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.

I think if he’s healthy and eating 3 meals a day then don’t mess with it. If he is naturally slim you will really struggle to get him to put on weight and what’s the point if he’s fine the way he is. Some people are thin, he probably only stands out because so many children are overweight.

So he's just had dinner & still going strong. Deep-fried cod & haddock (with skin) in hm batter (DH made with beer), equivalent to 3 fish fingers, 2 serving spoons oven chips & a dessert spoon of mayo (light as is what we had in, will buy full fat next time). 2 slices garlic bread. Pudding was 1/2 tin rice pudding & 1 large teaspoon hm jam. Will give milk & biscuit shortly for bed. Normally we have more veg with meals but this was a Saturday night fakeaway.

Not sure what he had this afternoon as I was at work, but he was at my parents' house & my mum had been baking so raisin biscuits, sausage rolls & madeleines often feature. Plus apparently a few sips of his Grandad's McDonald's milkshake

Your previous post mentioned berries, cucumber, courgette etc. As great as veg is, its also very low cal in the grand scheme of things. Maybe pad out the berries with full fat yoghurt and some honey, or swap the cucumber for cheese and crackers?

I will pad it out but I believe he still needs to have a good amount of fruit & veg, as surely it provides vitamins & other nutrients not present in other things?

Yes, hence padding it out rather than disposing of it completely. Fruit within a smoothie, berries with yoghurt etc.

He eats less at school because he's such a slow eater. So that's a problem. And he's underweight. That's a problem.

I have a fussy asd child who was very skinny at one point due to not eating. We were told to try to give high calorie snack, the Rolo desserts are really high cal for such a small portion, and eggs if he will eat them, milkshake made with ice cream, we did try the paediasure shakes but he hated them. Good luck, I hope he's OK!

Try adding peanut butter to the banana milkshake. Trust me, it's delicious.

Sounds like my ex as a ten year old.

Ended up 6'5" and built like a brick shithouse thanks to illegal steroid use - but he was also diagnosed with a particular genetic syndrome as an adult.

It's good that they are investigating why he is so thin.

Yes keep the veggie and fruit for nutrients but adding some butter or olive oil to the veggies and some Greek yogurt to the berries also a bit of cream added to his rice pudding. These fats are all very healthy even though people who need to lose weight may avoid them. You want to have the mixture of carbs and fat for weight gain.

Will try these things.

Tomorrow's menu includes frittata for breakfast (eggs, sausages, bacon, mushrooms, peppers, courgettes) with banana milkshake. Cheese & onion quiche (bought) for lunch, will accompany with salad, ham, crisps. Then I think roast pork for dinner with roast pots, yorkshires, carrots & green beans, broccoli cheese. Snacks maybe lemon drizzle cake (shop), berries, biscuits & he has demanded hot chocolate with whipped cream & marshmallows.

I am not going to let this get the better of me!

My DS had his weight raised when he was in year 6, he was unbelievably skinny but ate fairly normal. After shed loads of tests it turned out he had Crohn’s disease. He is now still super skinny, but at 44kg which for his age is nothing but is a huge improvement. This has been due to meds and filling him up with high calorie options, full fat everything. I definitely think it’s good they are investigating why as there could be something there that you are completely unaware of. If not even a dietitian might help give advice on how to manage his daily calorie intake, I’ve found them so helpful. Hope you are okay it’s such a worry.

I should add he’s 17 now.

Cake as a snack is a brilliant idea. So long as his main meals are healthy, cake is one of the easiest ways to consume masses of calories!

I tried peanut butter in banana milkshake today & he wasn't keen, but drank it anyway. Will try honey tomorrow.

So far today he has eaten

B - peanut butter & banana milkshake, omelette (2 eggs, 3 cocktail sausages, rasher bacon, couple of button mushrooms)

S - Yazoo chocolate milkshake, 1 digestive biscuit, 2 squares Galaxy, 1 raspberry.

Having a late lunch but will be quiche, salad, cheese, ham, cake.

FWIW this morning for my DS aged 12 (and 4 stone) i made him a chocolate milkshake with breakfast. I put in some complan, nesquik (which is fortified), clotted cream ice cream, full flat milk and some ground almonds. He loves it, and it has to be about a million calories.

His breakfast was toast with cream cheese and strawberries which is his (current) favourite.

Some good ideas there, ground almonds & ice cream in particular.

Also, OP, I found with my DS giving him the calorific milkshake before bed, after his tea, meant it didn’t affect him eating up his tea/dinner. I didn’t want to fill him up on sugary complan at the expense of healthy meat and veg, so he had if afterwards.

Another update. I have been adding extra calories in everything & offering food almost non-stop (which is exhausting!) & I think we are seeing results. I weighed him after breakfast on DFIL's manual scales, as we are here for a few days, and the needle settled somewhere between the 26 & 27kg. I don't know how accurate that is but seems encouraging at least.

I also think his vertical growth spurt is over. He certainly needs to go up an age in trousers

I have an update on this, in case anybody is interested & remembers the original post.

We went to GOSH yesterday as blood tests showed a slightly elevated level of creatine kinase (400, normal levels being up to 300 iirc). Paediatrician was a little concerned due to this, his development delays & his size.

We went to the neuromuscular department, and highly elevated creatine kinase can indicate things like muscular dystrophy. After an intensive physio & long consultant appointment, they were happy this is not the case with DS. Physio said he is slightly hypermobile & probably dyspraxic. Both also commented he is surprisingly strong for his build

He was weighed & measured before the appointments (and just after a massive poo ) and weighed in at 26.85kg, 140.3cm. So he has not grown upwards since my OP, but has put on over 2kg. According to the charts they use, this now puts him on 6th centile. The consultant was happy with this, would rather he was nearer 50th but saw his father & said that might just be the build DS is designed to be. It's strange because when I put it into the NHS calculator, I get 1st centile, but the GOSH charts say 6th & I reckon they know more than me.

His diet is still good & he is eating more than ever, drinking gold top milk etc. His face looks a little chubbier to me, I think. So all round I am happy with his progress.

Thanks for updating this OP - very helpful as I was looking for threads as have a similar issue with my DS nearly 10 - also SEN but ADHD and sensory so very picky with food. Will try some of these ideas with him and hope they work ( unfortunately my youngest tends to overweight so it’s tricky!)

Glad to hear things are ok, I would say he probably takes after his dad. I was always in the underweight BMI at school but I was just lanky. Not anymore!

I think he sounds perfectly healthy. Some people are just naturally very thin. Both me and DH were very thin growing up, as were our children. Tall and lanky. Now we are all average weight I would say, but on the slim side. Relatives were worried about me too as a child, and some of them told my mum I must be anorexic, which I definitely wasn't. I just wasn't able to put weight on.