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underweight kid

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by kingsmiley kingsmiley (Member)

kingsmiley has 5 years experience .

3,492 Visitors; 41 Posts

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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

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Flare is a ASN, BSN and works as a School nurse firefighter.

2 Followers; 5 Articles; 33,591 Visitors; 3,923 Posts

it all really depends on a lot of factors. how old is this child? Children can grow and change drastically in the span of a year - a severely under weight child may catch up by the end of the school year. Is there anything else going on in this child's world that may throw up a red flag? does the child refuse to eat or make statements about worrying about gaining weight? Is there a concern that the child does not get enough to eat at home?

We do heights and weights annually here in school - students with a BMI above 95% or below 5% get a letter per state law stating that their child was found to have fallen in this range. I have gotten in the habit of waiting until the end of the year and re-measuring the children that fell into the "alert zones" as many of them will have caught up or leaned out.

If you want a copy of the letter i sent home, i'd be happy to send it to you.

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1,715 Visitors; 28 Posts

As the parent of a young child who is in the 10th percentile in regards to height and weight for his age group I would be smoking hot if I had ANYONE from the school stick their nose where it doesn't belong. As long as the child is showing no obvious signs of abuse there is no reason to to insinuate anything is not right.Maybe the child has a high metabolism, maybe the child has a parent who is small and petite. There are many reasons why some kids are obviously smaller and not developed as others their age. That's why they have those graduated scales right? So 95% of kids that age are bigger, what's the big deal?That's just my thoughts on your post so please don't take it personal.

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CT Pixie has 10 years experience as a BSN and works as a RN.

35,397 Visitors; 3,723 Posts

My child is 'underweight' according to her percentile score too. Both myself and her peditrician are fully aware of that. Other than weighing less thn 95% of children her age, she is perfectly healthy in all aspects (physically, mentally and developmentally).

She was born at a weight not even on the chart. she was little . Took her a long time to make it on the charts. Her peditrician is very happy with her progress over the years and while she is still 'underweight' he has no cause for concern considering all the other factors (she is just as active, bright and healthy as any other child her age).

I, myself, am 'underweight' according to the charts (for that matter I am much shorter than the 'average' woman). My height/weight are that of the 'average' 11 year old, my sister a bit taller is still short as is my mother and her mother. My child's chances of being within the norm are very slim.

I'm not sure about laws in my state regarding yearly weight checks and mandated letters that go out, I've never gotten one. Nor has the school nurse ever addressed my child's weight with me or my husband.

I think before I'd be overly concerned and send a letter or whatever...take into consideration other factors. Other than weight, does the child appear healthy? Is he/she dressed in dirty clothes or are there signs that the child is fatigued or anything else that might lead you to think the weight is an issue. Does this child have siblings who are also on the lighter side, are mom and/or dad light also?

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schooldistrictnurse works as a School District Nurse.

6,287 Visitors; 400 Posts

I don't think a call to the parent would be out of line. Just an FYI. If the parents says I am aware and my child really has no health problems, then that's the end of it. I don't feel like it's interfering. I recently called a parent to report that her first grade son eats next to nothing at lunch. Same deal, just an FYI. Mom replied that he eats a good breakfast and is hungry and eats a snack at the end of the school day. Partly it's due to medication. No problem, thanks for the alert.

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Flare is a ASN, BSN and works as a School nurse firefighter.

2 Followers; 5 Articles; 33,591 Visitors; 3,923 Posts

As the parent of a young child who is in the 10th percentile in regards to height and weight for his age group I would be smoking hot if I had ANYONE from the school stick their nose where it doesn't belong. As long as the child is showing no obvious signs of abuse there is no reason to to insinuate anything is not right.Maybe the child has a high metabolism, maybe the child has a parent who is small and petite. There are many reasons why some kids are obviously smaller and not developed as others their age. That's why they have those graduated scales right? So 95% of kids that age are bigger, what's the big deal?That's just my thoughts on your post so please don't take it personal.

This is where a nice chunk of the aggravation in my day comes. The state makes well meaning laws that i have to follow or I'm not doing my job, but then i'm just trying to do my job and am accused of sticking my nose where it doesn't belong and have to deal with a parent flying off the handle. sigh... What's a school nurse to do?

oh, and for the record, i can think of 1000 things that would be a better use of my time than send the parents of the kids that are under/over weight a letter. I am pretty sure they've looked at their kids recently....

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I don't see any reason for the parent to be "smoking hot" over getting a letter that your child is in the 5-10% percentile for weight. It's not like we are "insinuating" anything or sticking our nose where it doesn't belong. Our JOB is to make sure that children are healthy and doing well. Part of that is yearly health screenings that include height and weight and BMI. I would think that parents would be more upset about getting a letter that your child is OVERweight than they would be getting one that your child is UNDERweight. If you're already aware of the situation, great. Just take it as note that your school nurse is doing her job and watching out for your child. If you aren't aware, well maybe it's something that needs to be checked out. I don't think any school nurse would automatically assume abuse because a child is underweight. There have been many other reasons listed that the child may be underweight. I would rather send 100 letters home to parents who are already aware than to stop sending the letters and miss a child who has a health problem that no one at home is aware of.

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3,249 Visitors; 113 Posts

My twins are in the 3%. I hv tried everything to get them to eat more & even went to a dietician - nothing has worked. They are activate 12yr boys, shortest in there class. My 10 yr daughter is also underweight, but she eats. Idk what to do, so I stopped forcing the issue.

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dfs1961 has 5 years experience and works as a RN.

4,195 Visitors; 77 Posts

Word.

This is where a nice chunk of the aggravation in my day comes. The state makes well meaning laws that i have to follow or I'm not doing my job, but then i'm just trying to do my job and am accused of sticking my nose where it doesn't belong and have to deal with a parent flying off the handle. sigh... What's a school nurse to do?

oh, and for the record, i can think of 1000 things that would be a better use of my time than send the parents of the kids that are under/over weight a letter. I am pretty sure they've looked at their kids recently....

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Nascar nurse has 25+ years experience and works as a Hospice Nurse.

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I am not a school nurse but my first thought was "What does your policy say to do in this situation"? because that is how you should handle the issue.

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