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.

BMI doesn't take into account frame size. DS is 98th percentile for both weight and height (so even though he's perfectly in proportion the NHS website says he's overweight) - there isn't an ounce of fat on him but he has wide shoulders and chest, wide hips, muscly bum and thighs and a massive head, just like DH. His cousin is exactly the same height but has a smaller head, narrow shoulders, almost no bum and is only about 75% as wide as DS. They are both very active very healthy boys with good diets but no doubt I'll be getting a letter when it's school weighing time.
I do agree that some people are confused or in denial about portion sizes/obesity in children but bmi is a very blunt tool to define health.

@DameHelena

I didn't say my daughter eats adult portions. I said she could eat them if we let her. There's a difference.

@DomesticatedZombie

Maybe, Teapacks, but look at the letter in the context of the OPs post:

...a big issue with the HV team...

... HV just weighed and said she’s still overweight and to watch portions

... being made to go monthly to the HV for weight checks and their disapproving looks when she continued along her centile.

I've had similar disapproving, stern talks from the HV (admonishing me for breastfeeding, etc) although in the opposite direction as my DD was always light and small. I think many others have had the same. Fine to use BMI to flag potential issues; not fine to use it as a stick to beat people with.

Of course not. It shouldn't be a stick for anyone. Funnily enough, my DD was exclusively breastfed until 6 months. Then baby led weaning - she fed herself. Still overweight by 2!

[quote Teapacks]@DameHelena

I didn't say my daughter eats adult portions. I said she could eat them if we let her. There's a difference.[/quote]
Yes, I know. My point was the OP doesn't seem to suggest that her DD has a particularly large appetite. (I do recognise that we don't know for sure.)

Ach, mothers will be blamed for doing it wrong whatever we do ... should come as no surprise!

We had same letter for DD1 who was 2nd youngest yet 2nd tallest in her class at that age. She was also the fastest runner over any distance over 100m and could lap the entire year group in the 600m. She's never looked fat, but is sporty and slim.
She's never been skinny size 8 (and nor was I) but has settled at 10/12 and looks very healthy.

Yes but if a kid is very overweight then it's highly likely that they are either eating more or moving less than their peers somehow (although there possibly may be other factors).
The OP seems to be doing all the right things (which I guess is what you're saying) and, at some point, it could just be how the child is.
And it's REALLY frustrating!!

@Fridafever

I’m intrigued that everyone thinks they all even out/ shoot up / whatever. That’s obviously not true is it? There are loads of fat teens and adults. I’m a fat adult myself.

Yes, this. People make it sound like there's no connection between being overweight as a child and being overweight as an adult, when in fact the correlation is very strong. Of course it happens to some children but very many will not just outgrow it and every year they're overweight it gets harder to change in the future.

@Teapacks

Yes but if a kid is very overweight then it's highly likely that they are either eating more or moving less than their peers somehow (although there possibly may be other factors). The OP seems to be doing all the right things (which I guess is what you're saying) and, at some point, it could just be how the child is. And it's REALLY frustrating!!

This comment was for @DameHelena

@Teapacks

Yes but if a kid is very overweight then it's highly likely that they are either eating more or moving less than their peers somehow (although there possibly may be other factors). The OP seems to be doing all the right things (which I guess is what you're saying) and, at some point, it could just be how the child is. And it's REALLY frustrating!!

Sure. In this case though that doesn't sound likely – as you say, she does seem to have a healthy diet and lifestyle. I would guess that it's a combination of BMI being a bit of a vague 'one-size-fits-all' measure, it being just be how the DD is –and maybe there is such a thing as puppy fat! Many (anecdotal I know) posts on here about 'overweight' kids growing thinner as they grow up seem to suggest that.

But the things said in that post simply don't apply to the OP's DD, who does a lot of sport/activity as well as non-formal exercise like a lot of walking (so is definitely not a couch potato); and there's no indication that she doesn't have a natural off switch or that she eats adult portions.

Exactly.

This is an active child not having many snacks or sugary foods and wearing normal size clothing. Who was in the same percentile from birth.

Do people really think these were fat babies?

Here are photos of normal weight kids from the 70s.

1 class photo ages 7-8
2 class photo age 5

@RantyAunty that’s so interesting thanks! DD wouldn’t look out for place in the 5 year old class picture.

Yes, this. People make it sound like there's no connection between being overweight as a child and being overweight as an adult, when in fact the correlation is very strong. Of course it happens to some children but very many will not just outgrow it and every year they're overweight it gets harder to change in the future.

No, I think people understand this. But there are also many cases where that does not follow.

In an instance where the diet and level of activity is fine, that seems a more likely trajectory.

@user1471538283

My DS when a baby was fat. He was a solid toddler. He then grew into his weight.

I know its upsetting but she is active so needs food.

Lots of people saying this but I think by the time the school checks roll around the idea is that they would have grown into their ideal BMI by then.

I guess the best thing to do OP is really look very closely at her diet, spot areas that you could make changes. Like my son would clear the cupboards out after school so he gets a healthy snack post school and then dinner a bit earlier. Not saying his diet is perfect, no ones diet is perfect and that's not even something we should be striving for but sometimes you do need to really look closely at it to realise any habits that have crept in.

@BlingLoving

Assuming your DH is a doctor with some knowledge of this stuff, what does he think?

There is no doubt in my mind that many parents are in denial about their children's weight. Having said that, there's a limit to what you can do when your child is this young and you have to be realistic.

DS was overweight. We knew it. Not crazily so, but clearly overweight. I discussed with the doctor. Her point was that at that age, restricting food is not advised. Exercise, healthy, varied diet is more important.

A few years later, we did have to take a more proactive approach because by then he was more overweight. He was also old enough to understand this. Part of fixing the problem was me and DH, as his parents, taking a long hard look at our OWN behaviour and what WE were doing.

We had to acknowledge that that he WAS having more treats and food that was high in sugar and/or fat than was good for him.

But we also had to acknowledge that as a tall child who genuinely has bigger bones than others, he needed more/different exercise than other children. I came to realise that he wasn't always incentivised to keep moving when he was outside and that he was more of a burst of activity type of kid. But that wasn't going to help him with the weight.

We also looked at his "healthy" food. And had to realise that traditional kids food wasn't good for him. If DD eats something like shepherds pie its a good dish for her - protein, carbs, veg (on side and hidden). But for DS, who loves food, he will eat a big plate of whatever is served to him. if that's shepherds pie, it might be very nutritious but a b ig plate is too many calories. As a good eater, we could switch to serving him the kind of meals many younger children wouldn't eat - a piece of salmon with rice and piles of steamed veg or baked chicken with salad and new potatoes etc - allowing him to have a large portion but without the same number of calories.

None of these things would have happened if we'd continued to be defensive : "but he eats normal healthy food" or "but he does lots of activities and is out and about all the time."

Most helpful post on the thread. It is so easy to feel indignant as a parent. Most parents of overweight children disagree. There was a mum in ds class who was shouting the school office down having received such a letter. It was awful because her daughter was clearly so overweight. My ds is in Y5 and we have to watch his weight, proactively. Much like the poster above, pretty identical in fact. Statistically Children and teenagers are at much higher risk of obesity than an eating disorder. In fact obesity is arguable an eating disorder too. Please don't be so indignant that you become ignorant.

I do see children these days who seem to be so skinny I can't help but wonder how their legs hold them up let alone walk; right up to teens/20s. Nary a sign of a muscle among them.

@Lndnmummy and @BlingLoving are bang on.

Great advice on here- throw the letter in the bin- it doesn't matter if she's obese as long as you thing she's healthy...

I’d go to the GP or seal further advice. They don’t say this to be mean, if she is overweight it is kinder and better for her health to manage it rather than bury your head in the sand

My friends who follow responsibility model feeding all have chunky kids. I do get the appeal but kids will just load up on bread if they're allowed to. When you say you're having jacket potatoes are you serving them with salad. Most nights we start dinner with a salad to fill them up with veg first.

Most people have lost sight completely of what a normal child should look like. If she's 75th for height and 98th for weight then she's overweight. There's no way around it. I'd start by trying to fill her up ok more veg before you get to the main course. If she wants seconds then let it be veg. The goal should be to maintain her weight and then she will slim down as she grows.

Can you see her ribs? Do they have a tummy? I was always told to go by eye.

That sounds tough. It's easy to be overweight in this environment. My eld, now a tall, skinny teen, was fat for a while. We all changed our diet and what was available to eat in the house: sensible meals and fruit always available, admittedly this can be pricey! Don't make it a diet fgs, this is dangerous for kids. But it's important to act now, subtlety. Don't bear yourself up, that's pointless. Just do your best.

If you truly, genuinely feel that she is not overweight then just ignore the letter.

However, I know several people who have overweight kids and all are in complete denial about it and just excuse it as their child 'loving food' or 'having a big appetite'.

Portion wise, I was told the following - not sure whether it’s true / helpful , but is v simple :

Food portion can be based on size of hand. Protein no more than size of palm. Carbs are the fingers. Fill rest of plate with veggies.

Anyone else get told this ?! I have big palms relative to fingers, so certainly don’t do this for myself !