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Original poster

DS11 underweight - how to talk to him about it, or not

64 replies

19Bears · 04/01/2023 13:05

I've put this as a reply to another thread but wanted to make a new one here if that's ok. I had my DS11's height and weight letter from the school nurse just before Christmas. He's on the 1st centile and therefore underweight, and they advised me to contact my GP. He's always been skinny, like me, and doesn't look as 'well' as other kids, in that he can look pale sometimes. He's very active and we have recently been climbing a few hills in the Lakes, so he's not lacking in strength or fitness, he's just thin and fairly fussy with food.

I hadn't mentioned the letter to him as I don't want to make an issue of it, and just want to use a few of the ideas here (peanut butter, croissants, full fat milk) to get him to gradually gain a bit of weight without him really noticing. However, his dad blurted out the other day to him, "this is ridiculous how massively underweight you are! You should be at least 7 stones! You're way too thin!" I felt like pointing out that he is ridiculous for being massively overweight, amongst lots of other ridiculous things, but I bit my tongue...

He's 29kg, which is clearly low, but I don't want him to worry about his weight and feel as if there's something 'wrong' in some way. Equally, I want to encourage him all I can to put weight on and be healthy, and not just let it drift. So my question is, how do you talk to your child about being underweight? What works and what doesn't? Any feedback would be very much appreciated.

OP posts:
emmathedilemma · 04/01/2023 13:06

What's his height in relation to his weight? If he's on a low %ile for height too then it's less of an issue.
No, I wouldn't talk about being underweight, I'd talk about what constitutes a balanced diet.

Original poster
19Bears · 04/01/2023 13:16

Sorry yes I should have said! He's 144cm

OP posts:
UnbeatenMum · 04/01/2023 13:20

My eldest had some eating issues last year and we were advised by the eating disorder service to give her 3 meals and 3 snacks for weight gain. E.g. 7am, 10am, 12:00, 3pm, 5pm, 7pm. And not to go more than 3 hours without eating. You could just say to him he needs to gain some weight so you're adding these snacks in to help with that and keep it matter of fact. With DD I've been feeding her foods that she likes, which has involved a lot of chocolate, but in our case calories was the most important thing.

stopbeeping · 04/01/2023 13:23

Holy god that is small, I'm 47kg and 156cm,

Does he have any food intolerances that you may not have considered? These can affect how we absorb nutrition.

I would want bloods done

All my babies were born under the 5th centile

Two of them are over the 50th and one is over the 90th centile now,
You can't really force someone to grow

But I would be worried about his absorption

Sending love, but yes, do contact Gp x

emmathedilemma · 04/01/2023 13:36

jeez, I agree that's worryingly low for his height. What does he eat in a typical day?

Fireflygal · 04/01/2023 13:43

When you say fussy, how restrictive is his diet? What was his birth percentile?

At 11 he is old enough to know having sufficient food is important for health. His bones are growing so he needs calcium and protein to avoid injuries.

At his weight he is likely to be deficient in nutrients unless there is an underlying health issue

PussInBin20 · 04/01/2023 14:10

I don’t think I would mention it. I would just give him more calorific healthy foods for his meals.

if he’s fussy I would give him say a choice of three meals for him to pick one. If he’s not eating a proper meal each time/persistently then maybe that is the time to have the talk about us all needing a healthy plate of food and what it should consist of.

Now it’s the New Year you could disguise it as you are all going to be a bit healthier as a family.

mrsfeatherbottom · 04/01/2023 14:18

My DD was referred to a dietician last year because she was very underweight. We were advised to switch to full fat milk and she drinks two glasses a day, 3 meals a day plus 3 snacks. She has a small bowl of cereal before bed. If she's having an apple, I chop it and give it with peanut butter. You can add double cream to sauces as well to add calories.

We were also told she should be having pudding of some kind every night after dinner - this was tricky because she doesn't like rice pudding, custard or yoghurt but if your DS likes these, it would be a great way to add calories.

Original poster
19Bears · 04/01/2023 14:19

On a school day he never wants any breakfast, which I know I have to work harder to get him to have, and he usually comes home with most of his packed lunch uneaten. All he takes in the packed lunch is 6 ritz crackers, a banana, two small yoghurts and a bottle of water, but he says he doesn't like to eat around the other kids, and that he's not hungry anyway. When he gets home he'll have two slices of toast, then his packed lunch, and another two yoghurts. Later he'll ask for two of those smallish part-baked baguettes that you cook, and more fruit like an orange or pear, and breadsticks with nutella. There's a lot of bread based food... then before bed he has two weetabix. It's all snacky food, no real meals. I hate that he's this way. His older brother was similar but not quite as limited, and he is only just trying more foods now he's 15 and more body-conscious. He is worried about his little brother too and wants to help. I just feel like I'm not doing very well and have been too soft and a bit too laid back with them.

OP posts:
Blondbombsite · 04/01/2023 14:24

19Bears · 04/01/2023 14:19

On a school day he never wants any breakfast, which I know I have to work harder to get him to have, and he usually comes home with most of his packed lunch uneaten. All he takes in the packed lunch is 6 ritz crackers, a banana, two small yoghurts and a bottle of water, but he says he doesn't like to eat around the other kids, and that he's not hungry anyway. When he gets home he'll have two slices of toast, then his packed lunch, and another two yoghurts. Later he'll ask for two of those smallish part-baked baguettes that you cook, and more fruit like an orange or pear, and breadsticks with nutella. There's a lot of bread based food... then before bed he has two weetabix. It's all snacky food, no real meals. I hate that he's this way. His older brother was similar but not quite as limited, and he is only just trying more foods now he's 15 and more body-conscious. He is worried about his little brother too and wants to help. I just feel like I'm not doing very well and have been too soft and a bit too laid back with them.

Do you not make him dinner? It seems that he has some food issues if he won’t eat in front of people and a visit to the GP might help.

To be frank though, you need to step up. Make a proper breakfast that you sit down with him for, a proper packed lunch- bit just snacks and then dinner. Plus snacks.

emmathedilemma · 04/01/2023 14:25

The fact that he eats all that when he gets home suggests he's hungry and it's more of an anxiety thing that he won't eat at school. Could you ask if there's a quiet space he could eat in? The amount and range of foods he eats definitely needs addressing. Does he never eat a "proper meal"?

YellowHpok · 04/01/2023 14:27

A few things stand out:

  • has he always been like this or has there been a sudden or gradual change?
  • there isn't a lot of protein in his diet. Is he a vegetarian?
  • does he restrict foods for certain reasons? Texture?
  • why doesn't he like eating in front of other kids? What does that feel like for him?

I wondered about ARFID reading your posts, or some form of social anxiety about eating in front of others. Both require input from healthier professionals.

I would explain to him that it's important for us to have enough fuel in order to grow and be strong. Protein and calcium are major elements of that, so together can you consider how to bring more of this into his diet. Give him some control here.

Is there ANYTHING he will eat for breakfast? Homemade milkshakes with banana, oats, peanut butter and full fat milk would be a great place to start.

cheeseisthebest · 04/01/2023 14:30

My 11 year old son is 154cm and I think about 5stone! But he eats loads just very active and burns it all off. Should I be worried?

Beamur · 04/01/2023 14:35

I think there's something going on here that's more fundamental than being a bit fussy. Can you explore sensitively with him his preferences - it is texture or taste? What foods are safe? Get him to work with you to explore things he might like and ways to change gradually.
There's a lot of starchy carbs and foods with very predictable tastes and textures there which is very telling. I don't think he's picky out of choice.

fairlygoodmother · 04/01/2023 14:40

So basically he eats bread, fruit and yogurt? Is this because he doesn’t like other foods? Does he eat meat? I think he is likely to be short on protein and micronutrients.

I would ask the GP to refer you to a dietitian because he sounds as if he has some food issues with not wanting to eat in front of other people, and you don’t want that to get worse.

In the meantime if he isn’t eating lunch at school it’s even more important that he has a proper breakfast. Ideally I’d make him eggs, if he won’t eat that then sausage or bacon. If he doesn’t eat meat or veggie equivalents then the weetabix and banana but try for something with protein.

It might help to put what he eats into my fitness pal or similar. Although these apps are mainly aimed at people wanting to lose weight they do give you a nutrition breakdown that could be useful to help you and your ds judge what his diet might be lacking.

Original poster
19Bears · 04/01/2023 14:43

Thank you so much for all the replies. I am going to make an appointment for him to see the GP and take it from there. Obviously there are psychological issues as well as just not liking things, so hopefully we can deal with all of it and get things on the right track.

OP posts:
Eatentoomanyroses · 04/01/2023 14:44

He’s the same weight as my 9 year old but she’s very tall. How tall is he? Does he enjoy any foods? When she got over her last stomach bug she looked gaunt I just made sure that I gave her a lot of things she liked to build her back up.

Summerhillsquare · 04/01/2023 14:48

Do you not eat meals together at the table?

catfunk · 04/01/2023 14:57

Don't you make a family meal on an evening? Or have you always just let him have 2 baguettes for dinner

Sunsetintheeast · 04/01/2023 15:07

My kids have pancakes every morning. I add an extra egg and serve with fruit. You could make with full fat milk. Most kids eat pancakes.
breakfast is essential, he is starving his brain.

Highlyflavouredgravy · 04/01/2023 15:13

Where's the dinner? Thecmain meal of the day where YOU cook something like meat, spuds and veg and you all eat together?
No wonder he us thin, there is no actual meals happening!@

Florin · 04/01/2023 15:20

Why no dinner? What does he do while the rest of you eat, does he sit with you? I think the doctor will be concerned he isn’t being made any proper meals.

JolieJ · 04/01/2023 15:23

My 7 year old is a very fussy eater, he has sensory processing disorder among other things. If I left it to him he would only eat junk all day. He has a few mouthful of a croissant for breakfast but eats most of his packed lunch (1 slice of bread with cream cheese/a apple slices and 2/3 biscuits). When he gets home I make him a 2 egg omellate and force/bribe him to eat it as it's his main source of protein. For dinner he eats the same thing every day: rice and lentils. I recently started giving him Paediasure milkshakes twice a day and he enjoys those, maybe try that for your son? It's really hard but unfortunateky you will have to make more of an effort, for his sake.

AnotherBrightSunrise · 04/01/2023 15:48

Similar situation as you really. I went to the GP recently as my daughter aged 9 was 1st centile on the kids NHS BMI chart, and they did give her laxido for sore tummy/ constipation, but didn’t seem overly worried about low weight. I was kind of hoping for a dietician referral, but I think the criteria is higher. Well meaning relatives talk about such-and-such a person, who used to be fussy, but she’s on a different level - just a handful of foods, would much rather go hungry than eat almost anything. I keep it relaxed as much as I can and talk about protein and vitamins for strength and health. We eat well as a family. But no, she’d rather eat bread and butter, and cold beans! She eats nothing mixed and almost nothing hot. It’s frustrating! All the best for you, and I will continue reading the thread for suggestions!

Annoyingwurringnoise · 04/01/2023 15:54

Honestly, unless you’re worried, I wouldn’t say anything, because the chances are it’ll probably right itself soon enough. When I was a kid I was underweight and my mum used to tell me they were worried about me. I ended up being secretly terrified that they were going to take me into hospital. Turns out by the time I hit puberty my weight was fine.

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