Overweight 3.5 yr old

[frazzledmumoftwo]

DD (3.5) was a large baby (8lb 11oz), and has always had a strong appetite and liked food. She has consistently been in a very high percentile for weight, and lower (50-75%) band for height.

She was a late crawler (10 months?) and very late walker (21 months), due in part to hypermobility issues we now think, but is now nicely active. Loves scooting, will run about, jump, climb, play, etc. Really enjoys being able to pedal her new bike. So there is a history of underactivity as a baby/toddler but is now definitely lively and active.

In addition to general running around and playing, she swims once a week, is doing a toddler football class, and they are very active at her day nursery (lots of outside play, she attends 4 days a week).

A lot of the baby chubbiness has gone, but she still seems to have stabilised in a reasonably overweight status, that just will not change. Current height 93cm, weight 17.1kg.

Re food, we eat healthily. Very few sweets (just very occasionally as a treat). Water or milk (semi skimmed) to drink. She is given a very definite smaller portion of food versus her 5 year old brother (I try to give her roughly half his portion). She happily eats vegetables, and they form a large part of her meals. Snacks are only occasional and are restricted to fruit (particularly loves banana), low fat yoghurt, rice cakes or raisins.

I think our problem is portion size & appetite. We are trying very hard to address this, but just still struggling. She is eating healthy but wants to eat so much! She will eat a meal, a reasonably sized meal, have a small "seconds" (usually just vegetables, or some of the first planned portion deliberately held back as she likes the principle of being allowed seconds) and then sob (yes, literally sobbing in tears) at the end that she is still hungry and wants more. Nursery think that something is not working correctly with a "I'm full up now" trigger not kicking in. (They worded it much more professionally than that, but hopefully you know what I mean.)

We are off to see the GP soon, as I think it is time we spoke to him. But in advance of that, would anyone have any suggestions?

If it's 'feeling satisfied' that's the problem you could try flipping around the nutritional make-up of her meals a little. 'Eating healthily' for adults often means eating low-fat. However, fat and protein are the most satisfying elements of a meal so you might want to increase them proportionally in relation to vegetables and starches. I would offer full-fat milk rather than semi-skimmed, for example. Naturally sugary foods like fruit and raisins, or refined starches like rice-cakes are not unhealthy by any means, but they can act as appetite stimulants rather than suppressants. What happens if you give her the same-size portion as her older brother? Does she still cry for more or is she happy with it?

Thanks for reply. Interesting thought about the fat & protein.

Re your question, if I gave her the same size portion as her brother, she would eat it all, but probably wouldn't ask for more, or at any rate wouldn't cry over it. So the "full up trigger" would eventually kick in, but she would be eating a massive (for her) portion and is already overweight.

Please read how to feed your child, helping without harming by Ellyn satter. Has transformed things in my house!

At this stage I would be less concerned about wheres she appears on the BMI scale than the obvious distress of being left hungry or denied food. She's at a stage in life where she is growing rapidly so her height and body-weight are all fluctuating. A muscular child will be heavier than one that is less muscular. If she is normally active, enjoys a good range of healthy foods and has a good appetite (rather than some problem with her 'full up' trigger), things should level out eventually.

Are you or her father particularly tall or broad shouldered? Grandparents? Do you have any photographs of yourself the same age? Siblings that age? Children tend to follow the similar growth patterns to parents.

Your DD sounds like a very similar build to mine. I just posted about her as I did a BMI calculator for her & she came out obese. She is 4 yo, 105cm & 20kg.

Someone said on my thread that protein & carbs should be a serving the size of the child's hand, & veg should be a cupful in your hands . Am trying to bear that in mind when serving her. It's hard, isn't it? We eat a good diet & she is active, & I especially don't want her to pick up on any anxiety.

Mine has a very small appetite actually (!), not sure how I would feel about denying her food if she is crying in hunger.

I have twins. One is underweight, he really takes after my family of tall, skinny men. The other is overweight. He really takes after his dad, really stocky and muscular. What can you do? It's just the way they are. As long as you aren't feeding them crap. If she is so active she needs the calories.

RillaBlythe,
Yes I feel really bad not letting her have more when she sobs, but yet I will feel equally bad if I am the mum who did nothing when all the warning signs were there, and then she ends up with a weight problem. Trying to get the balance right is really stressing me out.
The protein and carbs measuring is a good idea ... I'll try to remember that.
I am also really worried about not letting her pick up on any anxiety, although I have talked to her about it a bit, as she does tend to respond to a simple chat on things rather than lots of not understanding why M&D say she can't do xyz. (We are also trying to stop thumb sucking at the moment....)

Cogito,
Both DH and I are relatively slim build. As a kid I used to be tiny. When I was first at school, I was the smallest in my school ... slim and short ... Later in my mid teens I used to eat loads & loads (ie 2 donuts at breaktime at school, toasted cheese sandwich and full fat ribena as "snack" after school) and still was small ... I think I only weighed about 5.5 stone when I did my GCSEs. Unfortunately I have to be a bit more restrained in what I eat now, but am still only size 10-12, average height. DH is a sporty "wire-y" build. So DD isn't really like either of us. Older brother DS is slim, very active and often starving.

Protein and fat is very important in a child's diet. Please don't give them low fat etc all the time.

Regular greek yogurt ( add honey/ fruit)
Avocados
Nuts
Chicken/ turkey
Bananas
Eggs

These are all the easy ones to add

Try giving her porridge or eggs for breakfast

Include protein at every meal

Things like cereals are not very filling for long even for me as an adult. I know if I have a huge bowl of cereal alone I will be starving by mid morning and I don usually snack.

I'v always been a hungry person but doing means I stay full ( size 8/ 8 stone so not obese)

Also make sure she isn't thirsty but mistaking it for hunger. Try to give her some water 10/15 mins before her meals

dd1 is 5, and has had periods of being classified as overweight. we do monitor her portion sizes, but generally have notice that she tends to grow out before she grows up. so she'll become (slightly) overweight for a very short period, and then have a big growth spurt and stretch out a bit. so i guess i would just monitor things for a while, making sure that there's not too much of an upward trend, and see if her height catches up, before making any drastic changes.

WHat is a typical day for her, food wise? Agree with everybody else that she may need more protein/fat.

Is it possible that she's just about to shoot up? DS got very chubby before a growth spurt