Help with an overweight toddler

[Mushroo]

My 22 month old is overweight and whenever I try and raise it with the GP etc I just get brushed off and told it’s too early to be worried. But, I’m not sure that’s true?

Her BMI is 99th percentile - and she weighs about 12.5kg (about 80th percentile) and height is about 80cm (20th percentile). They might not be the exact right figures but thereabouts.

She just loves food and has eaten large portions since we weaned her at 6months. There’s no juice, chocolate, crisps, cake at all but maybe too many carbs?

Yesterday she had:
Breakfast: a weetabix, small scattering of Rice Krispies (about a teaspoon as she likes them but I don’t think they’re particularly a great breakfast), a tablespoon of full fat Greek yogurt with chia seeds and strawberries.

Nursery: see photo

Dinner at home: roast chicken, potatoes and peas.

I think the problem is she will just eat what she enjoys with no sign of getting full really! So she ate probably 3 or 4 potatoes at dinner which is what I would eat, but as she’s eating her veg and chicken too she genuinely seems that hungry.

I would say she probably has too many carbs, but cutting down carbs for a toddler seems wrong?

Actively level wise she’s at nursery all day, and I encourage her to walk there and back (it’s about a 0.3 mile walk) but she is not naturally a particularly active child and will resist walking.

Any advice? Am I right to be worried about this and cutting portions down?

She is constantly asking for snacks which I try and cut down, but she will often have a babybel after nursery, or some nut butter (she’s a little weirdo who just loves it on a spoon 🤷‍♀️)

She doesn’t sound overweight at all!?

Chubby babies are healthy, don't be silly.
All fine here, thanks.

@pambeesleyhalpert shes definitely overweight for her height unfortunately. I kept hoping for a growth spurt but I think we need to tackle her weight.

She doesn’t really have milk routinely - just a small glass occasionally.

The All+ at nursery is when she asks for more, which tbh happens a lot….

My toddler was really chunky..... at one point he genuinely ate more than I did in a day. He's almost 9 now and isn't chunky anymore but he is stocky.... He's as tall as my almost 11 year old DD, has same size feet / hands as her/ wears same size clothes

She isn't even two yet, I really wouldn't worry about her weight. Unless she's barrelling sweets, crisps and chocolates down, I would just let nature take its course and enjoy your mealtime together before she becomes a grumpy teenager!

I think 2 cooked dinners might be a bit much, even if it’s just a few nights a week. Maybe a small healthy snack at supper time if she’s ravenous before bed but otherwise it’s a lovely healthy and varied diet - I’d be very happy if my two boys ate as varied a diet as this!

80th centile for weight and height isn’t over weight. When she is naked can you clearly see her ribs?

I think it's ok that you eat together at dinner but she doesn't need to have a huge portion and it's ok to say no to her if she is asking for more. My kids could eat non stop if not given some clear boundaries about snacks and portion sizes.

If we were ever at a family party with a buffet out I had to always try and put food out their reach.

It’s a lot but only because you are duplicating meals. My kids are 2 and 4 and have their last meal at 3.30 and maybe a small snack if still hungry before bed at 6.30. I do understand that you want to enjoy family meals but I would knock that on the head for now and focus on an earlier sleep routine for your DD. Cutting out that final meal will solve a lot of your problems.

OP says she’s 20th centile for height, 80th for weight.

I have a child who eats like that - but he is extremely active and always has been.
Can you up her exercise quite a lot?
At 2 years mine was ok with walking 2 miles per day (to nursery and back), spend his day at nursery running around, with loads of outdoor play (balancing bike, 3 wheeled scooter, playgrounds, ballgames, swimming) in the weekend.
He’s 8 now, eats more than me and his 12 year old brother together, skinny, but still extremely active with at least 1 hour of organised sport per day, more most days.
probably best to both reduce food portions and up exercise!

I would ask for a dietician referral, your HV should be able to do the referral. If there are allergies involved you could use that as a reason for the referral if you get dismissed for the weight. I imagine some simple changes to diet would bring the weight percentile down over the coming months due to static weight rather than losing weight and then they will be in a better place.

Up to 3 percentile difference between weight and height can be normal. At 2 my daughter was borderline overweight as she was 50th percentile for weight but only 1st for height. Her dietitian and paediatrician weren't concerned as she looked normal and in proportion. She didn't eat a great deal and had a lot for dietary restriction due to a lot of food allergies and reflux.
At 4 she moved to 35th percentile for weight and 2nd for height and now at 5 she's just under the 25th percentile for weight and 4th for height. She does look better for the difference you can see her ribs more. She's eating more than she was at 2 although is probably more active. She became the size of a 3 year old at 3 and we noticed a huge improvement in what she could physically manage at this time. I think she struggled physically at times because of how small she was. At 2 she was still in 9-12 month clothes!

I think as others have said the issue might be the second dinner? Other than that, her diet looks healthy enough to me. For context my 18 month old DD has always been big and tall (haven't checked in a while but historically in the 90th centiles for height and weight). An average day is might be: breakfast 1 weetabix, some grapes and a few bits of toast or crumpet (shared with us), snack a banana and babybel, lunch a cheddar and broccoli tortilla wrap and fruit for dessert, snack an oat bar, dinner a jacket potato with tuna and corn and Greek yoghurt for dessert. Portion sizes vary a lot. Some days she will ask for more and others pick at her plate. I do think very active toddlers genuinely get hungry often. I wonder if there's way of building in more slow burn carbs and protein to keep her fuller longer?

I don't understand why so many people are worrying about her food intake - BMI is a meaningless metric for a toddler and 12.5kg is not heavy for a 22 month old at all. I am super strict about my kids' food in terms of loads of fruit/veg/protein/healthy fats and very limited processed foods but i would never restrict food beyond that i.e. if they are hungry my lot always are welcome to food.

Both my kids have been hugely fat at various points but they were both BF and once weaned only ate real food, nothing processed. I let them have as much as they liked. Once they started walking more they slim down. My 4yo is now very slim and the almost 2yo is going the same way.

I wouldn’t be concerned at this age, doesn’t sound from the weight she is that it’s a big problem. Probably due a growth spurt ion height and in 6 months will have evened out

She is very heavy for her height. According to the nhs calculator for children she’s 99% percentile of weight for height, so you are absolutely right in trying to find the reason.
Can you introduce a salad dinner at home? My bottomless pit of a child does well with carrots (the whole thing, not sticks, so its harder to eat), cucumber (pretty much water), whole apples, real bread (not sliced supermarket - sourdough bread with a crust) - pretty much everything that takes effort to eat to slow him down.
He’s hugely active, so we never had weight issues, but he does love food.

Ah! Then yes, that is a concern.

Does she look overweight? My toddler is 20th centile for height, and 75 for weight, but her head is 99 centile

I’m currently on mat leave so she goes into nursery a little later these days but she used to have two breakfasts, lunch and snacks through the day and then tea at nursery (beans on toast type thing), I would always offer her dinner when home but recently just do a snack plate instead.

if she’s having carbs at nursery I would cut out any carbs and sugar outside of nursery.

also perhaps water down any milk she has. Mine went through a phase of drinking cups of milk, I’d only give her half and would water down her porridge or weetabix

My DD was like this and I worried so much about it. The only thing I’m curious about is the Greek yoghurt and chia seeds - chia seeds are very calorific, which is fine if you are on a low carb diet, but she’s not and nor should she be.

How did you and your DH develop? Were either of you chunky toddlers who levelled out? My MIL did say to me this is just what DH was like but we were in the middle of a national moral panic about childhood obesity and there were all these experts saying on the TV that puppy fat was a myth etc so I wasn’t reassured… in the end DD did exactly what DH did, and, in the words of her childminder “sort of stretched” at 6.

Also, nursery menus always sound like feasts but the portions are usually very small

Definitely need to reduce that evening meal, she’s eating tea at nursery so only needs a light supper at most. If she wants Rice Krispies give only half a weetabix

Just to add, I did the conversion from pounds to kg and my dd was the same weight as your 22 month old at 5 months!
She was massive, and gorgeous, and healthy.
She has always been strong as an ox, fit and perfectly formed.

I didn't think to work out the weights to compare

My DS was 20lb by 5 month old 😅 he was so chunky compared to his older but dainty sister. She didn't reach 20lb until she was 10 months old

It's the two dinners.