BellaOnline Forums Health and Fitness Pediatrics When is Big Too Big?

I took my 19 month old in last week for a follow-up for her 18 mos checkup and the pedi said she was too heavy and we needed to adjust her diet. She saw her pulmonologist that afternoon and he was very happy with her weight/height; his main worry is children with asthma/pulmonary issues that aren't eating well and aren't growing. She saw her ENT the next day and he mumbled about the weight/height and suggested we see a dietician. She saw her orthopedist today and he's happy with weight/height.

She is a big girl--35 inches tall (plus or minus a wiggle) and 36 pounds. She's a milk addict and we switched her to 1 percent milk at 15 months. We also limit and still dilute fruit juice. She doesn't eat much junk--every other week we might hit McDonald's for a treat. But she does eat 3 solid meals plus 2 good snacks each day.

When is big too big and should we really worry now? She's very active, even though she has a little trouble walking (she has one leg a little longer than the other and is working on adjusting).

I'm about to pull my hair out. Her brother at 7 is 46 inches tall and weighs 42 lbs.

Lynn, I'm not a doctor BUT I say go with your gut.

I have a child who has always been bigger than the others, at 10 she's 91 lbs but she's also 5 feet tall and wears a women's size 8 shoe. She's always been above average on the charts and it's her normal. She is not overweight at all, in fact, she looks kind of skinny and I'm not sure how she can weigh that much. She was ALWAYS a chunky toddler.

My 2nd and 3rd are the opposite and fall around the 5% for weight. The 7 yr old is in 95% for height which makes her look even skinnier, she is 42 lbs but totally healthy. Kid #3 is 3 years old, 24 lbs and 38 inches.

Then we have kid #4. He is 19 months old, 26 lbs (bigger than the 3 yr old!) and 36 inches. He is asthmatic also due to something called alpha1 antitrypsin deficiency. Anyhow...he was teeny itty bitty as a baby, diagnosed failure to thrive! we saw a dietician along with all the other specialists and they had us feed him super fat stuff. They all want him to be bigger in case he gets sick.

Anyhow, while I dont think she has a problem and will outgrow the chubbiness maybe a visit to the dietician wouldn't hurt, if for nothing else he or she can give you hints about your child's diet and let you know from an outsider's view if there is a problem.

All kids are different and I'd follow up with what he ped things because I trust my peds as much as I trust my own husband. they aren't always right though <img src="/images/graemlins/smile.gif" alt="" />

meg

The big problem with our ped is that we use a group practice where the doctors rotate. So the opinion changes depending on which pedi we see that day. Out of the 5, 3 say "nice, healthy baby" and 2 say she's two big.

We visited with a child nutritionist and she didn't have many suggestions beyond change the milk, cut the juice and let her run.

I just feel like we're running in circles.

OK, I gotcha, we used to go to a practice like that. We switched to a different kind now and it's more of a PITA to make appts but it is nice to see just one doc.

Anyhow...what does YOUR heart of hearts tell you? Ignoring everything everyone else has told you, are YOU worried? Do your peds trust your opinion?

Meg

My son was big until he hit two, then thinned out even though he stayed short. My husband was big and did the same thing--but was tall. I'm happy to just let her be for now--especially as the doctors that are caring for her major health issues (the asthma and the bone issues) are very happy and they see her often enough to gauge her growth. She's still growing at an inch+ every 3 months.

It's just frustrating and I hate having to argue with them over this issue.

big is when your child is 75-100lbs at 2yrs old doctors are people like you and me they have to much pride to admit when they make a mistake it is a matter of opinon many have if you keep running around you will drive yourself crazy then it will be the doctors calling you crazy they did it with me children different races come in all shapes and sizes you have to listen to yourself or you will lose it

Fattina:

I wish I could say that weight is a matter of opinion these days. There is so much new data on when to worry about weight but what we don't have a good sense for is exactly when to intervene. That is that Lynn is describing and why she has faced so many different opinions.

I agree that kids come in all shapes and sizes and that race contributes to one's growth. But, there are true outlyers in weight and if we don't address those kids when young we now know they have huge health problems as adults.

You do have to listen to your gut as a parent but sometimes as parents we do not want to hear or see that there is a problem. I go by the rule of 3's. If you hear the same opinion from 3 docs in the same field, likely there is truth to the position. Same rule as deciding any fact.

By the way, I'd appreciate if you would use punctuation in your posts - it was really hard to read. And, please keep an eye on your tone and avoid over-generalization. Like all professions, doctors have pride but most are more than willing to admit when a mistake has occurred. I know many doctors and thankfully the situation you describe is a rare one.

Best,

Lynn:

You sure have many doctors in the mix for a small child! Given what you described, I�m not sure I�d worry yet but I would consider that a potential problem may exist.

What is her BMI? That tends to be very accurate. What you could do is plot her numbers yourself. Here�s a link to child growth charts and BMI information on my web site: http://www.pediatricsnow.com/tools_chart.html

I�m have no doubt your child is very, very healthy but the real issue is whether the weight is too generous for her age. It may very well be given a few docs have raised this as an issue. That said, when to intervene for very small children is still a matter of debate which is why you are getting some conflicting opinions. All we know is that childhood obesity is real and that kids with BMI too high during childhood do develop high BP and diabetes. We know in the medical community we need to intervene earlier but the details are still fuzzy.

I think your approach to wait and see is very reasonable at the moment. She is at a very active age so keep the diet healthy and see what happens by her next checkup. Usually that is what we do at this age in any case because more times than not it all works out.

If it would help, feel free to post a few more growth data points for your daughter and I'll plot them out myself.

I hope this helps.

Best,
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Meg:

I love your perspective - realistic and thoughtful and your suggestions to Lynn right on the mark.

I just want to point out that your 10 year old is in an interesting growth position. She is in early puberty and many girls hang onto a few extra pounds for a bit then slim down when they hit their growth spurt and get their first period. You are smart to not make too much of it yet. Plus, muscle weights more than fat so if she looks fine she likely is.

To be honest, I worry more when a child looks overweight - that's when the numbers start becoming more important. Kids have different body types and how they look and feel is always a huge consideration - at least it is with me.

Hi D.R. Gwen

I agree with everything that you are saying, it is that as parents we hear one thing and then another, and it drives us crazy I went through that with my 2 children and lost it. Yes weight is a very big issue especially child obesity a very serious concern and I have a few concerns unrelated, but the fact that I said doctors have to much pride yes some do some don't some cannot admit when they are wrong some can but that is what I have experienced I respect the fact that there are doctors in this world. Im not trying to offend anyone but if my opinion came out strong then Im sorry.
I will be posting some concerns I have with my 3yrold <img src="/images/graemlins/wink.gif" alt="" />