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?

50th centile is median expected (not average) height and weight for that age so if you are on 75th centile you are tall for your age on 95th you are very tall for your age so you would also expect them to be higher than 50th for weight too. I think so long as height centile is above or equal to weight it is fine is weight centile is more than height then perhaps overweight

Teacup- why do you think the centiles are based on expected not average weight.Who has decided what the expected weight and height is, if it is not based on averages?

I am seeing a lot of mums with their heads stuck in the sand on this thread.

Centiles, like bmi, don't suit every person. They don't account for muscle or build. My sister has a high bmi, she is a size 10 with a fantastic figure. Her muscle quota from sports & running marathons, and her large boobs, push her bmi up. You will always get a dispute because you posted on this board. My ds 2 has only just turned 4. He is about the same height as your ds, will weigh him later as a comparison for you.

I think I was one of those accused of having my head in the sand. I've just measured my youngest who is apparently a couple of pounds overweight, though a succession of medical professionals all say he is fine.
He's 86th percentile for both height and weight with a bmi on the 79th percentile.
No problem then as far as I am concerned.

The problem is that medical professionals are just as loath to tell people they are too fat as the rest of the general population, despite the impression we get that doctors are targeting the overweight.

I am officially obese with a few common health issues, some of which may be related to my weight. I therefore go to my GP's surgery fairly regularly and never once has anyone mentioned my weight, ever. I can see why medical staff may avoid telling someone their child is too big, even if that's what they really think.

I asked both my GP, a consultant and a specialist nurse if my youngest was overweight. The answer was an outright "good grief, no"

Omg. I am so glad I'm not a school nurse.
All that training and experience and the only option is to smile and nod, and tell ppl what they want to hear lest you be berated by parent's of chubby children.
That, teaching and childminding. Oh and social work. No thanks.

The thing is Amanda the nurses are not making a judgement , I fact I am not even sure that school nurses are doing the weighing and measuring , all that happens is that they height and weight are taken and they are fed into a central data base and the computer spews out the letters .It is a very blunt tool , and a nurse I am sure would prefer to be able to contextualise the results and you here frequent stories of people responding to these letters and being told exactly that .

Do you think people would take more notice if the advice after wasn't so shit.

With all this swapping for low fat low sugar full if sweeteners crap, and school dinners that serve puddings daily, as people assume it's down to the schools (which it's not) and the shitty change fir life leaflets that get handed out it's no wonder many feel that it's all a loaf of crap.

It doesn't help the case at all.

Which is a shame because really the idea is to help out children to be healthy and to get parents taking the blinkers off, and instead it's bred competitive deviance of the so called advice.

Defiance (iPhone fail)

Whatever. I see a lot of fat ppl about.
Everyone's in denial aren't they?

Yes giles I think there a issues with the standard Govt advice. Some of it is very poor.
But sugar is a problem. At this stage demonstrably far more so than the sweeteners (still not great) we're in a stew about.
Grazing is the enemy. And comfort eating.
That's very hard to tackle. It's almost an inevitable side effect of the current availability of food.
The idea that kids can eat any amount of sugary foods as long as they're running about is misguided. And commonly held.
Or that being overweight, but as a result of eating healthy food, is ok.
Not all the misinformation comes from the Govt.

Oh I know amanda :)

I've heard so many people say that famous s/he wears clothes for but there's not an oz of fat on them.

There are also a lot of threads on here where kids are eating what one person would feel is a ridiculous amount if food and weighs X and then someone else comes along who's kid eats twice that and is skinny and weighs Y instantly the op is talked out of the problem.

It would help I guess if it was more tailored to the individual child but I realise that is far to expensive to be able to do and parents just don't have time to be bothering drs with children who in their eyes look fine.

I actually think this scheme has made things worse as people don't let their kids participate (which affects the stats) and how much their kids eat is almost a competition.

I think it's hard for parents too.
ATM my dcs are slim. I think this is more luck than judgement on my part. I do allow biscuits and cocopops but their appetites aren't big. And i feel able to say "no" if I think DS is asking for fod for reasons other than hunger. But theyre still very young. They will likely grow up in a country choc full of food. It's everywhere. And high calorie, low nutrient food is comparatively cheap (whereas real food that's yummy and nourishing is fucking pricey) and we are expected and encouraged(mainly by advertisers, but also most tv etc) to eat and drink in response to internal and external stresses that have nothing todo with hunger.
I honestly believe we need to think less about food, rather than obsessing over what's good and bad. If the only way to get your "7 a day" is to have seven carrot cakes I'm not sure it's worth it.

I agree with that :)

I do realise that for many oarebts they have zero control over what the kids eat between breakfast clubs school and CM. And I realise it must be hard even you have children at vastly different ages. Teens who don't stop eating and a six yr old who wants to join them. Or a toddler who needs snacks along side a sad looking older child not allowed one.

But I don't Think it hurts to be aware though. Potion sizes can be reduced without them noticing too much and simple things like walking to the shop can make a difference.

OP, the quickest way to get your DC to drop a bit of weight is to ditch the school dinners, I've noticed my dd became a bit chunkier after adopting school dinners. They're full of carbs, always with some sort of cake or ice cream, surely these school nurses should be handing change4life leaflets to the school cooks too, after all we should all be reading from the same page!

True

Ignore the letter.
Dump the sugar free squash. Normal squash is better & offer only with meals.

My daughter is on the 2nd centile for weight and 30 th for height ! It goes both ways ... I think there is too much obsession over this.

Yes. There's too much obsession.
Obesity is a big problem here. But I think it's best tackled from several angles. Health education is useful. To a point. And it needs to be more accurate. It's also better IMHO to have a 121 with someone rather than sending a letter home that will be thrown away or cause offence.
Financial measures are the ones that make a difference.
A very crude example would be to increased the price of petrol station donuts and decrease the cost of public transport.
Larger scale interventions work better than the blame centred approach we have.
Interestingly, In prohibition USA certain crimes rose but there was a significant drop in alcohol related illnesses. (yes, another v crude example.)But we're only human. We are gonna eat. And if it's sweet, and cheap, we're gonna eat more.

sorry being away centiles are not based on average as that would mean centiles altering as obesity increased so 50th centile would change slowly upwatrds, it is also based on median ( ie 50th is the middle in values not adding them all together and dividing as that can skew the answer)

if 9 children weigh 20kg and 1 child weighs 30 kg

the average ( arthimetical mean) is 21kg so 90% would be under the average,
however if you write all the weights down in order and choose the middle one the average weight (median weight) is 20kg,
so all those that are 20kg are median not as with arithmetical mean which makes them look under average weight when in fact that is normal weight

also means can be skewed by highs and lows

change4life has some very silly advice and is not all medically based like swapping normal sugar free yogurt with 4% fat with no additives to low fat with piles of sugar and artificial sweetners and thickners

I just wanted to post a quick update.

I've taken DS off school dinners, he's been having packed lunch since Easter. I had him weighed/measured today and he's 20.4kg still but his height is now 110cm which puts him in the healthy range.

He weighs roughly the same now as he did then but his height has jumped by around 5-6cm. I think they've caught him pre-growth spurt (and, no, I never did ring them )