Ds bmi shows b underweight- after advice please

[missmapp]

13 year old ds is 155cm high and weighs 5st 7. According to the nhs calculator , his bmi is on the 1at percentile. He is like a whippet, no fat and fast ! He is active, not complaining of being tired and rarely ill. He has asd, don't think that is relevant .

Should I go to the gp? Am trying to get him to eat more and not sure what else they could do. I was underweight as a child and was put on complan, which I hated. Surely it is better for him to develop a better diet without that . Any advice gratefully received.

Does he eat well? Children with ASD can have a tendency to be reluctant eaters. I was an underweight, complan-fed child but it was definitely down to being a fussy eater. I reached a normal weight once I started eating more foods.

He might gain weight as he goes through puberty, but on the 1st centile, I would get a GP's opinion.

He used to be a terrible eater but has got much better. He doesn't like 'sloppy' food so no chilli, lasagne Tec but will eat a roast now. He eats well at home but not at school. He has a bacon roll for breakfast but that is it really as he doesn't like the queues. We tried a packed lunch but that was just left in his bag. Need to improve the daytime eating really.

Are the rest of your family (or his father's family) of a similar build? If so, I wouldn't worry. If not, I might check it out further.

I and my dad are similar build. My dh and his family not really. Dr 2 is small and on the 2nd percentile but he has Noonan s syndrome which is linked to slow growth. Ds1 does not have Noonan s.

Three meals and three snacks a day, try to make the snacks 'count' ie 200 calories plus. Add milk or juice to each meal and snack. Appetite can improve with more regular eating. I am all for wholefoods and healthy eating but with weight gain calorie dense (sugary fatty moreish) foods do have their place. And ice cream smoothies may taste better than complain It sounds like daytime eating is key - try to get him to get in the habit of having 'something' at breakfast snack and lunch and then you can increase quantities. Good luck

My DS is of a similar weight, height and age. He was only 6lb 1oz at birth and has hovered around the lowest percentile ever since. He has seen a dietician and apart from a mild lactose intolerance they found no problems. He is not so much a fussy eater as a grazer so while he doesn’t eat huge meals, he has plenty of snacks.

His dad and aunt were exactly the same as children, as was my mum, so I’m not too worried, but if you are it wouldn’t hurt to get him checked out.

Missmap - I also have a ds on the 1% so I just wanted to say I get how you're feeling and to send you a hug. No advice really but maybe GP for bloods to check on any thyroid issues?
My ds just can't put on weight. I'm sure it will happen at some point. Sorry you're worrying about it. Is your ds worried about it?

He is small in height, but that does seem very low. A gp could check there was nothing underlying. My ds1 has asd and his (mainstream) secondary school supported his lunchtime and eating with various strategies like a queue pass, a ta to encourage him and alternative place to eat. Ds1 has an EHCP, but they offered the same to other sen kids without one. Have a word with the school? Also snacks in his bag, coat etc, built into his routine?

Thanks all. The tips on snacks and I've cream sundaes are great, thanks eva .
defineme asking for a queue pass is a good idea, although I don't know if he would use it ! May talk.to the school. He doesn't have an ehcp but school have been really good in otherways. I suppose I haven't really linked the eating to the asd. Daft really !
eyeore thanks for understanding . Hope your dc is okay

I have similar concerns about my DD, who is 11 and also has ASD. She is 147cm and 31.7kg which puts her on the 3th percentile, which is only just a normal weight (normal is 3th - 90th). She was on the 75th percentile for height and weight when she was younger, but has dropped through the centiles over time and is continuing to drop, which is worrying. She has a very poor appetite both at home and school, and is very fussy. I took her to the GP, and she said she could refer her to a dietician, but her advice would only be to eat more, and advice on what sort of things to eat (ie. full fat dairy etc). But I know that already, the problem is getting DD to do it!

That's just it sleepy . I know what the go will say so am reluctant to go down the dietician route.

My DD claims she never really feels hungry. She can skip breakfast and lunch, and then come home from school saying she still doesn't feel hungry Apparently this is a sensory issue (sense of interoception - a failure to detect the internal state of hunger).

She sees food as some sort of massive chore to be endured, so obviously avoids it at any cost. She doesn't even like nice food, like chocolate, cakes, ice-cream etc - these are still a chore to eat.

She doesn't like so many different foods it's difficult to cook for her. She also hates sloppy food, even yogurt is rejected as its "too wet".

She is very rigid about what she'll eat - so she refused to eat sausage and chips, because despite liking both, she'd never had them together before, so that was ALL WRONG and she couldn't POSSIBLY eat it.

She won't eat a breaktime at school because she "doesnt eat at breaktime" - a self imposed rule that she rigidly sticks too from primary school days when they only offered fruit and milk (despite secondary offering chocolate muffins, toast and hot chocolate).

She refuses to use her lunch queue pass. She refuses to enter the canteen. She has the exact same thing for packed lunch every day, but only eats half of it because they only gets 30 mins for lunch and it usually takes her an hour to eat the tiniest meal.

So trying to get her to eat more / more often is naturally a massive battle.....

I worry, but what can you do?

Dd wouldn't eat because she wouldn't use the busy canteen and they weren't allowed food elsewhere - school arranged for her to eat in the nurture club and even for her to have tea, she wouldn't drink juice or squash and barely sipped water

My daughter takes a hit packed lunch to school most days (it takes some organisation and commitment on my behalf!). It's foods she likes and avoids the queues. She's such a tricky eater: rice and curried meat (no sauce). Pasta and pesto or tomatoey sauce. and lardons or chicken (add grated cheese for extra calories). Not that DD needs to gain weight at all !!
Are there hot meals he likes that you could put in a wide mouth Thermos flask?
For extra calories: add cream/sugar/honey/cheese/butter/olive oil to meals. Maybe not all at once ...

Hot, not hit!

My 15yo with asd is a reluctant lunch eater at school. He was always low in the centiles for bmi until puberty, but is fairly hefty, now. He might happily go without eating much for 10 hours, then demolishes everything beige in sight (conversely, pre puberty, he ate little more than vegetables, some days)

My boys were, are, fussy eaters, they eat healthily but perhaps not as much as they should, so at puberty they all shot up in height but not in weight, making them look tall and thin. If they are well in themselves, have energy, rarely ill, I wouldn't worry about it, especially if a parent or grandparent followed that pattern. You might still like to have a checkup with the GP.

I think you are right, ol dmum , he is otherwise healthy and the 're is a family trait so will monitor and go to the gp if things don't seem to get any better. We have talked about snacks and school lunch. Will try a packed lunch again to see if that helps. He says a queue pass won't help as he doesn't really like any of the food. Have also planned some better week day meals.
Thanks for everyone's suggestions. Good to know my little first percentile isn't alone !