The letter finally came. I’m really upset

[Hell0G00dbye]

Long story short DD has followed the 98th centile for weight since my 37 week growth scan. She has followed it perfectly and consistently which was applauded for the 6 months I breastfed and since then has been a big issue with the HV team. She’s at school and I’ve just received the letter saying she’s very overweight.

What can I do? She eats good, home cooked food, has the odd treat but generally healthy and normal child portions. She’s very active both structured (does dance, swimming and gymnastics) every week and unstructured (walks the 40 minute round trip to school daily, parks and long walks on a weekend, runs around the garden. She doesn’t look fat (to me) but she is solid and does feel heavy to pick up.

The letter says contact the doctor or HV but I’ve taken her before. GP says she’s absolutely fine and will grow into her weight and had no concerns. HV just weighed and said she’s still overweight and to watch portions. Day to day I don’t worry about it as she looks fine and is super active but the letter has taken me right back to her 2 year check and being made to go monthly to the HV for weight checks and their disapproving looks when she continued along her centile.

NB: she has followed the 98th centile but I think the issue is she isn’t 98th for height so her BMI puts her at very overweight.

My ds got these letters in primary school too. He's now almost 6 foot and skinny although he has his dad's rugby thighs.

Well unlike most on this thread I wouldn't just throw the letter away and forget about it. At what point would being on the 50th for height and 98th for weight be considered unhealthy if not 5? Age 10? During her teenage years?

What I would do is measure her height and actually see how tall she is because a child on the 75th percentile for height and 98th for weight is in a very different place from one on the 50th for height of the same weight.

As for what you do if you decide there is a problem, it's going to be down to diet (quantity or type). Exercise is a comete red herring - at this age they all should be on the go from morning til night.

Bin the letter . And the health visitor. Stop worrying.

@dementedpixie

My ds got these letters in primary school too. He's now almost 6 foot and skinny although he has his dad's rugby thighs.

And for every one of these stories there are many others where a "big for their age" child morphs into an obese teen. We might not want to recognize it as a society but our children are getting heavier and less fit.

Amongst all the reassurance that your child can't possibly be fat, can I recommend the Burnt Toast newsletter for anyone who wants to ponder more broadly their relationship with food and feeding their child.

Would it matter if your child was fat? Why would it matter? Some people are fat. Would it matter if your child wasn't active or enjoyed junk food? Would that make you a bad parent? Or your child a bad child? Are thinner children better children?

This being Mumsnet, where thinness and self-control are extremely coveted I don't expect this to get a warm response. But it's often a really interesting, thought-provoking read.

I honestly wouldn't pay any attention to it/them.

NHS BMI calculator states my 4yo is 'very overweight' which is a load of bollocks. He's tall but that's about it, and the calculator supposedly takes that into consideration.

Picture attached of my obese son

Oh I didn't see the bit about the height. If she was 98th centile for both I'd ignore it.

If she's 98th for weight and nowhere near that for height it needs addressing.

I'd consider reducing portion sizes.
Do they pick their own meals at school? Does she make good food choices?

Please please please just ignore it.My DD was (in her words) "chubby", and I was slightly concerned but not enough to do anything about it. Over lockdown she developed anorexia and ended up in hospital. Our lives have been hell for 2 years. Just ignore ignore ignore and only tackle if she's still like it at 18!

She does dancing and gymnastics. She will have more muscle than other inactive skinny kids. Muscle weighs more than fat by volume. She will also have denser, more solid bones as you have consciously fed her a good diet, plus impact activities like the ones she does also strengthen bones which means they are heavier too. She may be overweight according to some charts but she is a normal weight for her.

BMI is a very blunt tool. I really think these letters do more harm than good in many cases. She sounds fine. Its meant as a wake up call to parents who aren't paying attention.

My DD was very very underweight. For good reason, and she was under the care of a gastro consultant until age 10. She's fine now, once we sorted the issues out but the letter didn't half get the hairs on the back of my neck up.

Put the letter in the bin and carry on as you are.
I had similar letter when dd was in year 6. She had a fully developed woman's body. I put it in the bin and never gave it another thought.

I thought that until I had a newborn who had visible biceps. He was born muscly. It was deeply weird.

DS was like that - shocked the MWs- meant he had strength to carpet crawl very early and insentive to do so as older sibling to chase - didn't keep him heavy though if fact I got grief as I bf and he went down the lines. As a teen he's not noticeably muscular either.

If your worried see the GP again - they will be able to have eyes on the child to asses - otherwise don't worry and carry on being sensible with food and portions and keep her active.

I know DD2 would often get heavy - I'd start to worry and I may get a comment or two from others - and then she'd shoot up massively. She's the thinnest of them all and currently quite tall though not finished growing.

I had that letter at end of primary. The age where its normal to have a bit of puppy fat in readiness for the puberty growth spurt that can add feet rather than inches to the height. Guess what? Without us doing anything different to her diet or exercise (already did plenty of walking) she grew into that weight and was fine. If your child is eating healthily and exercing regularly then ignore that letter, it takes no notice of whether the weight is from muscle or fat.

I’d say she’s nearer the 75th for height and that’s tracked the same since she was little and they measured it as length.
Re: school to be honest I don’t know what she chooses unless she remembers to tell me but the menus are healthy and balanced and the portions are fairly small.
@Favourodds I appreciate that viewpoint- I found it really sad in the letter that is said along with physical health problems being overweight can cause low self esteem and lack of confidence. Children and adults should be allowed to have high self esteem and be self confident even if overweight for goodness sake.
I’m going to sit with DH tonight and just look at our lifestyles with a critical eye and see where we can improve. I feel confident she will slim down over time but ultimately if she’s active and eats healthily then she is a healthy person regardless of her weight.

@Hell0G00dbye

Thanks for all your responses.

She drinks mainly water, occasionally sugar free squash on a weekend but never fruit juice really and rarely milk these days.

In the week no treats really- yogurt or fruit after tea. She generally has toast or sugar free cereal for breakfast and school dinners.

She might have an ice cream after school on a Friday, whatever is on offer at kids parties as I don’t want to stop her eating in front of others (she is no different to the other kids there in how she eats). Portion wise we use child plates, start portions small and she can have more if she’s still hungry. Definitely don’t load plates and expect her to finish it!

All sounds reasonable. So she's fit, healthy, eats well and doesn't look fat ... I wouldn't put too much credence into BMI, considering it's based on an adult male ...

FWIW I have had the opposite issue, OP. My daughter was ill as a baby and underweight, much grave concern and tutting from HV and GP. Referred to paediatrician, who took one look at her and said 'there's nothing wrong with this baby'. She remained petite and slim right up until last year, when she suddently had a growth spurt and is now taller than many of her friends, same build, though. It's good that HCPs keep an eye on this, but I think it shouldn't worry you unnecessarily if she's healthy.

Remember that this is a screening process, which is why the standard letter advises recipients to get their child seen by a health professional for individual advice rather than giving generic advice on diet and exercise. There are lots of reasons why people are heavier, taller, lighter or shorter than average, some of which are normal, and some of which are not. All any screening process can do is identify those which should be checked further. Of course some parents will already have done that, but lots won't and the screeners won't know that, so everyone in the potentially problematic range gets a letter - its nothing personal to take offence at.
My children are at the other end of the spectrum and one of them was fairly extensively investigated before several specialists ultimately agreed that he was perfectly healthy, just small. But throughout his childhood I still got it pointed out to me repeatedly that he was short and skinny - every time he was weighed and measured at any kind of medical appointment, at school, at clubs, by random strangers in the street and so on.
Yes, it was a bit irritating as we had already seen specialist paediatricians and dieticians and ruled out any serious issues so the regular exhortations to see the HV or GP were pointless. But I would rather we got a bit of hassle than other children had potentially fixable growth issues missed, dietary issues unmanaged or neglect ignored which could easily happen if size becomes even more of a taboo issue.

@OnceAgainWithFeeling

We had that letter. The day after the GP had her stripped down to her knickers and commented how skinny she was. 🤷🏻‍♀️

Yes, my son was really skinny too, I laughed when I got the letter, GP thought he was underweight, don’t give it another thought.

My DS2 who is 6 is exactly the same - was 98th for height though, and 75th-90th for weight. He was a little chunk even when I was breastfeeding him and now is a chunky little boy. He eats well and is very active. I am slim and my DS1 is slim. My DH is chunky.

My DD is 8 and was very tall and slim until about six months ago, when she slowed down on the height but started being a bit chunkier around the middle. Then all of a sudden she stretched upwards and slimmed right down again! She's just started this process again (waistband a bit tighter on her school skirt, nothing too noticeable), so I'm expecting her to grow a couple of centimetres over the next few weeks...

I can sympathise OP. Both DH and I are at the lower end of normal BMI. Family of tall and skinny people on both side. Both of us work in healthcare!

2 year old DS has been 99th centile for weight since about 5 weeks old, yet round the 50th for height. EBF until 6 months. Eats identical food to DH and I which is all home cooked with lots of protein, vegetables, fruit and complex carbs. He’s never eaten chocolate in his life and I can count on one hand the amount of times he’s had a biscuit or crisps. The HVs want to see him (having never seen him before) because his weight is potentially concerning. Very stressful, not really sure what I can do differently - all I can think is that maybe he’s having too big portions. He was also late to walk so hasn’t had as much time ‘burning’ calories per se. Hope it goes okay for you x

We got that letter for my DS in reception. He was/is a broad, chunky lad. His diet has always been healthy and varied and he has always done sport. He was not and is not fat - big shoulders, big hands and feet etc. Tbh I ignored the letter and carried on. He is now 11 - still tall and well built but slim with it.

I wouldn't put too much credence into BMI, considering it's based on an adult male

I think this is the key point. As with many things, healthcare is geared towards men. Women are not small men and girls are not small boys.

Yes obesity is a growing problem (and I do take the view that it is a problem to be significantly overweight) but common sense needs to take precedence here. If she's fit and healthy, not over-eating and getting plenty of exercise, there isn't a problem.

My youngest child was similar. I pretty much just ignored it. He was very large at birth, really chunky as a toddler and young child (we had to buy bigger t-shirts as they would ride up on his fat belly - we called it his capital D) and he's now in year one and a scrawny little thing. I can see his ribs and all of his little muscles when he runs around. Looks as though there's no fat on him. We've always eaten a pretty average diet but he seems to need a lot of food.

My eldest was the opposite and dropped off the bottom of all the charts. I did take notice of that and he was diagnosed with a medical condition.

I don't really see what the point of taking the child to the GP is if you know that your child is fit and active and eats a healthy diet. Your child seems to be around the age that my youngest went from very chubby to slim, so maybe just wait and see what happens.

Bin it and forget about it. Your Daughter is active and eating a decent diet. Obviously if your DD was fat you would have to do something about it but as she is not ignore it.