Is my 4 year old overweight and what should I do?

[RoseGoldEagle]

I was told by our HV that DD is overweight. She’s on the 91st centile for weight, which is the same as she was at birth (she’s now 4). The problem is that her height, which was 75th centile at birth, has dropped to under the 50th- it’s been like that for a while. So there’s quite a discrepancy between her weight and height. We feed her a good diet- range of healthy foods with the occasional chocolate/sweet thing so it doesn’t become an obsession but overall she eats well, and I did lots of research into portion sizes etc and think they are fine. DH and I are tall and slim, not that that’s necessarily relevant. She has what I feel is a good attitude to food at the moment, enjoys a range of things, has a healthy appetite but stops when she’s full. HV suggested reducing portions but I’m so wary of doing it as I’ve read restricting food can lead to over eating in the long run as they then binge when they can, and lose their agility to self regulate. (And I feel trying to bring her down to 50th or 75th centile when she’s always been on the 91st seems wrong somehow). Am I in denial though, certainly taking her height and weight into account she’s coming out as very overweight. Any advice would be really appreciated, please be kind, I’m really worried but just don’t know what to do for the best. Thank you!

I think that sounds like a healthy diet and similar to what my waif like nearly five year old eats. She is likely about to shoot up in height! I would keep an eye on things but honestly it sounds like she eats really well and is really healthy.

That does read like a lot of food to me OP. I’m saying that to be honest and supportive so please do take it as it is meant. Perhaps consider how you would feel about the amount if you saw it all in one place, all at once? From what I am reading it looks like three substantial meals plus a snack and quite a big pudding.

My teenage DC eat a LOT at the moment (I also have younger ones) but that reads to me like my teenage DC’s habits, and they are in full teenage growth spurt territory. There is no filling up my age 14DC at the moment and due to lockdown I know exactly what they are eating daily. At age 4, toast would be one slice cut into four pieces. A sandwich for my youngest is one slice of bread with the filling, cut into two pieces. Pudding is occasional as in 1-2 meals per week and it’s fruit or a yoghurt, not both.

I know you have been looking at suitable portions but perhaps you could let her serve her own portions? My DC have often been fussy beasts and placing all the food (including any pudding) on the table and letting them pick and choose and be in control has often helped with their willingness to try/ease of regulating. Because if you serve a portion, you are essentially regulating on their behalf, and I read above self regulation is something you are keen to encourage? It also helps to put pudding out so they know to compensate for it by balancing it with the main meal? Every so often my dc have just plonked the pudding on their main plate too but never mind. It all goes down the same hatch!

Good luck OP

Fruit and yoghurt is not enough for a small child for breakfast. It's not filling enough. Breakfast is the most important meal of the day.
If anything I'd swap the bread at lunchtime.

Depends on the size of the bread too, but actually I think that sounds like quite a lot of food.
For contrast, my 13 yr old DD will eat one slice of toast and some cereal, or porridge for breakfast. Lunch would be a sandwich made with one slice of bread, or a wrap, bagel etc with some cheese and carrot sticks. Evening meal might be something like salmon, noodles and broccoli. She will have something sweet during the day - maybe some sweets, biscuits etc, but she rarely has a pudding after lunch or evening meal so has it as a snack instead, plus a bit of fruit at some point.

I have an 11yo (136cm, 30kg) and 8yo (122cm, 21.5kg) both girls.

Breakfast: 1 handful of bran flakes with oat milk. OR a soya yogurt with dried fruit. OR 1 sachet of flavoured porridge.

Either no snack or a piece of fruit OR 1 crumpet with nut butter.

Lunch: sandwich with 1 slice of bread, dairy free spread, a filling, 4 cherry tomatoes. OR a small sized wrap, smear of hummus and 2 falafel balls. OR half a tin of soup.

No snack

Dinner: Side plate sized portion of sausage pasta bake. OR 2 slices of 12in pizza 2 slices of garlic bread. OR 1 palm sized serving of chicken pie, 2/3 new potatoes, 2 tablespoons of sweet corn.

Dessert: 2/3 times a week. Small pot of ganache. OR 1 tablespoon of crumble with a drizzle of cream. OR 1 tablespoon of ice cream with berries or 4 mini meringues.

Give or take some serving sizes for the younger one.

Can you clearly see her ribs? You can in a child who is of healthily weight.

Her diet sounds very carb heavy. Proportionally carbs should make up 1/3 of her diet.

Does she actually look overweight?

My DS is just 4 and eats a similar kinds of diet and similar quantities. He is a bit of a bottomless pit. He demolishes a fruit bowl, hoovers up the leftovers on his brothers plate, asks for seconds.

He is tall (91st ish) but his weight is completely off the centile charts way above 99.9...he is very heavy! But...he doesn’t look overweight. His ribs stick out, no belly, no chubby wrists. He has legs like tree trunks, a broad chest and shoulders (wears t-shirts for 8 year olds), really big head (wears adult size hats!). So he is out of proportion weight and height but that really is just his physiology. Genuinely a ‘big-boned’ child!

If she looks a bit chubby I’d look perhaps look at her diet but if it’s just being read off the centile charts alone then I would question whether anything needs to change.

You're a good mum for posting and asking.
I have a 4 year old who is just under 50th centile in height. She weighs 16kg which I think is near enough what she should. I've been fat my whole life so am very conscious of giving her healthy eating habits.
Anyway, in case it's a useful comparison for you she would never eat more than one slice of bread at a time, sandwich is one slice with filling etc. Graham crackers she might eat 2 for lunch but a snack only one. Your daughter does seem to be eating a lot compared to mine. Today she's had

• innocent smoothie on waking
• toast 1 slice and fruit for breakfast
• cooked lunch (stew) at creche
• babybel cheese and petit filou yoghurt snacks
• currently refusing all dinner so will likely eat some porridge or an oat bar later before bed.

Can you maybe get an online consultation with a Dietitian to get some really evidenced based advice?

If shes having toast for breakfast and you say 2 slices , then cut down to 1.5 .
Give her half a jacket potato for lunch and fruit.
Dinner could be some form of protein and vegetables and perhaps a small yogurt.

e is tall (91st ish) but his weight is completely off the centile charts way above 99.9...he is very heavy! But...he doesn’t look overweight. His ribs stick out, no belly, no chubby wrists. He has legs like tree trunks, a broad chest and shoulders (wears t-shirts for 8 year olds), really big head (wears adult size hats!). So he is out of proportion weight and height but that really is just his physiology. Genuinely a ‘big-boned’ child!

parents are really bad at seeing their child's true weight. There is not really such a thing as big boned-yes kids can have a larger frame than others but you have to be really careful not to use big bones as an excuse.
what is your son's bmi?
*

2 slices of toast and fruit is lots for breakfast my six year old couldn’t eat all that! Half a slice is plenty for a little tummy with fruit.
Try and avoid more bread at lunch try brown pasta or a brown rice to fill her up for longer.
Dinner sounds fine but it depends on the portion. Try upping the exercise and laying off the bread for a bit, would she enjoy a riviera and cottage cheese for breakfast?

Rivita*

would ANYBODY enjoy a ryvita and cottage cheese for breakfast??? really?!!

Breakfast: 1 handful of bran flakes with oat milk. OR a soya yogurt with dried fruit. OR 1 sachet of flavoured porridge.
Yummy...

My 4 year old is 105cm and 2stone 5 which puts her on about the 4th centile. She gets given pretty much the same as yours OP and is not even remotely active at the moment past the usual playing in the house. We probably go on two half an hour walks a week at the moment. Does she always finish all the food given? Mine's been mainlining snacks for the past few months as well because she's bored.

No-one especially a 4 year old would enjoy a Ryvita and cottage cheese. I think just amend the portion control. You haven't mentioned whether you think she looks chubby. I dont think anything drastic is needed, other than maybe up the protein a bit

You have asked on the wrong forum about eating OP. The competitive undereating on mumsnet extends to the children who have half a yogurt between all 4 kids and a tin of beans does a weeks worth of lunches.

My daughter has always been tall and heavy. She is 22.5kg and 113cm at just 4. I have had the discussions with the HV and now ignore them as I know she is going to be having another height growth spurt soon. She tends to suddenly get podgy and then shoot up another cm or 2 in just a couple of weeks. She has size 11 feet, and is going in to age 6-7 clothes mainly for the length of them not the width.

She has been 99th centile since birth, we have had this discussion on and off since she was a year old and I now refuse weighing.

@lockedownloretta it’s my favourite breakfast! I have it with pineapple too, both kids enjoy it. What’s wrong with it?

Could you get her into porridge for breakfast? It's more filling and you might be able to reduce or miss a snack later on. Bread makes me fat and hungrier. You are a good mum to address it. But it's so important to. If they end up an obese teen it's very hard to come back from.

I often think that when parents think a food is healthy, they allow a child to eat far too much of it. An apple has 95kcals, only 20 Cals less than a Kit Kat.

Your dd is eating a lot of fruit, and add in the snacks of very fatty cubes of cheese and cashew nuts, it will be giving her more calories than she needs. They may be healthy foods but they are high in fat and sugar.

Also, we should be mindful of worrying about a child feeling hungry and suggesting they eat some carrots, an apple, handful of nuts etc. It is a great thing to feel hungry in the run up to lunch and dinner and helps the child learn that they don't need to act on every hunger pang.

I know someone who will get her kid to eat some veg before they eat something unhealthy like chocolate. I always think this is counter productive because it just increases the volume the child feels comfortable eating.

Don't worry about it unless she becomes obviously obese. Kids' weights go up and down.

That is a lot for a 4 year old to eat, at that age my dc would only have one slice of toast and not finish it and a sandwich would be a quarter, can you increase her water intake, cup of water before meals or similar

I had this issue with my son he was 98th for weight since birth but only 75th for height after 2 years old I was told he was over weight

I fed him decent home cooked foods. Now he is 6 years old he is tall and slim, he only slimmed down in the last year I'd say

Give her more time to grow.

@gamesetmatch - half a slice!!?? Adult competitive undereating is one thing, but to encourage people to give too little food to children is batshit.

OP g my daughter would have eaten a simillar amount to yours at 4 and although not huge, was chubby. She's now 6.5 and her appetite hasn't increased with age so she's now considered in the healthy weight range. I wouldn't change anything and would watch and wait

It sounds like a normal amount to eat to me!
I certainly don't think it's uncommon for a child to eat a normal sandwich rather than one slice of bread!

My DD is also 4 years old and very tall. She was 10lbs 5oz at birth so has always been on the large side shall we say. Her intake is similar to your DD's. I'm shocked some children only eat a quarter of a square sandwich! Mine would be crying at that. They're both healthy but eat a lot more than some of these posters claim