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.

Every evening cut up lots of different vegetables, ie carrot sticks, sweet peppers, cucumber, green beans, cherry tomatoes.....make these always available along with apples/oranges/banana.
Make these the ONLY snack at home but as much as she wants to munch on ( except bananas, one is plenty)

Get rid of cereal if she is prone to sugar cravings, starting the day with cereal is a very bad idea.

porridge with blueberries or strawberries is great and a big bowl is fine, if she is still hungry offer greek youghurt with blueberries.
I agree with previous poster scrambled eggs are also good for breakfast.

Cut out the empty calorie foods ie bread/cakes/biscuits, replace with crudite/ avocado slices/corn on the cob....almond butter on ryvita is a tasty snack and filling, and won't set off sweet cravings like bread ( most bread has added sugar these days)

Add huge varieties of veg, for her dinner give her 4 or 5 vegetables (and a little less spaghetti, pasta or potatoes) to help fill her up with good food,
keep sauces to a minimum unless homemade as they have so much sugar which will spike her appetite.

I have a DS who is always hungry and eating anything with suger will make him ravenous, so we do the above. Also l give him big portions of grilled fish as it is filling and healthy, and will stop him asking for more during the evening

Having a ready prepared bowl of crunchy raw vegetables really helps when he comes in starving, and otherwise would rush for a handful of biscuits.

I have 2 completely different DCs, DD is a natural beanpole with a modest appetite, and DS prone to being heavy with an endless appetite, any sugar really make him feel endlessly hungry so l try to avoid and replace with healthier items.

I also do sometimes say enough, no more, lets get up and do something else, if he says he is still hungry after a good meal.

Often distraction is enough to make him realise he was not really still hungry but bored and just likes to eat!

You're doing a good job to care about her health and diet.

If you've never struggled with your weight you might not be aware of the best ways to help manage her weight. Cereal and crackers and cut up apple are perfectly sensible for people with normal weight, not so much for those struggling with it.

It used to be recommended that low fat food, which is typically high in sugar or other carbs, were good for you. Now the recommendation is that high protein and high fat foods are more helpful as they fill you up.

Small ish portions of high protein or high fibre foods for main meals are the way to go. No need to bulk out with carbs. Do bulk out with low carb / low calorie fruit and veg. Fat is not bad, but is calorific so in moderation.

If you do have to give snacks (and it's a fine habit to get out of), unchopped carrots, cucumber, apple, cherry toms (chop them once for safety) are low calorie and low sugar, give her a bit of work to do so eating is a slower process. I also think that food habits get set in childhood, so developing a taste for these rather than e.g. crackers will serve her well in life.

Definitely talk to nursery about giving her smaller portions, especially if the GP does advise she should not gain more.

FWIW, my toddler daughter could occasionally get a bit chunky, usually as a result of portion sizes and treats getting out of hand. It was surprising how quickly her body lost the extra fat when we reined things back in. You do have to be prepared with 'no snacks, it's dinner soon' (I did keep an eye on time between meals so I knew she wouldn't be genuinely hungry), and 'no, you've finished your dinner, that's it, it's all gone.'

You are absolutely right to address this now, I wish my mum had!

To be honest her diet sounds fine, just the size of her portions. Id make her meals harder to eat so it takes longer. If she wants to be like you then she needs to cut it all up herself. Give her a whole apple. By the time she has eaten she might feel fuller.

Hi OP

Just a question. Do you give her a snack because she asks, or because you think she 'needs' a snack?

The snack culture is one of the biggest changes in diet since I was a kid I think. We never snacked. Now it seems kids - and adults in fairness - can't go more than 2 hours without eating

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.

The OP says that most of the nursery staff are overweight so maybe they don't know. When that is allied to comments from them about her being a good girl for eating all her tea then again there is cause for doubting that they know what they are talking about.

The volume of food sounds pretty normal to me, so perhaps as other PPs have said look st the types of food she is eating. My 3yr old eats way more than squashed describes but is a healthy weight. I think it will vary from child to child. She does ask for more sometimes, and bangs on about snacks a lot (often when she's bored I think) but I offer carrot/apple or nothing- I won't give in to requests for more unhealthy or filling snacks if I know she's eaten well already. We're pretty active, often out and about and go to active classes.

I'd ask for a medical opinion but if there's no underlying medical cause then limit portion sizes, snacks and increase activity.

There's a lot of processed carbs in her diet that may be contributing to toddler diarrhoea, it did with dts.

They have ff Greek yog with frozen berries or egg and cheese muffins for breakfast which keeps them (and me!) full until lunch. Lunch varies but usually 'picky' so ham cheese salad bits hummus etc. Dinner is a regular meal.

I'm not saying no carbs but white bread, crackers, breadsticks, more bread is probably not helping her with hunger levels.

Are you sure she's overweight? My DD at 3 was 75th percentile for weight and 25th for height - our paediatrician (whom we saw for a different reason) said that was absolutely fine and normal.

She's 6 now and still 25th for height but now about 50th for weight.

I'd see a dr and ask to be referred to a paed if you are concerned - there might not be an actual issue.

As others have said, reduce the carbs and offer protein and fat instead. What about a cheese omelette for breakfast? It would be much more nourishing and satisfying than all that cereal. Focus on leafy green veg, meat, eggs, and cheese.

Are you and your husband both quite short? Perhaps she's due a growth spurt which will even her out a little bit more.

As for what she's eating, it does sound like a lot of carbs and not very much protein.

As others have mentioned, porridge is a great breakfast as it fills you up more and for longer.

Crackers and other snacks could be replaced with veggie sticks. Carrot, cucumber and celery. Possibly with a humus dip if she's not keen on the veg by itself. This could even be lunch if she can go that long after breakfast.

Some carbs are great so perhaps pasta and protein for tea? Probably with a lot of veggies. Sweetcorn, carrot, peas, diced swede, cauliflower...

The fruity snacks are a good thing (more nutritional value than crackers) but are still very sugary. Veg is better than fruit, however, I think the shared apple is a good idea as a mid afternoon snack.

Pineapple etc. are also great "treats" rather than biscuits

Another key component of weight is exercise. If she's burning off roughly the number of calories that she's eating per day she would maintain her weight.

As she's only a toddler and she's growing and developing I wouldn't be comfortable letting her go hungry if she's asking for food but I'd replace snacks with healthier options. It might be that she's snacking when she's not hungry just because she enjoys the snacks (we all do that, don't we?!)

And make sure she's running around for at the very least one hour per day. This could be around the house or garden but soft play etc is much more likely to be effective.

How is she growing? Is she growing along the 9th centile for height, or has she dropped towards that more recently? Genuinely overweight children tend to get slightly taller younger than they might otherwise have done. Some problems that might affect growth would be consistent with becoming overweight as well. Whilst the most likely scenario is that she is a chubby toddler who will get more active and start growing into her weight, it's worth talking it through with the GP and deciding if any testing or monitoring is appropriate.

(doi my kids weighed a lot more than she does at her age, were "solid" with pot bellies, but no particular signs of serious overweight, because they were also tall. They slimmed down by about 5.)

Some of the dietary advice is shocking and totally inappropriate for a three year old.
Go and see your GP or Health visitor for a proper assessment of her growth, size and diet. Children of three should not have restricted diets without medical support. It’s likely to lead to malnutrition.
To be honest, your attitude towards her isn’t very pleasant. The issues with food and body image seem to be your problem.
Children of three need a balanced diet, not a dominance of carrots and watermelon. No, they don’t need sweets and fizzy drinks but they do need sufficient milk/cheese etc for Calcium requirements, sufficient proteins for growth and repair and sufficient carbohydrates for energy requirements. Fats are essential for certain vitamins too. These should not be restricted without professional advice or you’ll end up with deficiency diseases.

Thank you crumbs I’m aware she needs sufficient calcium, proteins and fats. I’m not ignorant or offensive to my DD. We’ve obviously fallen into a few bad ways and I’m simply looking for tips, which many have helpfully provided. I’m not about to prescribe to a restrictive diet based on internet responses.
Reason for mentioning my weight is that children pick up eating habits from parents. I’m actually v relaxed about mealtimes and she is too.
I don’t tend to offer snacks unless she asks except mid morning toast if I’m having some (I am breastfeeding so do need this sometimes).
I didn’t know about the processed carbs contributing to toddler diarrhoea - will watch out for that as I try to switch snacks.

Can anyone recommend a full fat low sugar yoghurt please? I could do plain yog with a bit of fruit purée but would be handy to have pre mixed. Used to buy Rachel’s and Sainsbury’s but can’t find them anymore.
This is for baby bro mostly.

Yeo Valley for yoghurt?

err CRUMBS, l cannot see any advice that suggested in any way restricting her food or dominating with carrots and watermelon.....

People have mostly given suggestions of snacking on vegetables in addition to her meals, (which seem very balanced from what the op has said) and offered ideas on healthy additional foods .Some children do have insatiable appetites

I have not seen anyone say to restrict fats or switch to low fat this or that, in fact avocado was mentioned which is high in good fats, yoghurt which is high in calcium.......many have suggested advice from the GP or HV.

So not sure what is so shocking! Also you are very harsh on the OP who seems to have a good understanding of food, we can all benefit from sharing ideas.

OP just checked, Yeo valley has 5 teaspoons of sugar per tub!!! this is pretty much in all yoghurt, except live greek youghurt.

This is why we struggle to cut down on sugar it is hiding everywhere!

Get a pot of plain full fat Greek yoghurt

Thanks all for yoghurt suggestions. Yep, couldn’t find a low sugar one so have gone with plain. Even the low sugar ones have sweetners which I don’t feel is necessary. There obviously wasn’t a market (at least where I live?) for the low sugar Rachel’s and Sainsbury’s ones.

We find that eggs for breakfast is a great way to cut down in sugary cereals. It also fills the kids up!

Also agree unlimited veg snacks is a great way to go.

The cereal wouldn’t fill anyone up. Let alone an active three year old. Porridge or something substantial like eggs is a much better breakfast and will keep her full longer.
I agree with some PPs though the way you talk about her stomach and calling her fat is unnecessary.

Definitely take her to the doctor - diarrhoea and big tummy are common symptoms of food intolerances like coeliac disease. And in the mean time increase protein, especially at breakfast, should fill her up better.

Little yeos have 4.5g sugar per pot, that isn't much. These ones:

www.ocado.com/webshop/product/Yeo-Valley-Little-Yeos-Organic-Strawberry-Vanilla--Mango-Fromage-Frais/48951011?dnr=y

I think you sound really OTT about her weight tbh, loads of toddlers are chunky at that age. My sister was a right chubster and it all fell off her by age 7. She's a beanpole now.