Very overweight three year old

[BatmanFlewAway]

Help please!!
My DD is grossly overweight. She’s just turned 3 and is about 75th percentile for weight and 9th for height. She has rolls of fat on her stomach when she sits down.
Me and DH both slim though I’ve just had a baby and I haven’t lost all the weight yet and I’m eating a bit extra for breastfeeding.
She eats way less junk than other children her age at home but we don’t make a fuss when we do have biscuits etc. I’m deliberately blade to avoid bigging them up as a treat. I try and make watermelon and pineapple our treats to get excited about.
I think she’s fat because of portion size.
She was born chunky (I was v fat in pregnancy with her. I put on 4.5 stone which I lost afterwards). She was at nursery aged 1 and eats a lot there. I keep asking the staff to reduce portions but there is some evidence that they don’t (bloated stomach and giant poos afterwards). She also has toddler diarrhoea which we have been unable to find a cause for.
I am so worried about her health. How do I do it?! I had avoided saying the word fat for fear of eating disorders but now have started to say it. She’s howling for more cereal after having some alpha bites, Rice Krispies and half a weetabix.
She doesn’t have milk other than at breakfast.
We don’t have pudding most of the time but sometimes fruit.
She asks for crackers a lot. She probably has 3 crackers a day. She doesn’t need a snack as she eats well (good balanced diet at mealtimes) but nursery and friends have snacks so it is hard to avoid entirely. I’ve given popcorn in the hope that it’s light and doesn’t make her tummy full - I think she’s got used to her tummy being v full all the time.

Yes some doctors are twats, like your brother by the sound of it. I have doctors in the family who are exactly like that. Unfortunately there are twats in every job,, and if you were inclined to being a twat originally, the massive self affirmative affect of qualifying as a doctor can lead to becoming an arrogant, judgemental twat.

However you have to hope your own GP has some sense of professional distance - more do than don't. If you have no choice of GP and the one you've been to was useless try the health visitor - perfectly normal with a 3 year old and some are very good. If yours isn't you don't have to take their advice. If you do have a choice of GP consider seeing a different one.

Telling a 3 year old she is getting fat is a terrible idea.

We can’t walk from our house - we live on a busy road with no pavement.
It’s not that she’s 75th for weight that’s the concern - it’s combined with being short. A child who is 75th for weight could be skinny if they’re tall. She’s not.
She doesn’t have tropical fruit very often - that’s a treat - probably once every couple of months.
Typical day is
Cereal fiasco
Snack - whatever they have at nursery or half a piece of toast or a cracker at home or if we are out then a mini packet of breadsticks
Lunch: veg soup and toast or a cheese sandwich with cucumber and tomato
Half an apple or a clementine
Tea: half a small jacket potato (quite often leaves!), chicken, broccoli OR pasta, peas and cheese OR spaghetti bolognaise - we use toddler plates.

I’m struggling to bring mealtimes to a close when I’ve just started weaning her baby brother who is v slow at eating. I’ve asked her to show me her ballet whilst we are still at the table. She’s wasn’t keen and whines and asked for more food throughout.

She obviously is fat though, and the OP is right to pick up on it.

Maybe she is used to feeling full all the time,maybe she is eating too many carbs and not enough other stuff. I think you could do with some help as what a small child should eat is not the same as what an adult should eat. Well done for making the GP appointment.

A lot of diet is habitual, so she should get used to a new regime in a few days with lots of distraction. Can you get nursery to keep a food diary of her for a few days? Are they giving her extra because she asks for it? (And if so can they stop?)

And usually an afternoon snack of two crackers.
I’d allow two pieces of fruit a day but I’ve linited because I’m unsure how much fruit she’s had at nursery and the HV and GP told me to limit because of toddler diarrhoea. It is better than it was so whoever said about carrot sticks is probably right that I can switch more that way now.

So she’s finishing her dinner and whining for more? Is she panicking because food seems rationed?
If you up the veg and protein but make it seem like you’re not saying no then that might help.

Evelyn you made me laugh about your GP comment! Fortunately they’re quite good at our surgery but I do remember lots of those at university!

Give her more food.

Just think about what you give her.

She sounds as though she's fixated on food because you limit it so obviously.

Why give her half an apple? Just give her the whole apple - not cut, the whole apple.

Stop giving her tiny amounts of empty cards and leaving her begging for more, give her free reign to have as many apples and tomatoes and cucumber slices and carrots as she wants.

Yes used to feeling full all the time I think.
Nursery staff are mostly all overweight. She told me the other day that they give her too much food and it makes her tummy hurt. I told her she didn’t have to eat it all.
One of the staff (one of her favorites) said in front of me that DD was a good girl and eats all her tea. Obviously I immediately said ‘we stop eating when we are full, we don’t have to eat everything’ and I’ve asked them to give smaller portions.

It's really only soft fruit you need to limit - you don't have to limit apples and carrots.

THe reason for half an apple is because she wants it cut and we share it usually. She doesn’t ask for more because she sees it’s gone.

She's seeing a very inconsistent approach to food between home and nursery, that must be very confusing.

If she asks for more after lunch give her a whole apple or carrot though.

If you google dietary management of toddler diarrhoea then it says to limit certain fruits and veg but not others e.g. Limit grapes, peas, raisins, baked beans, sweet corn but include all others. This might help:
http://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/PaediatricDepartment/6293-1-Dietary-management-of-toddler-diarrhoea.pdf

Cut out the sugary cereals

Give more eggs, porridge, protein rich food

My little girl would eat constantly if given the opportunity.

Snacks tend to be veg, we always have done cooked corn on the cob and brocolli in the fridge, just steam them then they'll keep in the fridge for a couple of days.

She will happily chow down on a cold corn on the cob while out and about or a rub of brocolli and cherry tomatoes.

Breakfast is porridge or scrambled egg and a slice of granary toast. Only takes 1 min in the microwave to cook scrambled egg.

She has lunch and tea at nursery, but at the weekend lunch would be something like a rice cake, couple of slices of cold meat, veg and some berries with a yoghurt. Tea would be whatever we are having.

If she wants a real bowl then look for some 'grown up' small bowl and side plates and buy her a set of special crockery.

OF course I don’t despise her!
That’s why I’m concerned. I’m not medical but I gather that overweight toddlers become overweight adults. Being overweight increases the risk of diabetes, cancer and heart problems. It can also lead to bullying. It can also be a self perpetuating cycle of unhealthiness as if you’re overweight it is so much harder to exercise. I love sport and I want her to be able to enjoy it without feeling tired or out of breath.
In fact I don’t even know why I’ve responded to that. Everyone KNOWS the above.
I simply want to look after her health and mental wellbeing.

Of course you want to look after her wellbeing and that is why you've posted! However, you've mentioned you own weight several times which, to us strangers, is a red flag that you are too aware of peoples weights. You sound stressed about food and weight and your daughter will absolutely pick up on that. If I were you, I'd try and back off completely and look at my reasons for stressing about food so much. I say this with sympathy as I'm an emotional eater, with two toddlers, who play up as soon as I get worried about food. You need to relax.

THANk you, demented - that’s really helpful!
Will try the broccoli snacks. Hope it won’t put her off. She’s currently indifferent between broccoli and banana and doesn’t actively seek out biscuits or junk etc other than crackers and popcorn. I’ve stopped yoghurt because that gave her diarrhoea. She has her own tiny crockery but she wants to be like me!
Thank you for all the help and advice, I really appreciate it. So helpful to discuss with lots of others and get a good range of ideas. I’m afraid to say all of our friends seem to give biscuits, crisps and chocolate and ice cream every day as standard. From a vitamin perspective I’m happy she eats well but it’s trying to reduce the portion sizes without giving her future food issues that’s the issue. Upping exercise in the house whilst I feed baby bro is also something I guess I need to do. I will push the ballet demos!

My (just) 3 yr old eats a lot more than that but generally more filling stuff so a couple of toddler bowls of porridge and a small sandwich for breakfast, cooked lunch and dinner e.g pasta, salad and meatballs, pancakes, etc, plus snacks - crackers and fruit throughout the day. Neither her or her brother is overweight, so to me it really doesn't sound like a large quantity of food just not very filling.

What is she drinking - does she still have a lot of milk, or juice at nursery?

Have you actually asked them what size portions they give them at nursery. Our nursery and ones I've worked at tend to give v. little portions and then give seconds, if available and wanted rather than give a large portion to everyone to have half of it wasted. So yes finishing the first little portion sensibly is praised to encourage good behaviour at the table.

I think PP has it when she says to relax a bit. I wouldn't portion her but I would control what you give her. If she is only given healthy food she would have to eat a heck of a lot to put on more weight. It's not about losing weight rather than growing into it at that age.

Find lots of fun ways to increase excercise. And ditch the cereal and crackers! Good luck

Please don't alter or restrict her diet in any way until you've consulted a doctor or HV!

Of course she can't see the design on her knickers, most 3 year olds still have the typical "toddler tum" that sticks out. It will appear even more bloated if she has an undiagnosed intolerance which also may explain the runny pops and insatiable hunger.

As others have pointed out the weight differences between the centiles are tiny at this age, and chub on a small child can be normal, not to mention necessary! Please don't diagnose her on your own; you may be the architect of the very problems you're trying to avoid!

It sounds like she's having too much carbohydrate and not enough fat or protein. All of her meals are based around carbs! It's great that she likes veg, so I'd look to substitute your fruit with veg like celery, cucumber peppers, etc.

For breakfast, why not try something like scrambled eggs, or porridge?

How much fat are you giving her? She should be having plenty of fat to help her grow/develop, but also because it's satiating - as is protein.

As for the diarrhoea, if yoghurt is contributing to this, is it possible that she has a milk/dairy intolerance?

I'd definitely go and talk to your GP, but beware that most GPs have very little training in food/nutrition.

Also you would expect that nursery would know what is normal for a three year old, so I'd be reassured by their assessment if I'm honest.

I really would go to see a GP and ideally get dietitian advice as well.
It’s hard to tell here whether you should be worrying or not.
In the meantime I would focus on finding ways to keep her active. What is her nursery like? Do they do a lot of active things?