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?

Rhonda they do only do mornings (right through school), system does rely on a SAHP yes, very old fashioned, though there is an afternoon club with lynch Mon-Thur with space for about 1/4 of the kids - think city schools often have more places. Its really expensive - 125 euro a month for childcare from 1-4pm including lunch, or 80 euro til 2pm. Bit off topic, sorry!

• lunch not lynch!

My oldest got one of those letters. I phoned up and told the nurse that while I was not a health care professional, neither was I an idiot and I knew that all of my children were healthy. She admitted that BMI calculations for children are not an exact science.

My son is not overweight - he is head and shoulders taller than all the other kids his age and is in proportion for his height. Not a scrap of extra fat anywhere. I chucked the letter away and opted out of further weighting/measuring in school.

Sounds like the schools where we lived in Germany. No afternoon school, therefore I couldn't work

queen, I'm sure the letter didn't suggest you were an idiot .

I work with school nurses and HVs. If it were me, I would smile and agree with the parent then move on, as there's nothing more frustrating than trying to convince a parent you have their child's best interests at heart if they are determined to believe the opposite.

I had exactly this at DD2's starting school check with the school nurse. When she weighed her she plotted it on the chart and then tut-tutted and said "oh that's a cause for concern, she's over what she should be". Her weight was just on the 91st percentile, as is her height, so in proportion.

I pointed this out and also mentioned that her height and weight was this percentile at birth and has been at every check since. She wasn't happy that I pulled her up on it and wasn't interested in hearing her tips on "getting a bit of weight off her". Absolute nonsense! Talking to the other mums at least 6 others were given this lecture too. Since when did charts and guidelines take over from common sense?

Interesting to hear all these parents who got the overweight letter opting their kids out of future weight checks.

The news suggested that kids were becoming less obese than previously. Maybe they're just not being weighed.

"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"

Now I would find that much more intrusive and irritating than a quick measure and weigh at school. Who pays for it?

Yep, Germany Rhonda, though I hear not all states still do the same. Martorana you could say its intrusive, yes. I only meant that my impression of kids being overfed by the same institution which then weighed them, labelled them fat and told their parents not to overfeed them was not directly relevant to me, so not quite causing my nlood vessels to burst :o (I realise from gollowing comments the 2 things are not directly from the same source for OP either, but still school "hosts" both the overfeeding and the weighing services)

Compulsary health insurance pays for it Mart

I'm really chuffed you spoke to your GP OP and that he put your mind at rest. I'm also glad the letter is going in the bin. I agree there are parents that are in denial about their child's weight but you don't sound like one of them.

Total scam, drinkingtea- children don't need to see a paediatrician every year! It's a job creation scheme.

Its just a different health care structure mart - fewer GP type doctors, peadiatricians do vaccinations too... no such thing as a health visitor, people go to peadiatrician voluntarily for everything you'd take a child to health visitor or GP gor in UK - in the same way you go direct to ob/gyn for contraception/ smear etc. Just a different system, not a scam.

I just loved the health care system in Germany! The sliding scale for contributions made perfect sense to me.

I really miss it.

Me too Rhonda - apt always available on the day, referal immediately if needed, and having babies here eas much pleasanter than in the UK :o

glad your mind is put at rest op. the rest of my post is about comments on the thread in general, not aimed at you in particular.

they arent supposed to be in proportion eg height 95 and weight 95
the centiles are descriptive, so as kids get fatter, so the 95 centile changes
it just means 94/100 kids are thinner, not that it is 'good' or 'bad'
the childrens bmi calculator is the one that puts the weight/height together and says 'good' or 'bad' (or overweight/underweight really)

i learned this on mn and it made me see my ds1 was fat. his weight was already charted 3 monthly for other reasons and not one health professional had ever said to me that he was getting overweight! he was 95 for both. he is now 95 height/75 weight.

face to face i think most health professionals will bottle it and not say the child is overweight.

BalloonSlayer think that was me you were quoting. I went on to say

"I think there are some indications that SOME tall kids are tall due to over feeding, hence over growing, but it might just be your son is tall.", so similar to you, but do you have anything to back it up?

Cheers

But the Ops letter is about BMI not height, not weight.
If he is on the the 95th BMI centile it means that 95% of children the same height as him are lighter than he is

as i said. . .

my comments about centiles are not about the op

other people, such as ohthedrama, have talked about height and weight centiles

presumably the op was sent the letter based on bmi, which is in turn based on height and weight

this is a child bmi calculator as an example

www.nhs.uk/tools/documents/healthy_weight_v3/healthy_weight.html?variant=phone

I think you sound like you have a happy health DC but I personal would never ignore a letter about my DC health, even if I thought the professionals were wrong. I'd much rather get a second opinion & be told I'm doing a good job. Maybe just a quick word with the school nurse or class teacher.

when i thought about it, of course it made sense. if i wanted to see if i was overweight, i wouldnt just look at how i compared with 99 other people. in paris i would be fat. in texas i would be thin. what i need is to know what weight i should be, not what weight everyone else was

the problem starts with baby books and baby weight, where being born on say 90 th centile just means your baby grew well, not that it was fat. then hv maps the line and you want them to stay on their line and worry if they lose weight

i dont know when it changes, i guess as they change to food?, but our attitude as parents often remains that chunky is better, they should follow their line etc

I've spoken to my GP today and he doesn't think there is any cause for concern and that DS is fine. I trust him, a medical professional who has known me my entire adult life and DS his entire life, over a travelling nurse who has met DS once.

Also some people have stated that the food listed in my OP seems a lot but the actual portions aren't big. They're all served on the plastic Ikea toddler/child sized plates and bowls. His cereal half fills one of these bowls. His sandwich is one slice of bread folded over and cut into two to make two little square sandwiches. The apple slices and red and yellow pepper slices aren't the entire apple it the entire pepper. It's one apple, one red pepper and one yellow pepper cut into slices/strips and divided between us all. He has 3-4 slices of apple and 2-3 thin slices of each type of pepper (think French fry size/shape but made of peppers). The three pieces of sushi are the mini sort, roughly the size of a 10p piece. The seafood stick was because I had some and he's never tried them before. His serving of chicken and mushroom tagliatelle is again half one of the little Ikea bowls, the broccoli pieces are in the sauce.

Not particularly to the OP but to all those quoting that they can 'see their child's ribs' can I point out that ribs are pretty much the last thing to go when you put on weight as fat tends to accumulate on the belly, bum and thighs first, so by the time the ribs disappear you are at the point of obesity.

I do think we have lost the ability to spot excess weight in children. I was always told that, after toddlerhood, the height percentile should be several points above the weight percentile for a 'normal' weight. Ds2 looks pretty chunky to me with height on the 75th and weight on the 50th. He'd be enormous if they actually matched.

I think what matters is how overweight he is. From the red book you can see how things compare. So my ds1 was heavy 95 percentile but also 95 percentile for height so no worries. But if I had compared his weight to his pals I would have seen a big difference.

I wouldn't worry about the letter but I would continue to monitor height and weight yourself every year or so. Some kids just need more food than others.