NHS bmi and GP conflicting - child's weight

[PalmLady]

I took my 7yo daughter to the Doctor today because she had blood in her urine on Sunday. Telephone appointment yesterday and face to face today. Urine was fine, and is now back to normal, no infections.

Whilst there, I took the opportunity to ask about my daughter's weight. She is 17.7 kg and 118cm which puts her on the 1st centile on the NHS bmi checker.
The G.P weighed her, and checked a graph on the screen and told me that my daughter was between the 50th and 75th centiles. I questioned this 3 times as it did not seem right. The G.P reassured me and showed me the graph, then told me I should not worry so much.

I'm now unsure whether to seek a second opinion, I'm not worried about my daughter's weight but I would like the correct information on her records in case it links to anything else.
For background info, my daughter has had on / off constipation since she was a baby and often complains of tummy ache. The tummy ache was checked by a G.P 2 years ago, they put it down to constipation.

Today is actually now yesterday 🙃

That's utterly baffling, OP! And if the height and weight are correct, your DD is quite severely underweight, so I don't understand why you're not concerned.

Perhaps the doctor entered the data wrongly? We once received a letter saying DS was overweight (after a school weigh and measure) and they had entered his height as 10 cm shorter than he actually was.

I would definitely get a second opinion

@Bloodybridget OP is concerned.... that's why she brought it up.

Yes I would get another opinion. Has anyone suggested CMPA? Sometimes the symptoms can be subtle like this but constipation and low weight can be among them. What was she like as a baby? Colic? Reflux?

Thanks for all the replies.

I'm not overly concerned about the weight because my daughter seems mostly healthy.
As a baby she was very happy, and never sick, she followed the 5th centile. She had constipation which she now sometimes gets mildly.

The G.P measured her weight on dial scales which rounded her to 18kg, they did not check height. The G.P. then plotted her weight manually with fingers on a graph that seemed to go up to adults. They showed me the graph when I questioned several times.

When the G.P told me she was between the 50th to 75th centile, I told them several things;
That I had checked the bmi on the NHS website and it came back as underweight.
That my daughter was usually on the 5th centile.
That my daughter was visibly skinnier than every other girl I know who's her age.

If was after this that the G.P told me I should not be so worried, and that I cannot compare children as they are all different. I was probably coming off as an anxious, googling mother, but all my concerns were mentioned because I did not feel the graph was correct.

The gp was wrong I think but using this she’s 2nd percentile for weight and 25th for height.

So she’s just small. Some are.

Are you and her dad tall or not? If not then her weight/height isn’t surprising.

www.rcpch.ac.uk/sites/default/files/Girls_2-18_years_growth_chart.pdf

HCPs generally don’t get concerned when a child crosses just one line, a change from 5th centile to 1st is only about 500g.

@YukoandHiro OP says in her first post "I'm not worried about my daughter's weight"!

If you feel it needs to be addressed then get a second opinion. Doctors are quite adept at minimising concerns and fobbing people off.

@PalmLady is your daughter's tummy ache easing now that her constipation is resolving? Has your daughter been tested for Coeliac Disease?

My daughter has not been tested for coeliacs. She often still complains of a tummy ache, usually after eating dinner. She can eat a lot for breakfast, but often doesn't eat loads of dinner.

If you feel it needs to be addressed then get a second opinion.
I'm honestly not sure what to make of it. Or whether it should be a cause for concern. If the G.P had said "yes she's on the 1st centile but I'm not concerned" then I would feel reassured.

My niece was diagnosed when she was 6, with over a year history of belly ache, usually after eating, the pain eased with paracetamol. Her mum wasn't that worried as LO was well, eating & drinking, playing, sleeping etc. Her dad pushed for routine bloods, & a scan, all were normal & only when she was referred to a paediatrician did they test for Coeliac Disease. It's definitely worth asking the GP to request the blood tests which can be taken at a children's clinic

Are you and her dad tall or not? If not then her weight/height isn’t surprising.
We are, I'm 5'3 and her dad is 5'7. Both average weight.

My niece was diagnosed when she was 6, with over a year history of belly ache, usually after eating, the pain eased with paracetamol. Her mum wasn't that worried as LO was well, eating & drinking, playing, sleeping etc. Her dad pushed for routine bloods, & a scan, all were normal & only when she was referred to a paediatrician did they test for Coeliac Disease. It's definitely worth asking the GP to request the blood tests which can be taken at a children's clinic

I just read a bit about coeliacs disease. My daughter never gets diarrhea or loose stools, so it seems unlikely, but I guess it's possible. She does get tired but I feel like it's at a normal level. She could play for hours in a soft play. Her hair is also very slow to grow, she's had one hair cut since she was born and her hair is quite fine and short. So fine you can see her scalp at the top.

@PalmLady

Are you and her dad tall or not? If not then her weight/height isn’t surprising. We are, I'm 5'3 and her dad is 5'7. Both average weight.

I think that’s your answer about her height and weight then. She’s just meant to be little.

While her small stature may just be down to small parents the small stature in combination with ongoing stomach problems would worry me.
I would ask for a second opinion and also push the fact that she has ongoing constipation / stomach aches. Play it up and say its having a severe impact on her quality of life. At the moment it seems GPs are trying their best not to refer but I would want her seen by peads.
My son has CMPA and is under the care of a pediatric dietician. My GP did not offer this and I only fought for the referral as I have a friend who happens to be a pediatric dietician and she insisted in cases of CMPA that you need the involvement.
My sons symptoms were also mild.
As somone up thread said celiac disease is a potential. It can present with a variety of issues including constipation. My sister was diagnosed off a rash so it doesnt always follow the expected route.
At a minimum I would be fighting for bloods to ensure she is not deficient.

@PalmLady

My niece was diagnosed when she was 6, with over a year history of belly ache, usually after eating, the pain eased with paracetamol. Her mum wasn't that worried as LO was well, eating & drinking, playing, sleeping etc. Her dad pushed for routine bloods, & a scan, all were normal & only when she was referred to a paediatrician did they test for Coeliac Disease. It's definitely worth asking the GP to request the blood tests which can be taken at a children's clinic

I just read a bit about coeliacs disease. My daughter never gets diarrhea or loose stools, so it seems unlikely, but I guess it's possible. She does get tired but I feel like it's at a normal level. She could play for hours in a soft play. Her hair is also very slow to grow, she's had one hair cut since she was born and her hair is quite fine and short. So fine you can see her scalp at the top.

Bowel changes can be either constipation or loose stool, my niece had neither. Agree with other poster, push GP to refer to paeds, GP can request bloods for Coeliac Disease while waiting for the outpatient appointment

I have coeliac disease and don't get diarrhoea ever. Mine is all gastric pain and symptoms of UTI and blood in my urine frequently. This is the allergen irritating on the way out.
Slow to grow, tummy pain, tiredness and the hair all sound like she isn't getting the goodness of what she eats. I would definitely be looking for some sort of food allergie, intolerance or coeliac.

Oh also while your fighting for the referral start keeping a food diary noting everything she eats.
While celiac disease can be diagnosed off tests allergies can be a nightmare to pinpoint and if it is an allergic reaction a food diary can help pinpoint which food is causing the issue.

Thank you for all the replies. I had no idea coeliacs could cause blood in urine.

I wonder if it would be worth ordering a coeliac test kit online? It's less than £50 and can be done with a finger prick. Does anyone know if they work?

Putting everything together, I do now think I need to persue it further. Each thing on it's own is not a worry but put together it's quite a bit;
Underweight
Constipation
Tummy aches
Lack of appetite
Hair slow to grow
Unexplained blood in urine
Frequent urination (2 years ago I mentioned this and it was also put down to constipation)

She also really feels the cold, which I thought was normal as there's no fat to keep her warm. She's shivering throughout her swimming lessons.

Arrange the test through your GP, my niece didn't need a biopsy. Don't change your daughter's diet unless you're advised this needs to be done, as this can affect the test result
www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/blood-tests-and-biospy