Childhood Obesity

[Unregistered]

Hello everyone! I have always received excellent advice on this forum, and I am seeking help tackling a difficult situation. Any helpful advice or stories of similar experiences would be appreciated!

I provide daycare in my home and, while I don't have children of my own, I dearly love each of the six children in my care. I am very invested in helping them turn out to be smart, successful little people by the time they leave my care for kindergarten.

One child, a girl age 3.75, is very obese. She is the kindest, sweetest little girl, and so full of love! However, she is unable to wipe herself because she can't reach, and she is unable to put a jacket on by herself because she is so restricted by her body fat. She tries so hard without complaint, but she can't keep up with the other kids when playing or walking. I was an overweight teenager and adult, and developed diabetes, polycystic ovarian syndrome, and a host of other problems in my twenties. I have overcome my health issues and lost weight, but I would give ANYTHING to spare this sweet girl from that fate!

We eat a very clean, organic diet here that is full of protein and tons of fruits and veggies. I coach them at every meal about what we put in our bodies. We also walk to the park, play in the backyard, or have dance parties if we can't get outside. I do everything in my power to help them understand how to take care of their bodies.

My dillema is this: the girl's parents were really excited to start her here because of a the emphasis I put on health. However, when she leaves here, I believe it is a different story. She tells me they eat at buffets or pizza or fast food every evening, and breakfast lunch and dinner on weekends. I've heard her parents say many times at pickup, "We're going out to eat tonight!!" Which makes it that much more exciting for the girl. Through all my nutrition coaching sessions with the kids, she has the least amount of understanding as to what nutrition means. For example, if I ask the kids to name a healthy veggie, she always says french fries.

She is in the best situation possible, because at 3 years of age, someone else is always in control of her food choices. She doesn't have the unlimited choices that adults face, making weight loss harder. She also has the advantage of growing taller and growing into her weight, unlike adults.

My question to the group is : How do I tactfully help her parents change this disasterous course? I was going to bring it up in next week's progress meeting I have with them. But I'm terribly afraid of offending them, or making them uncomfortable enough to leave. I feel I owe it to the child to speak up, but I'm so conflicted. Anyone else ever have a conversation like this, and what was the outcome?

Thanks everyone for all the help and support!

[Cat Herder]

Positive Promotions has many family handouts, coloring books, posters, plates, fun kits etc. with the MyPlate theme. Cover it during your regular curriculum to get the kids excited about it. Adding daily fun PE to your program would be beneficial as well (punishment style/obligatory PE will backfire).

All you can do is give them the resources, the rest will be up to them on their time. Parents have a right to parent the way they want to....

Hopefully the resources will plant a seed, though.... :hug: http://www.positivepromotions.com/my.../c/t_1001_411/

[LadyPearl]

Are the parents overweight as well?

[daycarediva]

That is so very sad. I had a little guy in care who was morbidly obese, wearing all modified clothing, and had similar issues as your dcg. It broke my heart, but in the end, there is nothing you can do. I am SURE the parents are aware, the pediatrician has spoken up.

I would do a nutrition unit and focus on health and wellness. Send home information about it, do menu education, I once broke down caloric and nutrition content in my daily menu for the week, and then gave parents an easy dinner menu to try so that the child has all of their food groups met.

We do a nutrition unit each year. This year, I did grams of sugar in different items. Ex Milk vs choc milk and then added baggies of how much sugar was in each on our bulletin board. I have kids refusing to drink choc milk at home.

I just got a new dcb from per diem to PT, and the main reason was that at his former center, they do a LOT of canned and processed foods. The parents are both obese and I am a health/fitness enthusiast. Dcm and dcd were both SO open and honest about their struggles and do NOT want the same for dcb. The whole family has made a BIG effort in healthier eating and getting active. I just LOVE IT.

I too, was the fat kid. I have PCOS, no metformin (YAY) even though I am not at all overweight now it is a CONSTANT struggle. I gain easily, and even a pasta meal a week would see me bumping up the scale monthly.

[nannyde]

You may have been hired for your healthy program because MANY parents are looking for child care where the provider does the right thing so they can feel better about doing the wrong thing when the kid is on their clock.

There are, for example, parents who look for child care without TV so the kid can have TV just on their clock. There are parents who want a lot of outdoor time so they don't have to take the kid out on their clock. They want their kid up all day so they can have them sleep on their clock.

Don't take it personally. It doesn't have a thing to do with you. The parents know the kid is overweight and they are fine with it. They will most likely tell you that someone in their family was big as a three year old and they are terribly thin now. Whatever words they need to come up with they will. A big one is "she doesn't hardly eat anything with us... she's really picky".

Telling them the kid is fat is not going to go over well. This is why doctors don't get involved any more than a cursory discussion to chart they have said something. Counseling obesity in kids is really time consuming so most health practitioners avoid it like the plague. It's not good for business and they don't get paid enough to put up with the crap storm that comes their way when they insist the kid is overweight.

The biggest increase in obesity in any group right now is the preschoolers. Infants are steadily increasing by the YEAR. Get used to it.

Just keep doing what you are doing on YOUR clock. If you want to deal with the parents on it then know you could easily loose the kid. Tell them the truth when it affects her ability to participate though. You can let them know what you see but asking them to change what they do.... it's going to be a long haul.

[mountainside13]

That is really sad! I completely agree with Nan!! Cat had some great ideas!!

[Unregistered]

re

Other than the handout suggestion, and sugar lesson (way cool, going to steal that!) I am a little sad to hear that most of you think there is no way to help a child after they leave dc for the day.. Nobody has ever had an honest conversation with a parent and had it received well? Or, as parents yourselves, on a scale of 1(grateful) to 10(hateful), where would you fall if you were in the parents' position?

[Annalee]

You may have been hired for your healthy program because MANY parents are looking for child care where the provider does the right thing so they can feel better about doing the wrong thing when the kid is on their clock.

There are, for example, parents who look for child care without TV so the kid can have TV just on their clock. There are parents who want a lot of outdoor time so they don't have to take the kid out on their clock. They want their kid up all day so they can have them sleep on their clock.

Don't take it personally. It doesn't have a thing to do with you. The parents know the kid is overweight and they are fine with it. They will most likely tell you that someone in their family was big as a three year old and they are terribly thin now. Whatever words they need to come up with they will. A big one is "she doesn't hardly eat anything with us... she's really picky".

Telling them the kid is fat is not going to go over well. This is why doctors don't get involved any more than a cursory discussion to chart they have said something. Counseling obesity in kids is really time consuming so most health practitioners avoid it like the plague. It's not good for business and they don't get paid enough to put up with the crap storm that comes their way when they insist the kid is overweight.

The biggest increase in obesity in any group right now is the preschoolers. Infants are steadily increasing by the YEAR. Get used to it.

Just keep doing what you are doing on YOUR clock. If you want to deal with the parents on it then know you could easily loose the kid. Tell them the truth when it affects her ability to participate though. You can let them know what you see but asking them to change what they do.... it's going to be a long haul.

[Blackcat31]

Other than the handout suggestion, and sugar lesson (way cool, going to steal that!) I am a little sad to hear that most of you think there is no way to help a child after they leave dc for the day..

Realistically WHAT can you do after hours when the child is not in your care?

Nobody has ever had an honest conversation with a parent and had it received well? Or, as parents yourselves, on a scale of 1(grateful) to 10(hateful), where would you fall if you were in the parents' position?

Just because you have an honest and frank discussion with the parent, doesn't mean the parent is going to listen to your advice and/or suggestions.

I have had many conversations with parents about things that concern me and have had a multitude of responses from openness to hear/listen to me to outright offended.

I think depending on what your relationship is with the family, only you know how much or little you can or can't say to the parent(s)....kwim?

[Cat Herder]

1. I am a little sad to hear that most of you think there is no way to help a child after they leave dc for the day..

2. Nobody has ever had an honest conversation with a parent and had it received well?

3. as parents yourselves, on a scale of 1(grateful) to 10(hateful), where would you fall if you were in the parents' position?

1. That is something learned from experience. YEARS of it.

2. I absolutely have. The topic being well received was not something so big as their entire lifesyle choice, though. Issues like their child not wear open toed shoes or party dresses to daycare are easier to see eye to eye on....

3. It can be viewed anywhere from "I am so ashamed" to "how dare you judge me!!!", either of those spectrum's creates more work for me. Adult care and education are not my job. Child Care is... For the sake of my own sanity I stick to encouraging the child instead of reprimanding the parents... That is most likely how they will see it, that you believe you are a better parent to the child...

I love your over-all goal, but feel strongly your intended message will best be served by educating and exercising with the child.

[Unregistered]

Thank you!

Thank you all for your input. I will take your advice and keep up with my program during the day. I asked here first because I would never intentionally injure a parent's feelings, and it seems that's pretty unrealistic when it comes to such a sensitive topic.

And yes, Cat Herder, I am fairly new to the daycare scene, and I really appreciate the experience I learn from all of you. I'm in the "I WANT TO SAVE THE WORLD AND ALL THE CHILDREN AND ANIMALS AND WHALES!" phase of my life...very idealistic but I'm trying to move to realistic. I desperately don't want to sound arrogant, like I am a better caretaker than they are, but (realistically) I think I would be. Yep, that's pretty arrogant. Better keep that to myself, !!

Thank you all again, and have a wonderful week!

[Starburst]

Many factors to consider

I have also dealt with weight issues all my life and still am technically obese (though I'm not huge and have been losing weight). I did a report last semester on childhood obesity for a teaching class and while I understand your concerns for the child, at the same time you can't control what happens at home or when she is not on your watch because she is not your child. Though, there are some cases where families have had their children taken away by CPS because they were morbidly obesity.

The thing about obesity is that while yes, MOST of the time it is cause by overeating, there are millions of things that can attribute to it that they aren't legally obligated to tell you. Lower income families are more likely to have obese children than middle to higher income families (either because of access to better information or price of food). Medication for other condition can cause significant weight gain. EX: I was given prednisone for a severe asthma attack when I was only 3 months old (I was diagnosed with asthma at 1 month old, was BFed, weighed normal 7lbs at birth and my mom was at an ideal weight before I was born; it's genetic and I was a high risk pregnancy). I ballooned up and it change the chemistry in my brain permanently (long term affects in young patients can include increased appetite). Asthma in children is also on the rise and tend to correlate with weight issues. Some doctors believe that the treatment medications, as well as the symptoms of asthma (Fatigue, shortness of breathe with physical exertion, inflammation of body fluids), can be as much to blame for obesity risks as obesity is for asthma risks (inhalers have steroids; can cause weight gain). Insulin for diabetes can also cause weight gain, there is actually an eating disorder called 'diarexia' where people with diabetes stop taking their insulin to avoid gaining weight. Obviously parents are not going to risk their child's health by not treating their biggest health concern so that their children will be thin.

Also, while long term obesity can lead to many health problems, there are people who are considered "obese" but actually have more muscle mass than fat (need a special test). And also, there are some kids who are very heavy when they are young (no matter what they eat or how much they work out) and as they get older just get a growth spurt and thin out a bit (I did). Plus, there are some people who are just a bigger build than others and can still be healthier than others who are smaller. Most doctors today are ditching the traditional BMI calculations because it (by itself) isn't 100% accurate because every individual has a different body structure, different shape, different distribution of fat, muscle, fluid, and tissue. For my age and height, using BMI, my approximate ideal weight should be between 99-130lbs, my doctor told me that 130lbs would be a good weight for me (maybe even 140) but that I should not go under 130lbs because of my body frame and shape, I would look sick if I went too far under 130.

Unless you are a medical professional it's not wise to give weight loss tips to the family. Don't get me wrong- promoting healthy eating styles and activities are one thing, but any type of special diets for a child this young should be under close supervision of a doctor. At this age diets can be dangerous because they can stunt or even delay growth/development and if the parents misunderstand the information and wind up underfeeding her, they could wind up accidentally malnourishing her instead or (even more dangerous) they may start shaming her into not eating so much which could lead to a variety of eating disorders (anorexia, bulimia, guilt binging) or other self-destructive behavior when she's older (self-harm, drugs). If you do give them any advice, I would suggest it be asking their doctor about things they can do to help her and ask for a copy of that information to make sure you are consistent with what the doctor says the child's individual dietary/activity needs are.

[GKJNIGMN]

All 3 of my kids were overweight. I had the opposite problem that when I made the lifestyle changes, my provider felt bad limiting their food and not giving them as many helpings as they wanted at meals which would be 3rd and 4th servings often times.

When I stopped working outside of the home that was part of the reason I did it. My 9 year ds weighs 15 lbs less than he did 2 years ago and pants that he had to put up because he got to big in the 1st grade now fit him in the 3rd grade. He is a healthy weight now and you could never tell it was an issue.

With that being said, I did not appreciate the feedback from the school nurse when the yearly letter came home and I would not have taken it well from a daycare provider either. I was well aware my kids were overweight.

In order to fix the problem, I had to get to the point of accepting that I was the cause of it since I bought and prepared the food. My reaction probably came off as offended but it was more me being ashamed.

I watch the number of servings and foods my kids are getting and say no regularly now. I pack lunches and make sure the private prek my younger ds goes to knows he cannot have extra snack servings. I also have them playing sports that require a lot of conditioning - Tackle football, hockey, etc. It is an entire lifestyle change and I think at the time I was overwhelmed and didn't know where to start.

I would not have this conversation with a DCP.

[Annalee]

Medication for other condition can cause significant weight gain (I was given prednisone for a severe asthma attack when I was only 3 months old (I diagnosed with asthma at 1 month old, was BFed, weighed normal 7lbs at birth and my mom was at an ideal weight before I was born; it's genetic and I was a high risk pregnancy), I ballooned up and it change the chemistry in my brain permanently (long term affects in young patients can include increased appetite). Asthma in children is also on the rise and tend to correlate with weight issues. Some doctors believe that the treatment medications, as well as the symptoms of asthma, can be as much to blame for obesity as obesity is for asthma (inhalers have steroids; can cause weight gain).

I have not heard this before, but it makes sense to me after reading your post. I go to church with two children that are significantly bigger than children their age and both have taken steroids off and on in heavy doses since birth due to breathing/asthma/respiratory issues. They are now 5 and 7 years old and medications do make sense for their issues.

[NoMoreJuice!]

Tough

Wow, that is a tough spot to be in! I see how much u really want to help that poor girl, and u are a very loving person!!! As long as u show them your heart when u talk to them, I know they will understand u are only acting out of PURE LOVE!!!

Go with your gut!! The depression and suicide rate for overweight teens is getting out of control, and if u are able to prevent even ONE kid from suffering, I feel u are morally obligated to do so!!!

I understand that u other providers may have been burned in the past by trying to help a fam, but that doesnt mean u should give up hope!!! We are preached to by the dept of health and DCF that we are sometimes the kid's best advocate and we need to be sources of support and information for families.

GOOD LUCK!!!