (DH thought it was cucumber 🤣), bag Wotsits. Squash to drink.

I'm at work now so not sure what snack DH will give this afternoon

D - will be hm battered haddock & hm wedges. 1/4 tin rice pudding with teaspoon hm raspberry jam.

Milk for bedtime.

So hoping we're doing ok but still feeling nervous about it all!

I think having a doctor involved is good as he is getting checked to make sure there is no health concern and they could also refer you to a dietician if it turns out to be related to his diet or anything to do with what he eats.

As you already started noting down what he eats maybe it would be worth continuing that for a while so you have your own record and can look at whether any changes you make are helping, and you can show any doctors or HCP who might want an idea what he is eating.

Thanks for the update.

Let us know if they find anything interesting?

fwiw, my son is 6'1" and 67kg, and still 24th percentile. I don't think your husband is as slender as you think -- nowhere near the 2nd percentile for height, anyway.

I will do!

I don't know what DH weighs but I don't think it's more than 10 stone. He has only recently developed a very slight paunch, at age 44. He is 6'3" & often wears Tshirts for 13yo. He is definitely a similar build to DS & from photos I have seen of him as a child was every bit as skinny But I have no idea about centiles & he certainly doesn't have any learning difficulties & was not delayed, so who knows!

Why are they using the adhd meds that can suppress appetite when their are others like attomoxetine which don’t have that effect?

Sirzy that is a good question! The paediatrician didn't tell me about that side effect in person, I read it on the letter I received this morning. So my plan is to feed him up over the summer, then try them & see what happens. With any luck it won't affect him like that.

I think it’s just something they have to flag. The school also told my parents they were concerned when I was younger. Some kids are just super thin. It’s just genetics. DS is stick thin- turning 5 and wearing 3 yr olds clothes. He’s definitely well fed 🤷🏻‍♀️