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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To ignore the nurse about DD's weight?

56 replies

FoxyTheFox · 03/12/2020 14:08

3yo DD had an appointment with respiratory nurse today. She has mild asthma and it was her first routine check-up. They did height and weight as part of it. Her height is 100cm and her weight is 17kg. The nurse told me that this isn't acceptable and she is overweight because her weight is a higher centile than her height however she did point out that DD has been on the same centiles for height and weight since birth so her current height/weight show her growth is consistent with previous measurements.

She advised me to cut down on her portion sizes and make her move more.

Yesterday DD had one Weetabix for breakfast with a spoonful of natural yoghurt (she doesn't like milk) and some blueberries. At nursery she had half an apple at snacktime, she didn't want any of the other food (they have the snack in little bowls on the table for the kids to self-serve). For lunch at home she had a soft-boiled egg and a slice of toast cut into soldiers, she ate around half the soldiers dipped in her egg, one small spoonful of egg, and left the rest. At dinnertime she had 5-6 cucumber slices, a small slice of roast chicken, around half a serving spoon of sweetcorn, 2-3 red pepper slices. She had a wrap but didn't eat it. This is a typical day for her. So far today she has had the same breakfast but with half a banana instead of blueberries. Her book says she had three cherry tomatoes and a breadstick for her snack at nursery. For lunch she had 5-6 raspberries and a slice of brown toast with peanut butter on, she asked for a Babybel too but didn't eat it. Dinner tonight is going to be steak with roast potatoes, spinach, broccoli, and beetroot. She will likely have 1-2 potatoes, a small piece of steak, and one piece of "tree" (broccoli). Drinks are all water (all day) or sugar free squash (mealtimes only). I don't know where I could make cuts to any of that.

Appearance-wise, I can see her lower ribs, no double chin, and she's all in proportion. She wears age appropriate clothing although she has short legs so I tend to buy leggings and tights in a size lower otherwise they're too long. She is always on the move. She goes to nursery five days a week and they have a large indoor play area as well as an outdoor one so they run around and play whatever the weather. We walk there and back unless its absolutely tipping down with rain. At home she is in and out of the garden where she has a trampoline and a seesaw, up and down the stairs, constantly climbing, etc. I'm not even sure where she is hiding this 17kg!

My other DC were very similar at this age and they all had their height and weight centiles catch up with one another between the ages of roughly three and four, although one does now see a dietician due to being underweight (ASD related food restrictions).

AIBU to disregard what the nurse has said about it and just see for myself how DD goes over the next few months?

OP posts:
AnneLovesGilbert · 03/12/2020 14:10

YANBU.

Mythreeknights · 03/12/2020 14:35

Totally disregard that nurse - your daughter sounds perfectly sized!

PlanDeRaccordement · 03/12/2020 14:35

YANBU. The nurse seems to be too picky. Healthy weight is a range, not a single % on a chart.

majesticallyawkward · 03/12/2020 14:42

YANBU.
Children grow differently and I don't see that plotting them on generic charts is useful after the first year or so. If you line up all the kids from an early years class you'd see a huge range of height and weight combinations and it doesn't necessarily mean anything.

My DD is now 5 and at the reception height and weight check we got 'the letter' telling us she was obese. She's a decent weight, 98th centile at that point but she's also well above that in height. In age 8-9 clothes because she's so tall, we struggle with waists because she's also fairly skinny. Eats well and has a big appetite but never stops moving.
I saw other people panicking about these letters and crying when their kid was over weight/obese, I glanced at it and promptly binned it!

DS just turned 1 and is off the charts too, I've had the eyebrow raise from the HV already (and the lady in Clarke's when their widest shoes didn't fit him). He's happy and healthy though, I've accepted the combination of our genes have produced huge children.

SunniCameHomeWithAVengeance · 03/12/2020 14:46

She sounds healthy, and is plodding along her centile just fine.
Two of my DC (close in age) ate the same foods, were similar heights, same levels of activity but one DC weighed more until about the age of 6.

opinionatedfreak · 03/12/2020 14:49

Plot her using the NHS BMI checker (there is a tab for children).

If she is in the green zone you don't have to worry.

If not - maybe the nurse had a point!

www.nhs.uk/live-well/healthy-weight/bmi-calculator/

Ratbagratty · 03/12/2020 14:51

Percentiles lines are a flaff, I've been told by HV that they are allowed to be two lines apart before it becomes a cause for concern. Not sure how this works as 2 lines difference at the lower end is hugely different to the other!

My almost 3 eats waaay more than yours and she is 2 percentiles apart so I'm not concerned, just aware of it knowing that she will grow into her weight as my other did.

flaviaritt · 03/12/2020 14:54

Totally ignore them.

Ratbagratty · 03/12/2020 14:55

@opinionatedfreak I've just done that calculator and it's completely different to the chart in the red book. Confused

FoxyTheFox · 03/12/2020 14:57

That calculator is putting her at 87th centile. I've got to ring the HV about an unrelated issue (hearing test) so I might ask her about it, she's known DD and my other DC from birth.

OP posts:
Backbee · 03/12/2020 14:58

That sounds like hardly any food, if she is following her line then I wouldn't worry too much, even on the calculator she is showing as a healthy weight. But if her typical daily food is:

One Weetabix
One spoonful of natural yoghurt
Blueberries
Half an apple
Half a slice of toast
Half of an egg
5-6 cucumber slices
Slice of toast chicken
2-3 red pepper slices
Half a spoonful of sweetcorn

And it still at the top of her weight range might need to look into her activity levels or metabolism, that's around 400 calories.

YerAWizardHarry · 03/12/2020 14:59

@Ratbagratty the red book plots their height and weight as a separate entity the above BMI calculator takes into account both together

Topseyt · 03/12/2020 14:59

Just continue as you are, I would say. I don't see that you can make too many amendments to it anyway, and her portion sizes don't sound massive.

I used to wonder sometimes whether they just had to find something to say. One Health Visitor once began speculating that my DD2 was overweight because she was on the 98th centile. She wasn't. She was very long though, off the scale long and quite lanky. Once the lady had taken that particular measurement she changed her tune and decided that DD was nicely in proportion.

GhoulWithADragonTattoo · 03/12/2020 15:00

Rather than ignore the nurse I’d check the NHS BMI calculator for kids. Healthy weight goes up to 90th centile. Depending exactly old DD is she may be slightly overweight or towards the top of healthy BMI.

GhoulWithADragonTattoo · 03/12/2020 15:02

Sorry just 87%. I wouldn’t worry in that case just keep and eye to make sure she doesn’t get overweight.

FoxyTheFox · 03/12/2020 15:06

That sounds like hardly any food

Thats the last two days but the portion sizes are typical for her. She doesn't like milk or cheese so the only time she has them is if I put them in mashed potato or use them in a pasta sauce, now and again she'll grudgingly drink a small cup of milk or a hot chocolate.

OP posts:
B1rthis · 03/12/2020 15:06

She's on the 87th centile and always has been. Your response could be "thank you for your suggestion, could you please provide me with the evidence based research that backs up your suggestion? I can then read it and discuss the research with my child's other parent and make an informed decision"

BoomyBooms · 03/12/2020 15:08

I do this for a living. A child's measurements are a rough representation of their calorie intake and activity level, so she did the right thing by bringing it up with you. But if you are absolutely confident that how you have described your daughter's diet and activity level is correct, then she does seem to lead a healthy lifestyle - and that's what's important. She may have a natural build a bit larger/denser/heavier than her peers, particularly as her siblings have been the same. I wouldn't now ignore but I would do as you say and just keep an eye. If her diet changed because she got fussier, or she became less active, then she could be at risk of becoming overweight and the three factors combined is not a good place to be. However it sounds like she's just growing as she is meant to grow!

Backbee · 03/12/2020 15:08

It's at least half of the recommended calories for a 3 year old, I know that every child is different, but to be so low on calories and 98% centile still is quite surprising.

sunstreaming · 03/12/2020 15:12

I would say the nurse is being a bit simplistic. The height for girls of this age is btween 86.9 and 101.79 cms, so your daughter is taller than average. Her weight is heavier than average (as it's on the 91st centile - in other words she is just inside the top 10% for weight in her age group) But as you say, the matching of height and weight is what matters and it seems that they are not as mis-matched as the nurse thinks. I would also question the accuracy of the weight measurement. I have my weight chcked annually, as part of surveillance for something else and the nurse who does mine seems to think it doesn't matter whether I'm wearing my shoes, coat, enormous sweater or not. But if they measure my weight in different clothing each time, the weights cannot be compared.Was your daughter's weight measured in her outdoor clothing? I know that my BMI is within the 'normal' sector and I say this as an ex-Dietitian (NHS)

Porcupineinwaiting · 03/12/2020 15:19

I wouldnt ignore it. I cant think of any circumstances where having your weight on a higher percentile than your height is a good thing in a child. Usually (on average) the weight percentile should be considerably less (equal weight and height percentages are right at the top of the health range and v few children should be there ).

But ultimately your child, you do what you think best.

oiwotaluvlyday · 03/12/2020 15:21

If you already have 2 healthy children and think your daughter looks fine I'm sure you are right, thank the nurse for her information and ignore. The diet you describe sounds perfectly healthy, your daughter is probably about to have a growth spurt.

Graciebobcat · 03/12/2020 15:22

If I put her figures into the NHS BMI calculator she's in the healthy weight range, albeit at the top end. So I'd keep an eye on her weight as she grows but she seems fine at the moment. Particularly if she is eating a balanced diet and you aren't exactly feeding her junk food all the time.

DD2's height and weight were always high in the centiles until she started to slim down at about age 3/4 and I can tell you she is a very tall and slim 11, almost 12 year old now - 5'7" and still growing and she is still no more than 8 stone which is right in the middle of or at the lower end of the healthy weight range for her age and height.

Graciebobcat · 03/12/2020 15:27

Just looking at the WHO baby growth charts, DD2 started off at 99.6 for length/height and 98th for weight. So if you have a big baby to start with it takes a while - a few years - for their weight to get from the upper end of the centiles to settle somewhere in the healthy range for a pre-schooler/school age child.

tyrannosaurustrip · 03/12/2020 15:29

We saw a dietician recently and my DD (just turned 2) came up 91st for weight and 50th for height - at birth and till age 1 she was 91st for both so I was worried about the drop but told not to be. If she's tracking onto the same centiles that is just her build, I think the nurse was unreasonable.

If I gave dd as little food as you've outlined she would stage a walk-out. Just did the BMI checker and it puts her at 93% and overweight, I'm concerned about this as her dad has weight issues but honestly unsure what you're supposed to do. The nurse said to cut back portion sizes, but are you really meant to sent them to bed hungry? DD loves her food, eats everything she is given at home and in nursery and often asks for more. She has allergies but a very healthy diet, basically never has any 'treats' (I wouldn't give her crisps and she can't have things like chocolate. biscuits or cake due to egg and dairy allergies).

All the advice I've read seems to be about increasing activity (already incredibly high) and reducing unhealthy snacks, but there literally are none - she will have a cracker and hummus, or a mandarin, or a soy yoghurt as a snack.

I've asked for advice and been told not to worry, we're giving her health food so portions aren't such a concern once she stops when she's finished but its frustrating as at the same time you read about how being overweight at this age sets them up for a lifetime of obesity. I really think this is one area where the official guidance is mostly guesswork.