Obese Kinder Child

ruby_jane, BSN, RN · Jan 30, 2019

"We're all concerned." Whelp...then ALL of "We" should be contacting the parent with those concerns, no?

I think they're dumping on you. Happens sometimes. There are two ways you can go: First, jump in with both feet. Second, see my comment above.

You are going to get a lot of dumps. "I think you need to call CPS." "You need to tell the parent that their student smells bad."

What do you have time for? Did this kindergartner have screening already this year? If so, is this documented (I am sure that a disproportionate height/weight/BMI gets a letter home).

OldDude · Jan 30, 2019

I wouldn't proceed with anything. There's not a chance anything you say or do will have a positive affect on the girl's weight.

In Texas you'd be sending home an Acanthosis referral next year in 1st grade, and another in 3rd grade, and another in 5th grade, and another in 7th grade; each time she'll be heavier and heavier and when you see her in public after she graduates she'll still be obese.

I've yet to see a deviation of this cycle during my entire elementary school nurse career.

Guests · Jan 30, 2019

I've got several of those. We also provide free breakfast and free lunch and are not allowed to deny a child if they ask or if they take one. I had one K student last year who was morbidly obese, eating her breakfast at home, her breakfast at school, and any leftovers other kids weren't eating. Same cycle at lunch. She was sneaking food from kids under the table, it was really terrible. My heart hurt for her. I did make a call to her mother because I had to take her into my office after I watched her take food from another student without permission (even with permission they are not allowed to share food). Mom was embarrassed and said she would talk to her and the behavior continued. We are not the food police. We can only do so much.

**LibraSunCNM, BSN, MSN, CNM** · Jan 30, 2019

I can't imagine expecting the school nurse to solve that problem. As Old Dude states, if her parents also have weight problems, it's highly unlikely that any feedback you give them will magically cure hers, and it's almost certain to hurt feelings/ruffle feathers. Sad, but to be expected in a country where 1/3 of the population is obese.

Amethya · Jan 30, 2019

38 minutes ago, OldDude said:
I wouldn't proceed with anything. There's not a chance anything you say or do will have a positive affect on the girl's weight.
In Texas you'd be sending home an Acanthosis referral next year in 1st grade, and another in 3rd grade, and another in 5th grade, and another in 7th grade; each time she'll be heavier and heavier and when you see her in public after she graduates she'll still be obese.
I've yet to see a deviation of this cycle during my entire elementary school nurse career.

I agree. We have this issue as well and it will continue on, even after letting parents know.

UrbanHealthRN, BSN, RN · Jan 30, 2019

If you typically screen kids for height/weight/BMI, and have some sort of follow-up letter that you send home after these screenings, then I think that's all I would do, and make sure to include my phone number if mom wants to call and talk.

If the little girl is demonstrating inappropriate behaviors around mealtime, like stealing food from kids or shoving food into her mouth, then that could be addressed with mom. It could also be used as a gateway conversation to discuss her health.

I know we all want kids to be their healthiest and happiest, but honestly, I don't feel that I'm the appropriate healthcare provider to address weight issues with a parent. Compared to the kid's pedi, I'm a stranger who does not have a long-standing professional relationship with the parent.

Side note: we check each kid's height, weight, and BMI at the start of the year, and send home letters with that information + available resources if a parent would like help. One parent was so offended at her child being categorized as obese, she actually got the pedi to write a letter saying he's aware the kid is obese but it's fine.

Amethya · Jan 30, 2019

Just now, UrbanHealthRN said:
If you typically screen kids for height/weight/BMI, and have some sort of follow-up letter that you send home after these screenings, then I think that's all I would do, and make sure to include my phone number if mom wants to call and talk.
If the little girl is demonstrating inappropriate behaviors around mealtime, like stealing food from kids or shoving food into her mouth, then that could be addressed with mom. It could also be used as a gateway conversation to discuss her health.
I know we all want kids to be their healthiest and happiest, but honestly, I don't feel that I'm the appropriate healthcare provider to address weight issues with a parent. Compared to the kid's pedi, I'm a stranger who does not have a long-standing professional relationship with the parent.
Side note: we check each kid's height, weight, and BMI at the start of the year, and send home letters with that information + available resources if a parent would like help. One parent was so offended at her child being categorized as obese, she actually got the pedi to write a letter saying he's aware the kid is obese but it's fine.

Wow... that's messed up. We do AN checks and in turn we send parents letters that their kid is obese, but most of them ignore it.

tining, BSN, RN · Jan 30, 2019

Had an obese kinder last year wearing shorts/pants with zipper & button. Poor LD couldn't get them back on (had to tell mom about her clothing difficulty). Would also have breakfast at home and school. Lunch consisted of J.U.N.K. Already had the acanthosis marker.

EnoughWithTheIce · Jan 30, 2019

I am not sure why teachers think we have some sort of special ability to make parents / students make healthy choices!

Do they have special abilities to make a kid do their homework or pass a class???? Would they be offended if someone suggested that??

JenTheSchoolRN, BSN, RN · Jan 31, 2019

18 hours ago, EnoughWithTheIce said:
I am not sure why teachers think we have some sort of special ability to make parents / students make healthy choices!
Do they have special abilities to make a kid do their homework or pass a class???? Would they be offended if someone suggested that??

THIS. THIS x10.

Look, I'm not skinny. I had a rare time in my life when I was. But I'm active (though not as much in the cold winter as I likely should be), I try and make healthy choices when I can. But I'm overweight. I've been lectured at by a couple health care professionals (that were not my regular practitioners) and it made me feel so small. I remember that. Weight discussion with a parent/child that has no previous relationship with me may also make them feel small and that takes as all no where.

Also, I'm all for supporting a child that is ready to jump on that boat towards lifestyle changes, but I can't help someone who is still afraid of getting in the water.

Amethya · Jan 31, 2019

I have a student who came in yesterday for a stomach ache, kinder mind you. And I asked her why her stomach hurts, she says it's because she ate too much. She eats Mcdonalds for breakfast because if not she throws a fit and comes to school and eats the breakfast here.