My DS is ENORMOUS. Can I have some reassurance please?

[GinAtMerlottes]

He’s just huge. Always been stocky with a BMI hovering on the overweight but it’s definitely tipped over now. He’s 4.5, 115cm tall and 23.5kg.

He is definitely big boned.... he has
no fat on his ribs but his rib cage is half as big again as his friends, who is a year older. His hands are bigger than those of his brother, who is 4 years older. He takes size 1 shoes.

Over lockdown of course our activity levels are much lower than usual, although we’ve been having our daily walks. He’s just started school, and restarted rugby and swimming.

Food wise, he has weetabix or porridge for breakfast with a cup of milk, fruit for snack, school lunches, fruit or peanut butter and apple or similar after school, and normal family dinner. Has fruit and a biscuit after dinner. Has a glass of squash at dinner but otherwise drinks water.

Eldest DS has always been very slim. My family and DHs family are all overweight. My brother is very very tall, over 6 ft 7.

I can see DS2 is destined to be tall and large, but any tips or reassurance would be very welcome.

My youngest has always been tall and heavily built but has always sat easily within the healthy BMI range,
For there to be a range some have to be nearer the top end though. Otherwise it would be one healthy weight for each age.

Two of mine have always stayed consistently central but my other two have been at the top end of the healthy range since birth, I imagine they've pushed over into overweight a couple of times but that seems to be how they grow, they get a bit wider then grow taller again.

My two were a similar size at his age, and I didn't worry. They slimmed down steadily through primary school - basically stayed the same width from age 4-10. (in fact DS had the same games shorts throughout ... admittedly bought big at the start!) They are now fit teenagers, DD muscly and lean, DS slowly starting to fill out but also normal weight for age (and teens BMI range is lower than adults).

Tall kids need enough protein and calcium in their diets - please don't think cutting out milk / switching to skimmed milk is a good plan in this case. By all means think about what you are offering them when but you shouldn't need to restrict in this situation. If a child is still podgy at 7-8, or has become so having not been so, then you need to change something.

With regards to "The Letter", I suspect both of mine would have had one (they went to independent schools), and I would have ignored it too. I have a theory - and one day I might even look into doing the work to investigate it - that the BMI trajectory of children is a little different depending on whether they are taller or shorter. If you look at a children's BMI chart, it is a sort of skewed U shape, with the lowest point around age 6 (off the top of my head). If taller children's BMI falls more slowly and starts to increase a little later than shorter children, this would be consistent with how many people comment on their clearly not overweight but tall child being picked up age 4-5 as too high on BMI assessment. Conceivably if data showed this, we could have a different BMI range for the highest 25% and the lowest 25%, and it might be more useful as a screening tool for later obesity (which is the actual main purpose of these school entry measurements).

Do they still need snacks when they're at school? I thought that was just a baby/toddler thing as their stomachs are small at that point. You could cut down on snacks and I would cut out peanut butter as that's quite fattening.

When people say 'solid' when they are talking about a young child what do they think that 'solid' consists of? 🤷🏻‍♀️

Rugby players are 'solid' but they have a crazy training regime.

Two of my kids were chubby (ie FAT! 😅) when they were toddlers. It wasn't an issue. I noticed it and made little changes in their diets and they slowly grew into their weight.

There are dozens of posts on this thread (including my own) where chubby (or so called solid !) little kids grow up to be thin but statistically if you are chubby as a little kid you are more likely to grow up to be fat.

It's not difficult to make minor tweaks to a kids diet and levels of exercise so I don't understand why some people are so reluctant to do anything about it.

@Wanttolearnmore they ask for a fruit snack to be sent in, and after school most kids are ravenous aren’t they? I could easily change that snack to carrots though or a small piece of cheese.

@msflibble thanks, if things don’t even out by Feb half term I will have a look at that book. DS def has a sweet tooth and will nag for snacks. Hopefully a proper routine will sort that out a bit.

Look at his body truthfully, remember the old special k advert "can you pinch more than an inch?" Well forget about weight, is he carrying excess fat - if that's the case reduce sugary snacks and increase exercise, look at portion size for evening meals in particular. Increase veg as the proportion of meals to half, but don't make a big deal, he'll loose excess as he grows. If he's not carrying excess weight then he's simply the right weight for height.

Kids however are getting fatter generally so our eyes aren't noticing a bit overweight as much.

I think for DS by solid I mean his wrists and ankles (at 7) are the size of mine and they arent fat. His feet are a wide 4G and his hands arent much smaller than mine.

The width of his shoulders is wider than some adult womens already (and isnt far off mine) and his bum is solid muscle.

We do go through periods of being a little podgy but they are always followed by a growth spurt. He is an excellent swimmer (very powerful) and going to start boxing.

His sister however is petite but again still solidly built

I've only read your posts so apologies if I'm repeating something said by others.

On plus side, with a similar DS, no one was ever too concerned because his weight and height were on similar lines. He's been consistently 95% for height and 98% for weight. As a result, although I mentioned it a few times at check ups etc, they told me he was still too young for them to worry about it etc and because he was ALSO very tall, there was much less concern. The most recent conversation about this was when he was being seen by a paediatrician aged about 7 (for something else). He's nearly 10 now.

Having said that, as he's got older, he definitely got distinctively and noticeably overweight vs just big all round. We've got on top of it now with his help and the realisation that he needs a lot of food, so we have to make sure he's filing up on things like salad and vegetables as he can and does eat a lot no matter what is being served. Also cut back on treats - which had crept up alarmingly - and upped the activity. Again, it's just clear that he's a big lad and as such an hour's hard exercise isn't enough. He needs lots of low level constant movement as well as bursts of hard exercise. Which can be hard to implement.

It's a concern as I can see DD going the same way - she's also very tall for her age but also on the edge of being properly overweight - but she's much trickier on food and exercise. She's much younger so we're making small changes in the hopes that as she gets older we can increase the impact.

Also, I'd be very hesitant to be trying to restrict food or offer low fat. From what I can tell, it's about balance at this age. It's very easy to slip into a situation, for example, where most of their calories are coming from pasta/bread/rice. They're getting nutrients from the side portions of veg or fruit or whatever, but they're filling up on a carb heavy diet. Certainly, this is the challenge we have with DD - she gets sufficient other stuff to be super healthy, but I suspect an analysis of her calorie intake would have carbs as the vast bulk which is not ideal.

Peanut butter, in moderation, is not the problem. Peanut butter sandwiches twice a day would be but more because of the bread.

Children don't need low fat diets. They need balanced diets.

Honestly the best thing you can do is get healthier as a family. Lead from the front with diet and fitness. Don't dread the letter it literally is just a piece if paper and you know his bmi is out of the normal range.

I’d weigh his portions and make sure they are the right size for his age(not when he’s there). Then I’d try to keep his weight the same until he has grown taller. It’s easier to deal with this now than later.

Also when you get the letter saying he’s overweight I’d call them to try and access any help about nutrition.

@TheTeenageYears - at my DD's school they have dessert with school lunch everyday but it is something like yogurt, sorbet or a flapjack so not the stodgy puddings that used to be given. Incidentally, packed lunch has no rules except no nuts but there are some recommendations including 1 'treat' - she will have something like banana bread or yogurt in her packed lunch.

There were some comments on here about cutting back to skimmed milk but I think it has the same calcium as other milk and the main difference is the fat content. NHS says you should not have it under 5 due to children needing the calories but that doesn't seem to be an issue for your child. You could discuss that idea with a HV if you wanted to be sure it was ok

www.nhs.uk/conditions/pregnancy-and-baby/drinks-and-cups-children/

*My son was not a huge baby but he grew pretty quick
**By the time he was 2 we were being asked why he wasn’t at school when out and about and getting funny looks when he behaved like the toddler he was. He started school much taller than everyone else and finished Primary the same. He has just started Secondary and is so much taller than the rest of his year, he is also well into puberty and has the beginnings of a moustache! He is taller than me and his 15 year old sister and has size 9 feet. He could pass for 14 easily
He has been a bit chubby at times but he seems to go out and then up so it evens out.
*He still wants cuddles from his mum though, although these days it’s like hugging a man rather than my baby boy

This was my two exactly. My oldest was head and shoulders above his peers from 6months old. He grew fast, often putting on weight then shooting up. In the summer holiday between yr7&8 he grew a full 8 inches - so fast that he has stretch marks and he towered over his friends! By the time he was in the 6th form he was 6ft (and still is at 21) and many of his friends were much taller than him.

The youngest was the same except he grew much more evenly. He also put weight on then shot up and he was always bigger/taller than his brother had been at the same age. When he was in the 6th form he was already 6ft2 and the shortest in is pe group. Now he's 19 and almost 6ft 5 and makes his brother look short.

Both were on the 98th centile for height/weight all through their childhoods. They were fit, sporty and healthy but both put on/lost weight regularly regardless of their diet.

All you can do is make sure they have healthy food when it's in your control and plenty of exercise.

Mine was like this - two beanpole siblings and he was always much chunkier even as a baby. I have thyroid issues, so worried he might too, but he had tests etc and it all looked fine. I didn't want to make an issue of it, so just carried on feeding him normally the same as his siblings. He is just a much more chilled out personality, so I think their 'nervous energy' must be burning off a lot of calories.

Anyway, he hit puberty, absolutely shot up and is now nearly 6ft and skinny at the age of 15. He's totally grown into his body, with no input or judgment from us.

As long as your DS is eating reasonably healthily (all kids are entitled to enjoy some snacks too, so don't let the houmous brigade make you feel bad for allowing him the odd pudding or sweets!) and is active and happy, that's the most important thing. Not making food/weight into an issue is the best thing you can do for him.

statistically if you are chubby as a little kid you are more likely to grow up to be fat.

Yes, this is absolutely true, but people misunderstand the reason for it. It is not because parents don't try to intervene when a child is chubby, it is often precisely because they DO intervene. Try to restrict what a child eats and they'll smell it a mile away, develop a fear that food is scarce, and overeat in response. Overeating happens in response to a psychological impulse, not a physical one - as an ex compulsive eater, I know this very well.

Research clearly shows that the more you restrict what children eat, the fatter they get. Ellyn Satter's webpage is full of studies that corroborate this. I've seen it play out in real life too - my daughter got chunkier and more obsessed the more we tried to cut portion sizes and limit food groups. She has slimmed down and gone from 86th percentile to 74th in just a few months since we chilled the fuck out and let her eat what she needed. Her attitude to food is also so much healthier and her obsession with it is gone.

Portion control sounds all well and good but if your child asks for another portion and you say no you are teaching them that they will not be able to eat until they are satisfied, and this will turn things pathological. The only part of a meal that should be limited to one small helping is dessert.

@GinAtMerlottes routine is absolutely essential, ES talks about that a lot in the book. Kids need to know when the next meal snack is coming so they don't feel anxiety about going hungry. It's this anxiety that prompts overeating. Good luck!

@msflibble completely agree that restricting food is not the answer. And in fact when I mentioned DS' weight to a GP when he was around 6 she told me that she absolutely would not want to restrict food at this age. That's why we've focused more on changing food choices and it's really worked for us.

The only part of a meal that should be limited to one small helping is dessert.
The rest of your post makes sense, but that bit is nonsense. All high calorie low nutrition food needs limiting - chocolate, cream, crisps, processed meats etc. They are the classical “sometimes “ food. Vegetables etc - let them fill up.
And obviously don’t say “you can’t have it” while you continue stuffing yourself. Limit portions from the onset. If there are no more sausages, there are no more. but there are veggies on the table (not drowned in sauce and butter) that everyone can have seconds, thirds etc.

My DD is 4, just started school and 113cm with size 12.5/13 feet. We are both really short, but she's not unusual as some other children in reception are the same height or slightly taller.

@timeforanew
I don't count junk foods that you described as part of a meal, they're definitely snack foods, on a par with dessert, but things that should be limited to snack times and not eaten at proper meals. However even if a child wants to just eat rice or pasta for a meal and leave all the veg, the best thing to do is let them. I know it sounds mad, but our DD was obsessed with carbs until we made it clear she could have as much as she wanted. Now she tends to eat a decent amount of veg and rarely finishes the carb portion of the meal. By limiting certain foods and offering unlimited amounts of others, we send signals to children that one food is highly desirable (because it is scarce) while another is not. It has the opposite of the intended effect. Parents make mealtimes a battleground by trying to steer kids towards foods they prefer and it often backfires. Parents should be responsible for the food choices served, but kids can decide what they eat from the meal and how much. It's called the division of responsibility and it works incredibly well, taking the stress out of mealtimes for both kids and parents.

The reason skimmed milk isn't recommended for children (apart from the calorific content, which they need) is because most of the vitamins are fat soluble, particularly vitamin D and that is lost when the fat is removed.

My nieces have never had their portions restricted and now at 13 and 15 are both obese. 'Eating till satisfied' is something that makes more sense for people with certain sort of bodies I think. My nieces are never satisfied really - may not be starving but always want more. In the past there wasn't enough food for many people to eat till satisfied and yet it is only more recently that people have got to obese. I am not convinced that free access to however much you want is really the simple answer we would want it to be.