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

[19Bears]

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.

I sympathise OP, I also have a 1st centile boy; he’s 12, 246 cm and 29.4 kg. He was also diagnosed with ASD and ADHD when he was 7, so we know why. Restricted diet, plus wonky interoceptive system so he can’t tell if he’s hungry or had enough to eat, plus non-stop fidgeting so he burns off any calories we can get into him make it very tough. We do insist on breakfast and do eat together at the table, but DS will only eat tiny portions.

Has your son’s issue with eating in front of others been going on for a long time OP? What was he like when he was little?

😁 i think you mean 146cm. 246cm is 8 foot tall

🤣🤣🤣 That would be pretty wild. He’d have a negative BMI! Yes, I mean 146!

Do you remember the news story from lockdown about the guy who got called in for his vaccination because his BMI was 28000? Turns out his medical record had his height down as 6cm instead of 6ft.

For lunch you could swap the two yoghurts for a protein yoghurt pouch maybe? Aldi do them
And something calorie heavy to drink as well as water, would he have a milkshake maybe

But yeah he needs actual meals and then the snacks as well

Don't blame yourself op, we can only try our best and our kids aren't puppets we can control. My dd has ASD and sensory issues so I understand food avoidance around taste, texture etc. Definitely a good move to see the GP and discuss any food issues / disordered eating, as well as general advice. I think I'd also want to rule out anything like IBD, allergies, anything medical as a cause or contributing factor, maybe they can run some blood tests, refer you to a dietitian?

Hello again everyone, sorry to be away so long, I've been busy with the tea, ironically. So to address the burning question about sitting down for a meal, I'm ashamed to say we've never had a table. Well, I bought one several years ago but then it got commandeered as a work/computer desk. We all just have our meals sitting on the sofa, and I always did that when I was younger. Even my wider family, we've all sat on the sofa to eat, except for Christmas Day! know that all sounds mad, but that's just how it is. I also know it's up to me to break the cycle and start a new routine.

Also to address how we eat, I make a meal for myself (normal healthy meals, meat and two veg, pasta, all the usual), the kids have what they have, and we're all in the living room together. Dh lives on pot noodles and frozen pizza and comes and goes and does his own thing to a certain extent. There are big problems between us which I also need to face head on. That's another whole long story. I realise I'm painting a very dysfunctional picture here, but really, it's not how it sounds. The kids are flying at school, and they manage to dispel the theory that an early night and a good breakfast makes you learn better, as they are doing it all without that. It's hard to argue otherwise.

When they were both little they would eat anything. I'd make a dinner for all of us, some for me, some for them, no problem at all. But then they started going off things one by one until there was barely anything left they would have. My brother gave my eldest a cheese string and that was that. He seemed to develop a dislike for all kinds of things. I'm not sure what it was for my youngest, but they both seemed to reach this stage at about three years old and it's been like this ever since. I do think it's a lot to do with texture, smells, sensory issues, and probably a lot of overthinking. I went on a school trip recently, and all the rest of the kids were almost throwing their food around, munching right up in others faces, not to that extreme but I could tell that ds felt this magnification of the lunchtime hustle and bustle and just was put off by it all. I can understand that. I have suggested that we ask his teachers if he can sit somewhere quiet for his lunch at school, but he just says he's never hungry at lunchtime. He's hungry and asks for food when he comes home, and I know he's frustrated that he can't think of anything he'd like apart from what he already has. Ds15 is starting to try more foods now, and I'm hoping it will rub off on ds11 as he idolises him.

I do know what he needs, of course I do. As does he, he's an intelligent boy. But it's just how to deal with it in a sensitive way that doesn't discourage him further and make things worse.

Thanks again for everyone taking the time to make suggestions x

I'm very glad that they're doing well at school. But it doesn't counteract poor nutrition which they are getting at home. Sad to say.

Not having a table isn't anything to do with it. The fact is, you're not providing one, decent evening meal for your sons. (Your DH can do whatever he wants to, as it sounds like there are other issues going on there.)

So back to the $64,000 question - why aren't you cooking a proper evening meal for your children? If you're making one for yourself, why aren't you also doing that for them?

has his weight always been like this or has it fallen? I’d def get him checked with the gp who will likely check things like coeliac. In the meantime I’d try and increase what he eats without making a big deal of anything. Even things like nut bars will provide quick extra protein

NHS BMI calculator says see your GP.

I realise I'm painting a very dysfunctional picture here, but really, it's not how it sounds. The kids are flying at school,

You do know kids can be both bright AND come from a dysfunctional background. Don't think they're fine because they do well at school.

What would happen if you just gave him an evening meal rather than a couple of bread rolls?

Does he not like scones with jam and cream, or pizzas, or cake - all of which can be made at home?

I feel like I would start by doing a lot more cooking and leaving it around to be eaten.

Do you think the fact you don't eat together at home could be why he is uncomfortable eating around other people at school? It might take the pressure off him if food is just provided rather than him being asked to choose.

I was coming on to say that my DS was similar with dropping foods from his diet at a similar age. I can see he has other things going on with not wanted to eat in front of others etc

If he eats with you though that’s a good thing and (I am not judging you OP ) but if you swapped sitting in the lounge and all ate together around a table there’s real benefits to it. Is this something you could try? Seeing and sharing food , making it more relaxing, and acceptable to eat - seeing his big brother try things etc. It’s also a good opportunity to just talk about the day….and might help him to open up a bit?

The way I tackled it with my DS ( he didn’t have the concerns re eating in front of others he just didn’t ‘like or enjoy’ a lot of foods) was to make sure I cooked the same meal for us all, but with every meal was something he ‘would’ eat, and plenty of it. Alongside (a lot of the time ) things he ‘wouldn’t’ eat, I didn’t make a fuss but I made sure that I could offer something and he was eating something.

What also helped was a buffet style of food, so wraps for example where he could make it himself from a choice at the table or pizza ( homemade ) using ingredients he liked and offering on the table things he ‘didn’t’ - but sometimes would try on a pizza. (Using plain Nan breads are a good basic and quick pizza base.) I’d also do raw veg and various dips - houmous has protein and fat and can again be a variation if eaten with carrots or even breadsticks.

Try also to offer different coloured food- bread etc = lots of beige, which isn’t always attractive.

So my DS always got served the ‘ family ‘ meal and eventually ( and it took a couple of years ) he reintroduced foods back into his diet slowly.

My final suggestion would be use high protein version of things he likes e.g. if he likes yogurts, go for high protein ones, bread with added protein, does he eat baked beans? That was a staple in my house. Also small portion cheeses, peanut butter….also multi vitamins.