To bin this letter and not ring them about DS?

[Oddthomas]

Got a letter about 4yo DS today. He was weighed and measured last month at school (yes, it's one of those threads). The letter says he is overweight :( It lists the dangers of being overweight with the line "you are putting your child at risk of..." and finishes with the sentence "to obtain support on what to feed your child please contact..." and the phone number for the nurse who visited the school. Also enclosed was a change 4 life leaflet.

I sat and I read the leaflet and there is nothing in there that we don't already do. He gets at least five portions of fruit and veg a day. He has at least 60 minutes of exercise (usually more as school alone is a 20-30 minute walk each way and he's always in the garden on his trampoline or scooter, rain or shine). He doesn't have fizzy drinks (despite his best efforts to persuade me that all of his friends do) and I don't keep sweets in the house, gets them now and then as a treat, generally when we visit grandparents.

He's always been on the high end of the charts, 95th percentile at birth and stayed there right through his baby and toddlerhood. He's a solid little thing but when he's got his top off I can see ribs and the knobs of his spine, he doesn't have any rolls, has just the one chin, and he's in the appropriate clothing sizes (a mix of 3-4 and 4-5).

Yesterday he ate:

• breakfast: blueberry wheats (like shredded wheat with blueberry filling) in one of the kids bowls with semi-skimmed milk. A banana.
• lunch: cheese and tomato sandwich (one slice of bread, folded over and then cut in two), sliced apple, sliced red and yellow pepper. A seafood stick. Three pieces of tuna and vegetable sushi.
• dinner: chicken and mushroom tagliatelle with broccoli and sweetcorn in a homemade garlic cream sauce (garlic, herbs, low fat creme fraiche).

Drinks: glass of milk with lunch, the rest of the day either plain water or very weak sugar free squash. He has a drinks bottle that we top up as needed so he always has a drink available. We went to the park in the morning, walked there and back, and to a softplay after dinner.

Today, so far, he has had marmite on toast (two slices from one of those mini-sized 400g loaves), a satsuma, an apple and tuna pinwheels for lunch (tuna in a flour tortilla with mixed leaves, rolled up and sliced). Dinner tonight is going to be Spag Bol, lean steak mince with homemade sauce and hidden veg. We're about to head to the adventure playground for the afternoon.

This is all pretty typical fare. At school he has school dinners. Typical menus include pizza and wedges with carrot sticks followed by cake and custard or breaded chicken pieces (nuggets then?) with potatoes and seasonal vegetables followed by cake and custard. I'm now considering putting him on packed lunch instead!

He seems healthy enough to me, I'm not filling him full of shit and he never sits still and I mean never, he's a fidgeter. My siblings and I were all solid children, when I compared DS to photos of me and my siblings at the same age we all have a similar build, and we all stretched out around about when puberty hit.

AIBU to just bin this letter? Or should I be paying attention to their chart rather than the child in front of me?

• chips or wedges

My son had one of those letters too - I sent pictures of him to Local authority alongside a letter of complaint - he is a skinny nothing - my dd who was short for age but solid had no such letter (she is older). - I think we are all getting a bit obsessed by weight and why justify what he eats unless you are worried about it yourself ??? I knew there was no way my son overweight ad I have to buy next age up clothes due to height) and the. Pull the elastic waist band I. To nearly the end so that they don't fall of his hips --- Oh and I was conscious of dd weight so really really monitored what she ate and got her as active as possible - she is now nearly 12 and has no weight problems what so ever :)

Clearly standards very. I would think it's a pretty safe bet that the school dinners are responsible. Hopefully menu will be getter when it changes but the op seems to be very aware of a healthy diet and I think she will be fine doing the packed lunches. In her case it's worth a shot.

Course it could be a mistake with the scales or storage before a growth spurt but things are easier to tackle at this age when they don't have the free rein to food and before it goes to far.

With a try, I can't see his it will be detrimental to him as he has a mum who knows what she's doing.

no harm trying packed lunches but it is unlikely to be connected to 5 meals out of 21 only

my kids never eat much at lunch anyway - rush to play out! are you in scotland, op? less rigorous conditions on school dinners there i think

It's impossible for any of us to say.You have no pictures of him on your profile and you only give details of his menu for one day.
You say yourself he is 'solid', is that a euphemism?
My DD who is short and muscular as anything (15 hours gym a week) is 8 and on the 28th centile for BMI, so I really don't believe the muscularity excuse.
When you see news stories about this , the kids are always chunky but the parents are comparing them to the structure of an adult.Children shoul be way way thinner.Ignore this at your (or your DS's ) peril!

My DS had the same letter at 5. When I asked the health visitor she told me that while he was on the 95th centile for his weight, he was also for his height, making him spot on! She then had a word with the school about measurements etc. the following year, he was going through a 'tall' phase and I got a letter saying he was underweight! Interestingly, I didn't get a letter with high calory diet tips, but a offer of counselling for him to encourage him to eat.
Given that he never stops eating (mainly fruit), and at 10 is only half a stone lighter than me, but I can still see every ribs, and have never found a pair of trousers he can wear without a belt, I have very little faith in the ability of the charts to say anything.
Incidentally, I work at a hospital and have plenty of kids with normal BMIs but huge belly rolls!

sasdy, I've already explained that by solid I mean not soft. There are no wobbly or squishy bits on him.

I spoke to our GP this morning when I was dropping DH's repeat prescription request off (advantages of a small practice!). He put him on the scales and makes him 19.6 compared to their 20.whatever and my flat 20 on the scales yesterday. He also puts him at 106cm, same as me. He agrees that DS is active, healthy and not fat. He says that weight fluctuates depending on time of day, when you last ate, when you last pooped (!), what you're wearing and the make/model of scale as well as the person doing the measuring. Basically there are a lot of variables, even more so when measuring children, and the numbers are just a rough idea. As DS looks okay and his diet is okay he says there's no problem. Then I got to hear all about the percentile charts and why he dislikes them, which I've heard several times since DS was born. If DS starts to look chubby/flabby or needs the next size clothes without getting any taller or starts gaining weight but not height then there may be something to look at but for the time being "he's four and he looks like a four year old".

Letter is going in the bin :D

And, I don't know what difference it makes, but the trousers he has on today are sized 3-4 and I have the adjustable waistband pulled tight for them to stay up.

Maybe he really does have bricks for bones.

I don't really understand the centile charts. From birth DS has been on the 50th for weight and the 9th for height (which would suggest to me that he is too heavy for his height?). At his 2 1/2 year check they measured him and he is still exactly on those lines. I asked if that was ok and they said yes, as long as he follows his own curve that's fine and that to look at him you would not say he was overweight at all.
I also asked my nurse mum (who is very honest about weight!) and she said the same.

I am a bit paranoid because he is going to take after dh and I who are both fairly short, and its so much harder to keep your size down when you are short because there is less surface for the fat to go! I am dreading the weighing at 4 already! We are an active family but I also worry about too large portion sizes etc (although ds never eats more than he wants and we never make him finish his plate etc). Dd I think I will be less worried about as she already seems to be a tall and skinny thing somehow!

Also, my ds is now 2.8 yo and can still fit into most of his 1 1/2 to 2 trousers so I figure he can't be really overweight!

I'm opting him out of the next weight check, more hassle than its worth!

I think the problem with school dinners is not so much the main courses (although chips or wedges 2/3 of the times sounds excessive) but the puddings every day. When I was at school, we ate puddings at school but at home sweets were once a week and a pudding on a Sunday, the rest of the time it was fruit or nothing. If a child has a pudding every single day at school, that's all the stodge/pudding calories used up for that day, so when they go home, have a piece of cake at their friend's houses, a biscuit at home, eating out as a treat etc., it all adds up to too much.

My dd's school serves fruit and yoghurt but she can't/won't choose them when faced with a sticky pink bun, so it's pointless.

I am not convinced that feeding the entire nation a large stodgy pudding every day is a good thing, even if some lunchboxes are crap.

"IME, some very tall kids are identified as overweight, when they are actually very tall (and hence heavy) for their age."

but actually overweight kids often grow tall sooner than they should because they have been overfed. A quote: "Overweight children tend to be taller than average because the additional fat tissue makes more growth hormones to stimulate vertical growth. However, this early growth spurt does not translate into taller adult height."

If you look at sites that predict your child's adult height, they often ask for the child's current weight. This is because, as above, a child that is tall and heavy is probably going to be normal height and overweight when they are an adult, whereas a child that is tall and skinny is likely to be a tall skinny adult. (If I try to predict my teenage DS's adult height, it says 6'2. If I add a stone to his weight, they say 6'1")

SuburbanRhonda your menu exactly illustrates what I just said. The mains all look healthy and great, but the puddings are substantial every day- cake, crumble, cookie. I know from having gone into my children's school that the pudding portions are huge (giant cookie for one child, large helping of crumble) but the portion sizes of the mains are tiny, one slice of meat, half a jacket potato for a roast.

My own suspicion is that these companies use the bulky puddings to make sure the children aren't hungry and so they don't need to increase the expensive meat and veg portion.

I am very depressed about this as I am a huge school dinner fan and much prefer to pay for them than faff about after a long day at work emptying skanky lunchboxes.

I disagree with the 'it's only 5 meals out of 21' approach- you can't tinker that much with breakfast, and at the evening meal, it's hard to give your child a measly sandwich or small toast and eggs meal to see them through the evening as they are hungry at this time of day, even though that's what they should have if they genuinely had a full dinner with pudding at lunchtime.

I've just checked ds's BMI, and as I suspected he is in the 90th percentile (at 16) which is about the same as he has been since he was 4, though at times he has been up as high as 95th.

According to his rugby coach he is seriously underweight. I can see all his ribs, and his backbone and hipbones.

The charts don't take into account size of skeleton, and they should. His wrists, hands, feet etc are massive, so his bone weight must be high.

I think to get weights right, they need to take into account height, but also possibly shoe size, and come up with some way of working out which children are naturally slight (narrow pelvis and shoulders, thin wrists) and which are naturally solid.

There must be naturally slight children carrying a lot of fat who are the same weight as naturally stocky children carrying not fat. Not all skeletons are the same size and weight in children of the same age.

balloon that generalisation doesn't work 100% any more than any generalisation - one of my children is 134cm and 29kg, at just turned 6.5 - both tall and heavy - but his shoulders are too broad for age 8 clothes, even without considering any other part of his body, and DH is 6ft 4 with broad shoulders and size 12 feet and both his brothers are over 6 ft 2, it seems unlikely my tall 6 year old will be a short, or even 5 ft 10 average, adult - though whether he will struggle with weight or not I don't know.

Another thing the school does that I don't is agree with is that they reward the children for emptying their plates. I don't know if its actually the school or the lunchtime staff but DS comes out with reward stickers for eating all his lunch and pudding whereas at home we encourage him to stop when he's feeling full, whether the plate is empty or not (like every child he has days where he picks and days where he cleans the plate). I've raised it with the school before. Back in September when he first started he was getting upset if any of us left anything on our plates, crying and demanding we eat it then attempting to eat it himself if we didn't. I raised the point with the school that if he is leaving food every day then his portion is obviously too big and that I didn't want him pulled up by anyone for leaving food on his plate. Now I'm wondering if I need to go in and tell them I don't want him to be rewarded for emptying his plate or cajoled into emptying it in return for a reward. At home we don't nag him to eat and other than encouraging him to at least have a taste if its a new food we don't comment on how much it how little he's eaten and we don't punish or reward in relation to food/meals.

Really sympathise with your anger, but IMHO it would be easier to sort this out now rather than wait till he gets older. Cut down portion sizes, or reduce the amount eaten somehow, get him to make his own food, enjoy food in smaller quantities. If you don't believe there is a problem ask the GP for medical opinion, or dietician to check how much is normal for a boy of his build and age. That would rule out any reasons why the statistics are wrong for him. Don't ignore it, you owe it to your son. So many children are overweight it sometimes looks normal, so there will be a lot of other mums getting the same letter, don't blame yourself, from day one they weigh baby and emphasise you must get them to put on weight, then 4 years later you get this bombshell.

tallesttower, it must depend on the school, then.

One that I work in has tiny puddings and children can have seconds of dinner (not pudding) if we know the family might be struggling financially. But then it's a small school with really dedicated kitchen staff who do other jobs in school where they get to know the children better and know what they like and need.

(The only people who have a big pudding are the staff )

I have to say I hate those stickers, OP. I'm not sure whether we have them, but I will check. We do encourage children who are fussy eaters to try their food rather than just saying they don't want it, but if I'm in the dinner hall I tend to focus on whether they've enjoyed it and which bit they like best.

Plate clearing stickers? Really? 1970s throw back to rationing and war time shortages, certainly inappropriate to a society where over consumption is the norm - kids know their appetites if we just avoid interfering ... the hard thing of course is to allow them to self regulate we have to avoid offering them too much "addictive" processed and high sugar foods, which is easier said than done. Bribing children to clear their plates whilst sending home letters to any child whose weight plots too high on a graph is absolutely ludicrous and inconsistent! Looks like school need to sort out their approach to food if they want to be respected when they send out letters preaching to parents! Wow!

drinking, just felt I had to tell you before you burst a blood vessel , the height and weight scheme, including the letters home, comes from the Heath Authority.

The Local Education Authority is responsible is for school catering. Not all schools have the "clean plate" stickers and of those that do, some only give them to children who never eat anything at lunchtime (we have several).

Blood vessels intact Rhonda :o :o - doesn't affect me, live abroad, kids come home for lunch, compulsory and pretty comprehensive annual child wellness check ups for all with a paediatrician, nothing to do with school (though they have to see the book to confirm the child is up to date on starting school).

However as my mother was/ is massively controlling of what her children ate (both bribing, begging, pleading and threatening to make children eat beyond appetite and restricting portion size conspicuously and with much public comment and explanation as to why, as she deemed appropriate) I feel quite strongly about both bribing kids to eat more than they want, and about singling them out for any noticeable restriction or labelling in any way they will take on board as part of their identity - both things are harmful to life long weight and relationship with food and thus inappropriate/ unhelpful IMO.

Glad to hear it, drinking.

What happens where you are if there is no-one at home to give the child their lunch? Does the system rely on there being two parents, one of whom is a SAHP? Or is coming home for lunch optional? Just interested. I can imagine some children wouldn't want to go back (unless they only do mornings).

Sorry, meant to say I'm glad to hear your blood vessels are intact, not glad that your mum had such massive food issues