Overweight 4 year old. Looking for advice.

[OhThunderRoad]

I’m so sorry this is so long but I didn’t want to miss anything!

DS (4 and 2 months) is due for his reception health check soon. We measured him today for interest and he’s 107cm and 20.5kg. This puts his BMI on the 91st centile which is just into the overweight category.

I’m surprised by this and would love some advice if anyone can see any improvements. FWIW I am 5ft6 and 59kg and his dad is 6ft and 72kg, ie we are both pretty slim, his dad verging on skinny.

To look at I’m not sure you would guess he’s overweight. He has slim arms and legs and no fat around his face with a slim neck. His belly is flat in the morning but can be a little rounded by the end of the day. He still has a tiny bit of padding on his lower back. His upper ribs are visible but not his pelvic bone or his spine. If it makes any difference, he has a ginormous head (off the top of the centile chart) like everyone in DH’s family. Paediatrics investigated as it was so big as a baby and subsequently said nothing to worry about, just genetic.

We travel nearly everywhere on foot including school. He doesn’t mind walking but generally balance bikes everywhere. Maybe I am kidding myself this is as good exercise as walking? Of a weekend he’ll easily balance bike 4 or 5km per day alongside doing football on a Saturday and Gymnastics on a Sunday (an hour each) and often a few hours at the park and lots of sessions on his trampoline. He is very physical in school. I am pretty confident he is above average when it comes to physical activity but happy to be told otherwise.

He likes to eat. We are very lucky he eats a wide variety and easily > 5 fruit/veg a day. But maybe portions could be reviewed. Today was probably pretty standard for a day at home:

Breakfast: 1.5 pieces of 50:50 toast, a scrambled egg and 4 strawberries
Snack after gym: yo yo fruit winder
Lunch: 1 crumpet with tuna sweetcorn, half a pack of mini cheddars, cucumber sticks and carrot sticks, a teaspoon of hummus. Half a banana with a tablespoon of custard.
Tea: toddler bowl of butter bean, tomato and chicken stew with basmati rice. Handful of blueberries and a chocolate he got from school on Friday he found in his bag!

We are lucky that he isn’t fussed on cake or biscuits. He likes sweets and chocolate but they really are special treats from parties (we don’t have in the house). He prefers squash but we only allow 1 cup a day with lunch, otherwise water. Pudding is 95% fruit if it is served.

I really am open to any suggestions so please fire away.

Looks to me as though he's on the 97th Centile for weight and between the 91st and 98th for height.

I would say that that's not overweight but in proportion for his height.

If you do want to check that you're offering a good, balanced diet for a child of his age I'd check out this guide from the Caroline Walker Trust

Has he always been in this centile? My four year old was a similar height and weight as this at her 4 year check up but the health visitor wasn’t concerned as she has followed this centipede since birth. Also, as the last poster said, he sounds like he’s in proportion for his height and I’d say he’s at the top of the healthy weight range rather than into the “overweight” category.

I love the idea of following a centipede I stress of a centile!

My 4 year old is similar (98 cm and 20.6kg)

We know it’s normal for the girls under 5 to be like this in our family though so have declined a referral to the child obesity service

Thank you @PolaroidPrincess

His portion sizes are probably bigger than average. I’ve trawled other threads and he seems to eat more than the average 4 year old. TBF he doesn’t eat far off what my mum (his grandmother) eats. But equally he’s just so physical I can see why he needs to. He won’t think twice about walking 5 or 6 miles if we are on a day out we are enjoying. He sat and played with toys for an hour today, probably due to tiredness from starting school and it’s the stillest I’ve seen him in years.

Without meaning to be harsh, there are a couple of kids in his class who are notably fat and he looks nothing like them. He certainly isn’t bean pole skinny, but equally he looks more similar to the skinny kids then the clearly overweight ones, albeit just bigger my pelvic floor still hasn’t recovered from his head 4 years on.

😁

I honestly don't think you have anything to worry about. DN has always been on the 98th for both weight and height. They are a very regular looking adult now, albeit pretty tall

Not quite. At birth he was just above the 75th centile for both, head >98th. He breastfed like a champ though and was >90th for height and weight by 6 months and has kinda stayed that way ever since.

My four year also has a massive head and also had investigations as a newborn to rule out any medical causes! I really wouldn’t worry. His diet sounds great and he gets loads of exercise. It’s probably just how he is

I don’t think he is overweight at all. I would not restrict his food intake.
He needs food not just for daily activity, but for growing and development.
The general rule is height and weight percentile should be close. They don’t need to match exactly as there are different body types and more physically active kids will be a bit heavier than their just as tall but less active peers due to higher muscle mass and higher bone density.

Thanks all. I’m not sure if I’m being stupid but it’s this calculator the letter from school say they use: https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-children-teenagers

And this is what’s telling me from his details that he is overweight. The letter from school says we will be notified if/when this is the case and potentially referred on. It made me feel gutted tonight tbh. He was a massive gorgeous blob of baby but it all just seemed to fall off him from age 2.5 ish (when he could run and climb really) so I really wasn’t worried (maybe stupidly).

I got this letter through the other day for my DS and I'm trying not to worry about it as we saw his doctor recently for a chest infection and he's on the 98th centile and she was not remotely worried as he's been on it since his birth. She just said he is as he is.

I'm not a massive fan of BMI. As you're finding out, it can give false information about being overweight.

Much better at this age to go off the WHO Growth Charts as then you can see height alongside weight.

Just measuring weight is pretty meaningless