underweight kid - page 4

dear school nurses, im new to school nursing and have a question and hope i can get some answers please. a teacher brought down a kid to me who is 37lbs and has a BMI of 14.6. now this is in the 5th... Read More

  1. Visit  intheweeds profile page
    1
    My daughter is 3rd percetile. I'm aware and ped is aware and we're not worried. I wouldn't mind an 'FYI' letter or call AT ALL. We don't do BMI measuring at my school, but I think a letter stating something to the effect of "There may be many reasons for BMI to be outside the norm, but we recommend that talk to your pediatrician if you have not already done so" would be pretty inoffensive.
    Simply Complicated likes this.
  2. Visit  classicdame profile page
    1
    have parents considered patient may be undiagnosed Type I diabetic??
    sharpeimom likes this.
  3. Visit  ProfRN4 profile page
    3
    I'm always surprised (but not really) how PROFESSIONALS here are so defensive about certain things. If this were a plain old parenting board, I wouldn't be surprised at all. But this is a licensed professional with a concern. When we are talking about the lay public, we cannot assume they know everything that we Do, what is WNL, both physically, cognitively, developmentally or behaviorally. I am a Peds nurse, and when my child was in pre-k I got a note home suggesting that I work with my child, regarding zipping her jacket, there was nothing developmentally; just always did it for her! I was not at all offended.

    It here could be a million (well, maybe not a million) reasons the weight is below the curve. In clinical, we recently had a teen-age pt who was the size of an 8 year old. He had crohns. Docs told the family he probably had it for about 5 years and didn't know it. obviously if he was the size of an 8 year old, he's been below the curve for years. Bt let's throw stones at the school nurse, because its not her business to observe and act on a normal finding... Until the parents are looking for a lawsuit. And they pull the school records and see that he's been weighed and measured every year and no one did anything.

    As a society, we need to get over ourselves, and not be so suspicious and defensive.
    sharpeimom, Elvish, and Flare like this.
  4. Visit  momnurse23 profile page
    1
    Quote from intheweeds
    "There may be many reasons for BMI to be outside the norm, but we recommend that talk to your pediatrician if you have not already done so" would be pretty inoffensive.
    I think this part is important and may "soften the blow" so to speak. Even our vision/hearing screening referral letters say something to the effect of "this is only a screening and does not necessarily mean there is a problem."

    I'm also wondering if in the OP this was part of a yearly screening. If so, was this different from last year? If the child is routinely in the lower percentile it may be the child's norm but if the child suddenly started losing weight then there may be more to it. I know that for some reason our PE teacher is required to do a height and weight in gym class, but I do not do one in the clinic. If I had a student I was worried about I might be able to check with her as well.
    Sudsy likes this.
  5. Visit  mustlovepoodles profile page
    1
    Quote from kingsmiley
    dear school nurses,
    im new to school nursing and have a question and hope i can get some answers please. a teacher brought down a kid to me who is 37lbs and has a BMI of 14.6. now this is in the 5th percentile which means the kid is underweight. now will u handle this situation. call the parents, send a letter home? what? any info is very much appreciated
    If the kid weighs 37-lbs and has a BMI of 14'.6, he would have to be 3"6", right? I dont' think that is terrible, if he is very young. I have a couple of kindergarten kids at school who probably are this small. Their parents are aware and they are being followed by their doctor. I think my oldest son was probably close to this BMI.
    kingsmiley likes this.
  6. Visit  MommyandRN profile page
    1
    I am sure the parents already know. Do they go to the pediatrician for well visits? They get weighed there too. My kid was way below the percentile chart for years. Was on meds for acid reflux. Then at age 3 decided it's just a case of being petite. And a picky eater. There's not much I can do as a parent. Unless this family is extremely uneducated and poor, they are well aware of their child's weight. Maybe if this is an area where you think the family does not go to a pediatrician once a year, and really needs an intervention as far as feeding them, then maybe give them a call. But as a parent of an underweight child, there is no need to. Would I be mad if you called me? No, I would understand that you are concerned. But don't be surprised if the parent says yes, I know, and there is nothing we can do about it.
    ProfRN4 likes this.

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