Should I question school actions ?

[lottysmum]

DD started private girls school last Oct, very happy settled in quickly and had a good selection of friends.

Today I had a call from school nurse just to inform me that she had seen DD today because a couple of girls were concerned that DD had an eating disorder....

DD is a like a stick insect and always had been since she was 3 months old (she is between 9th and 25th Percentile), she eats well - picky in terms of she doesnt like butter (limited amount of cheese) - varied diet (she eats Indian/Chinese/Thai) ...she's not into fancy food - just likes most things plane and if she does have Indian/Chinese etc the sauces are mild (Korma/Sweet and Sour etc).

The nurse stated that she was not concerned about DD, she said that DD was happy and chatty when she saw her and DD had stated that we chat about weight - which we do - I would love her to put "a little" weight on but given that she has a small tummy then we just manage her weight as best we can .... The nurse stated that they had recently had a PSHE lesson where the girls had been encouraged to come forward if they felt that their friends had any issues ...hence why she thought that the girls had come forward

DD was bullied about her weight at her previous school - accused of being anorexic etc (which she isnt) ...so I am a little annoyed at this raising its head again - I just wonder whether a call to myself before speaking to DD would have been more appropriate ....

I have asked the Nurse to speak to the two girls because I am concerned that this will become a topic of conversation all the time which will make DD more self conscious about her weight ....

DD is very healthy rarely ill .....

Your thoughts would be welcome ....

I would be careful about dismissing the girls concerns, you almost imply it is gossip. It took courage to come forward and they showed they were good friends to raise it through the school nurse.

My Dd2 slipped from very slender to an eating disorder very quickly after her father died and early intervention allowed us to manage this. She is now at university happy and healthy but she knows that when she can't eat she needs support.

Whilst I am not at all implying there is an issue don't dismiss it, you don't know how she acts at lunch and there might be red flags. People with eating disorders are amazingly good at concealment.

Good luck and be glad she has good friends!

Did the nurse agree to talk to the 2 girls? Did you tell her about the bullying? And did the nurse let on to your DD why she was talking to her?

I don't think the nurse was wrong to have spoken to your DD. It sounds like they've had a very valid discussion in PSHE, the message has sunk in, the school are acting on concerns the girls raise and the nurse is taking appropriate and sensible action. This is all good. It's just a shame your DD was the trigger.

I wouldn't worry too much, as long as you can make sure this singular incident gets nipped in the bud.

I would echo tryings concerns. Many children are stick thin. Few have the suggestion made that they are anorexic. For it to be suggested twice about your DD in two different schools means it is likely rightly or wrongly that there are other red flags.

What do you mean by "a small tummy"? that is an odd thing to say!

You should be very grateful that your daughter attends a school that is so pro-active about identifying eating disorders. It sounds like a very good school, it's a shame all schools aren't.

I think that's very responsible of both the girls and the nurse.

You say she is 9- 25 centile - for what weight for age? What's her height and bmi? They're far more revealing than just weight centile. 9th centile for a 12 year old who is 5' 10'' tall for instance would be a virtually off bottom of the bmi scale.

DD is 13 and 158cm .....she is very slim but also has incredibly long legs hence why she looks "even slimmer". It runs within wider family both my nieces are 6ft tall and very slim but very healthy now 16 and 18....they were referred to the hospital by school nurses at some stage in their school life....

Everyone thinks DD is slim but she has always been like that ....she has never been referred to a hospital after weigh in's and her GP has never raised any issues .... (She's very rarely ill )

She eats well at home in fact she has two cooked meals a day - dinner at school and dinner at home (always dinner plus a pudding at home)...always a snack after school ...loves milk shakes and chocolate too!

The girls commented that DD didnt eat has much bread as they did at lunch ...(Lunches at school effectively are like a proper "Posh" restaurant - see below)

SMOKED MACKEREL & HORSERADISH PLATE
with pitta bread shards & summer green salad
PANKO CRUMBED CHICKEN
with katsu curry sauce & oriental salad
C H A R G R I L L E D M E D I T E R R A N E A N V E G E TA B L E F I L L E D P I M E N T O
with a creole sauce
JAMAICAN CURRIED MUTTON
with fried dumplings

DD has often stated that sometimes she has only eaten certain things because perhaps the sauce was too spicy and therefore when she has come out of school she has asked for something to eat straight away.....so she isn't hiding anything - we have an open discussion about food and because she is slight she needs to ensure that she does eat small and regular .... We had an occasion 18 months ago when she had a three course meal and ended up really poorly because she had eaten too much (painful tummy ache). I have said that she can take sandwiches if she would prefer but on the whole there is something on the menu that she can east - Pasta Bar ....

The school nurse stated that she would speak to form tutor to speak to the girls (not to tell them off) but to say that she was not concerned about DD ....

I suppose I feel that it would have been nice to have had a call from school where I could have spoken to them before DD was spoken too - although she seems to have handled the situation well ....I'm just mindful that we sent through this issue 12-18 months ago with girls teasing her about weight ...which is just naturally the way she is ...

From the point of view of safeguarding/looking after the interests of the student, there is of course a risk that if a student did have an eating disorder then this may be triggered in some way by something going on in their homelife, so I'm not surprised that the nurse talked to your dd first. I can understand why you might be frustrated. Equally it does sound as if this might not be the last time the issue gets raised, and it does mean that you can discuss with your dd how to handle it in future. Sounds as if she handled it well here.

I work with children titchy but anorexia and other eating disorders are not my area of expertise but I do listen to my colleagues who are experts talking about it, as far as I understand BMI is not used in children, centile are, it is also about the amount of weight you loose over time and staying on the same or near to the same centile. So for example my DS2 was up until recently was on the 99th centile for height but the 25th for weigh they always have been. For unrelated reasons his weight and height have been monitored all his life and at various stages in his life I have raised concerns about him looking very thin though God knows he never stops eating but have been told that as he's consistently on these centiles no one in concerned. Now in his later teens he's filled out and his weight has recently jumped three centiles.
I think it was good that her friends raised it and the school nurse spoke to you, if you concerned perhaps see you GP.

I guess it has been commented upon not because your dd looks thin, but because she hardly eats anything at school. As it was raised by your dd's friends, I wouldn't worry too much about it at the moment, as that doesn't sound like bullying, so is different from the situation at her previous school. At least if she is eating at home, you know she isn't starving herself, even if she isn't keen on school meals.

I too think the school should be commended for being proactive, raising this issue as a serious concern, and encouraging the ethos of seeking help for friends if you are concerned.

I think you just need to keep the red book going - highlight she's always been "long and thin" and that it runs in the family....maybe keep a food diary for a week to show what she actually eats.
The nurse had to speak to her, the concern having been raised, as others said - it might have been related to issues at home.

Thanks everyone ..... I do understand that the school is pro active in asking girls to look out for others within their peer group....

Obviously my issue was that my DD has always been very slim ....there is no change ...I also think that this was an instant reaction after the PSHE session which covered eating disorders etc ... DD did say that one friend had asked her whether she had an eating disorder straight after the session of which DD replied No - friend then stated but people with eating disorders always say NO because they hide it ....

I think generally she does eat well at school (apart from days when there maybe nothing on the main menu that she likes - like most kids)...she doesn't eat as much as her friends because they are all VERY sporty (some in county teams)- hence their appetite may reflect this ...DD has also just had braces (11 weeks ago) so she had a few days when she struggled to eat certain foods and another day when the braces were tightened that she struggled again ...

For me its just frustrating because her weight has always been a worry effectively since birth (she was a big baby who dropped from 75th to 9th but HV's were always happy because she was eating, active but contented) ...I do wish she carried more weight ...but she is consistently between the two centiles and I dont have an issue with how much she eats - in fact I spoke to her dad (we share care) and he said if anything she was eating more now than she was a few months ago and eating quicker (she has enlarged tonsils so eats slower than most children).

She's happy....healthy and I hope in an environment where she will not be picked on for being "skinny" ... I dont mind concern just as long as that is all it is ...rather than her being constantly being made aware of her size.... Size does not necessarily reflect eating disorders

I can come at this from a slightly different angle. The two friends angle.

When I was at school one of my friends, though not one of my very close friends was anorexic.

She was always slim (and beautiful). She didn't eat badly either, I've a small appetite and I remember partnering her on a school trip and she definitely ate more than me at some meals. And she ate something at every meal.

About 2 months later some of her close friends started getting concerned. They'd noticed that her school skirt was hanging loose on her, and then she offered one fo them some trousers they'd liked because "she no longer fitted in them"-and turned out to be because she'd lost weight.
They initially apporoached it in probably totally the wrong way, and kept offering her things, in a fairly natural way, as far as I know she didn't notice. But she kept on losing weight, and the point came when something happened, I'm not sure exactly, and a couple of her friends came straight out and round to the senior mistress to share their worries.
Mum was phoned, and actually her reaction wasn't too dissimilar; that she'd always been thin, and had a small appetite and it wasn't an issue.

Two weeks later she was, at the insistance of school, admitted to hospital where she was in for 6 months. I think she was about 5'10" and around 6 stone in weight by this point.

Now actually the friends who reported it were desperately upset. They felt blamed by the mum, and terribly guilty that she'd been admitted to hospital-and at the same time terribly guilty that they hadn't done something sooner.

So I think you need to acknowledge that the girls did the right thing. They came and talked to a teacher, and it probably took a lot of courage to do that.

Having the full braces fitted can make a huge difference to a child's ability to eat and impact on appetite. Mine, even when hungry, can turn away food because of the issues and length of time it takes to eat, especially with all the tightening trauma. She's also very slim, tall and sporty, and has learned that other girls talking about her (e.g. when she was in the toilet and she overheard a group analysing if there was an issue) was with positive intent, not malicious. Her close friends know she can eat like a horse. I will have to keep drumming this into her, that if girls do gossip maliciously, they have the problem for other reasons (including possibly jealousy), not her.

Your DD's school sounds very sensible. Girls only environments can be more rife for eating disorders so the fact that your DD's friends are confident enough to flag a concern is great, even if it is the wrong conclusion. Your daughter's shape is her shape, if all is well with eating in general, don't try to change her/bulk her up etc (Mine was always below 9th percentile, I stopped seeing mid wives VERY early!), and just keep an eye through the methods highlighted by other posters as girls can change so quickly in these difficult hormonal years.

Absolutely spot on that the nurse talked to your DD first before you.

Do take on board all your comments - Deewe - I have actually altered DD's school skirt because it's now too tight (she popped two buttons) so I know she's actually put on weight since she joined the school....

I do feel that sometimes a little bit of knowledge can be a detriment though, in DD's case her closest friends actually couldn't believe that this had been flagged up ...

The friend (s) who did flag it up in DD's words are a little over reactive in flagging things up ...DD had an issue with one girl when she joined who was being a little unkind (this girl had a small friendship group and felt threatened when DD joined and became friendly with her BFF). Friends wanted to flag it up has bullying (which it was low level), but DD said no and actually handled it really well herself (and is now friends with this girl).

I've thankful that I'd like to think that I have a very open house in terms of DD can talk about anything - she had been bullied on several occasions for diverse reasons (she has gap in teeth - hence braces)...she knows I am protective and will support and deal with issues (I did address bullying with last school) She's also mature and we talked about the fact that the girls were only showing signs of concern ....

Its odd how this does make you feel under the microscope and I did end asking DD to have an extra yogurt yesterday at breakfast ... hopefully she's not feeling under the microscope too ...