Reception age health check in - child overweight?

[Caledoniadreaming]

Hi all,

Not sure this is the correct topic/forum but hey ho. It's a vent more than anything.

My son (age 5) had his height and weight measurement checks at the end of March as part of the (national?) scheme when they're in Reception, and we have now had a letter through to say that he is "overweight". Now, I should say I had misgivings about giving approval for this to be done, but with life I completely forgot to say to the school I don't agree for him to be weighed and measured.

For context, on the letter the measurements given are 107.5 cm and 21.5kg, which, if you put those into a BMI calculator (which I have serious issues with anyway, and why do BMI on 5 year olds?!!!) yes he comes in as "overweight" but to look at him he is a fit, healthy boy, yes eats like a horse. There's barely any fat on him - it is muscle and bone.

DH is very much "it's all bllcks", but I can't help but feel that since the letter was sent from the school nurse team, it's now a record that he is classed as overweight and there will be checks etc., going forward.

In future if asked I will not be giving permission for him to have his measurements taken, and I do worry that the nursing team haven't factored in just looking at the child and thinking, "do they look healthy" and taking that into account rather than just statistics.

Am I worrying unnecessarily, or is there a wider issue here with labelling children at such a young age?

I appreciate why you be upset about getting a letter saying your child is overweight but I don't think it is fair to get upset with the school. It's good they are checking things like weight, height, eyesight, hearing etc. This has always been the norm. What you choose to do with the information provided is up to you. Even though your son is healthy, there are unfortunately a lot of overweight children in the UK who do need support

Is it more that there is a disparity between his weight and height centiles?

I’m great at plotting centiles but the results I’ve got are that his weight is over the 91st centile and his height is just over the 50th? Usually they like to see them more in line. So for example my DN is on the 98th for weight but isn’t overweight as they’re in the same centile for height.

What weight centile was he in last time he was weighed and has he tracked that one or gas he been steadily creeping up or has he always a difference between his height and weight centiles?

I don't think the school nursing teams have any option but to do it according to the statistics – school health checks have to be pretty basic to let them get through so many children. They're good for flagging possible problems, but often you then have to go further to get the whole picture.

BMI for children is a bit different from BMI for adults – basically it looks at children of a certain age and certain height, with a range of weights. Those in the bottom few percent for weight should be checked because they're potentially underweight and those in the top few percent because they're potentially overweight. Mathematically, it comes down to pretty much the same thing as @BunnyRuddington talked about, that your son's weight centile is quite a bit higher than his height centile. Has he been that way since toddlerhood?

Another thing would be to just check the measurements yourself, just to make sure it's not a data entry error or something.

why do BMI on 5 year olds?!!!

Because it helps to identify children who are over/underweight and might need some extra support.

Your suggestion of 'just looking at the child and thinking "do they look healthy?"' is all well and good, but everyone has a different idea of what 'looks' healthy. It would be extremely arbitrary, even when done by nurses.

You would have nurses telling parents that their child doesn't 'look healthy' and parents kicking off because there's nothing to support this claim.

BMI is not a perfect measure but it's a measure, and they need a benchmark. That is why they use percentiles.

Of course you know that your son is healthy, but when in school, he is one of hundreds of children than they are keeping an eye on, and some of them will need support and need identifying. These checks are there for the good of large numbers of children and public health which is important to all of us.

If you know that he is healthy then there really isn't an issue, is there? Any follow ups are just to make sure he's OK and all in his best interests anyway.

My 5 year old has just been weighed and measured too. She's 108 cm and just under 18 kg. She is very normal looking (not skinny and has good musculature). In her centiles she was about 40th for both height and weight.
I know that weights can vary but I would be surprised if a child the same height as her but weighing 3.5kg more than her didn't flag as being too heavy for their height. To be honest it is only in the child's interest that things which can potentially affect their health long term are evaluated and followed early.