To tell my HV I will NOT restrict DS's food intake

[thefuturesnotourstosee]

we've just come home from DS's one year HV check. DS has alwiays been a big baby and today he measured the 99th centile for both weight and height.

HV told me he was overweight and I should restrict his food intake. I told her I wanted to talk to the GP about this as I disagreed with her and she told me "he should be no higher than the 80th centile, you're clearly overfeeding him its obvious you don't need the doctor to tell you that".

I politely told her Id seek a second opinion scooped up DS and walked out.

Had his weight and height been substantially out of proportion I may have engaged but I don't think there's a problem. AIBU?

At a hospital appt a while ago my then 4 year old DD was weighed and came out at the 99th percentile. I asked the consultant if that was anything to worry about and said she does eat pretty healthily (most of the time...) He looked at me like I was mad and said she was so tall she must be at the 99th percentile for height and clearly isn't overweight so it was fine. He seemed less than keen on the percentile charts and told me to ignore them and just look at her.

Some babies are a bit more than just chubby and perhaps are overfed, but if yours is the same percentile for height and weight it would seem this isn't the case so YANBU.

Hv is an idiot .

We had our one year check yesterday. Ds is 86cm tall and weighs 30lbs. She didn't even mention his height or weight except in a nice "what a big healthy boy" type way.

Ignore ignore ignore.

My dd is 10 years old and now skinny as anything and she was the same as ds when she was little.

I've just been looking at the NHS explanation for centile charts and it's quite clear. So the HV really needs to be flagged up as not understanding them.

MrsDeVere I noticed that there was a comment that the UK charts are based on the WHO charts. "Since May 2009, the centile charts in your PCHR or red book have been based on measurements taken by the World Health Organization from healthy, breastfed children with non-smoking parents from a range of countries." Hopefully this might cover your ethnicity issue.

You get it if your child is smaller, too. My DS is two, and has always been 80th-90th centile for height, and 10th-25th centile for weight (though he just crept up to 25th-50th at his most recent check).

I have been on the receiving end of grief his entire life. Plenty of "Are you sure he's getting enough solids/milk/meals?" He was breastfed on demand as a baby and breastfed until he was a toddler, but he ate plenty of solids from a year on, and a huge variety.

Disregard, and move along.

Hi OP,

I don't very often post here but I wanted to add my support. My ds is 9 months old - just. He is 28lbs already, he is on the 95th centile. BUT he was big to start with - 9lb 6oz at birth and he was two weeks early!!

No child is the same, please ignore the hv. Sounds like you're doing a great job

Mine were like this, 99th centile born, in fact DD went off the chart at one point so I didn't go to any HV checks, didn't see one since she was 6 weeks old. I was scared they'd take her away from me, it was around the time of that dreadful doco where there was a 9 month eating a whole portion of chips from the chippy!

She got uber fat on milk alone and now at nearly 4 she is quite a bit leaner than I imagined, she still has the toddler sticky out tummy but its not fat, its sort of hard? Her previously munchable legs are getting quite lean.

Haven't even weighed her since I got on a plane with her at 7 months.

Ignore, smile and nod, don't see them, and if you have any genuine concerns see your GP and if they talk shit get a 2nd opinion.

My DD was on the 98/9th centile from about that age, she is now a gorgeous almost 6 ft-er size 12/14 .

She was one ofthose who was quite a chunky monkey till she crawled & then lost it. I always knew when she was starting a growth spurt as she'd eat for England, get a real pot belly & then shot up another inch or two & get skinny again!

I agree with others go to your GP just to make sure your concerns are logged about this HV's incompetance.

The bmi chart your HV could have used is available online here. Plot the weight centile versus the height centile and the chart will clearly indicate if the child is overweight or obese. BUT I mis-remembered and it's only valid from age 2 years . That said, it's not as straightforward as same centile for both = fine, perhaps because of the aforementioned trend for overweight children to grow taller too.

If the HV has genuine concerns about your child's weight then you should be getting a referral to a paediatrician/dietician, not random advise to feed them less, which is not helpful, specific or likely to be well-received.

HV is an idiot. Someone has to be on the 99th to make the chart up.

I don't think it's fair to say the HV is an idiot. We have not examined the child. Maybe she has genuine concerns for valid reasons that the OP has not understood because of the clunky way it's been communicated?

Sme children are naturally and normally very large, but not the numbers that Hv's will be seeing nowadays. At 12 months, in the absence of any other concerns, it might just be a question if the health professional exploring the child's diet a bit and watching and waiting, or maybe a referral might be appropriate in some cases.

Sensitive communication and good training is the key, but they cannot dismiss all large children as normal, because we all now that is not the case in a society where 20% children are obese...

HV is talking rubbish. Somebody has to be the biggest/smallest. It's not possible for all children to be under the 80th centile.

What is a bit more important is weight relative to height. If your DS was substantially under- or over- weight for his height then that might be a problem. BMI tries to get to this idea in a single measure but has its shortcomings and shouldn't be used as a blunt instrument without thought.

Your DS is unusually tall and unusually heavy for his age (did she use the right age for him, do you know?). But that doesn't mean there is anything necessarily wrong with him!

I'd complain - someone this thick/ignorant/both should not be giving medical advice.

She's a knob, ignore, ignore, ignore

From the Royal College of Paediatrics and Child Health guidance:

"Because it is difficult to measure length and height accurately in pre-school children, successive measurements commonly show wide variation. If there are worries about growth, it is useful to measure on a few occasions over time; most healthy children will show a stable average position over time."

Maybe get him re-weighed in 3 months (by someone else) and see if anything's changed ?

(Although I agree that many of the top 20% children by weight in the UK probably are at serious risk of obesity because that's the way we're currently distributed - but not the OPs child if he's been unusually tall from birth).

However, re-reading the OP, the 80th centile bit sounds weird. Even if she were meaning bmi centiles for 2 yrs+ overweight is the 91st+.

I had the opposite issue with DD, who I was apparently under feeding as she was only in the 20th. That was also at a year. Currently pg with DC2 - we will not be getting him/her weighed unless worried about something and then straight to GP.

DS1 was on the 97th centile for height and weight at 12 months. He was 7lb 6ozs at birth and weighed more than 8lb a week later (ebf). The HV rode my ass about his size from day one. At school he looked like he was in the wrong class being a head taller than every other kid until he was about 14. Then hey presto, everyone shot up around him and closed the gap.

Today, age 27, he's a very gorgeous 6ft 1in with a powerful, muscular physique.

Concentrate on the quality of your DS diet, encourage him to be physically active and give yourself a pat on the back for raising a robust, healthy child.

DS was off the chart weight-wise at around a year old. His height was around 50-75th centile, I think. He was a dream to wean as he ate everything until he was a year old, and still drank lots of milk too. He never crawled, though he was cruising at a year.

My HV told me not to worry. As long as he was eating a good well balanced diet with lots of fruit, veg and milk and not too many treats, then it would balance out.

He started walking at 13 months and gradually became less of a chubster! He's always going to be heavy, I think, as he has a broad, muscular build like his dad but now, at 5.5. he has very little spare fat on him.

If you have no concerns about your DS's weight, then carry on with what you're doing.

my health visitor wanted me to put my 3month DD on a restricted diet. she was born big at 9.6 and a half and was a hungry baby.
I refused to do this because I knew she wouldn't settle unless she was on hungry baby formula, I had to stop BFing because she wasn't getting enough and I asked to see someone else.
I had a visit with doctor who measured DD height, weight head the whole shabang.
his opinion was I had a very healthy, but large baby because she was in proportion with everything else.
I think HV get to focused on the numbers and don't look at the big picture.
DD is now nearly 3 and doesn't look much different from her peers in nursery so really no need to worry.

Sounds stupid! If your child becomes overweight/chubby/chunky etc. it would be a much better solution to increase activity levels, rather than messing with his head about food!

It sounds like the HV doesn't really understand how centiles work or what they mean.

That said, there's a difference between being on the top centile line and being over it. A child could be precisely on the 99th centile for height, and several kilograms over for weight - and that could be an issue.

My DS was on 75th centile for height, 98th for weight, at his check up at 10 months. We did BLW and he is a very enthusiastic eater, but it is all healthy home cooked food. He wasn't crawling at that stage, and I have just assumed that he will naturally slim down as he becomes mobile. He's now 11 months and just starting to crawl).

It does worry me sometimes, but I am hoping that feeding healthy food to the child's appetite, not making a big issue of how much they eat (restricting/coercing etc), and encouraging them to be active, is the way to ensure they are a healthy BMI as an adult. Some of these stories have made me feel better!