Discussing BMI with Parents

Having calculated a child’s BMI and knowing the relevant and appropriate information to share with parents about growth, healthy eating and physical activity, and thus promote a healthy BMI, the challenge is to give this advice in a sensitive and effect manner.

For an overview of this section, download: Discussing a Child's BMI with Parents (pdf - 32.54kb).

Primary Messages

Think through the primary messages to give a parent regarding growth, a healthy diet for their children and physical activity.

Read the information below to check if you are covering most of the key points.

Growth

  • Growth patterns are individual.
  • Growth patterns over time are more important than a single measurement (repeated measurements every 6 months is ideal).
  • Growth is one sign of general health.
  • A child’s growth often reflects family growth patterns – for example a child with two short parents is unlikely to be tall themselves. However, if both parents are overweight this does not make it OK for the child to be overweight too!

Healthy diet

  • Parents are responsible for what and how much they provide their child; children are responsible for what they choose to eat from the food provided
  • Parents should offer a varied diet, including foods from all food groups.
  • Aim for 5 servings of vegetables and 2 servings of fruit every day.
  • High fat, sugary foods should be limited and ideally kept for special occasions.
  • Water is the best drink; juices, fizzy drinks and cordials should be avoided.
  • In most children over the age of 2, low fat dairy products and milk consumption should not exceed 500 - 600mls a day, (less if other dairy products are eaten).

Activity

  • Children need at least 2 hours of physical activity every day, usually carried out in short blocks of time.
  • Physical activity includes both structured and unstructured activity.
  • Outdoor play should especially be encouraged.
  • Screen time (TV watching and using a computer) should never exceed 2 hours a day and ideally should not be more than 30 minutes a day for young children.
  • Child physical activity is easier if parents act as a good role model.

Refer to: Advice to Promote a Healthy BMI for more detail about these primary messages and appropriate parent information sheets.

Monitoring and Referring

Ideally children should be weighed, measured and have their BMI calculated every six months. As with growth charts for infants, serial measurements provide more useful information than a single measurement.

Some children have a greater need to be monitored more closely than other children do. The same children may also need to be referred to another health care professional for additional support. These children include:

  • Children who are very overweight (well above the 95th BMI percentile).
  • Children who are rapidly gaining weight (crossing BMI percentiles upwards).
  • Children who are underweight and appear not to be healthy (below the 5th BMI percentile).
  • Children who are losing weight or fail to gain weight over an extended period (crossing the BMI percentiles downwards).

Try to monitor these children more closely and refer to other health care professionals where necessary. If you have monitored a child closely, you will be able to provide important, subjective, information when you make a referral. This information may include:

  • The child’s current weight, height and BMI.
  • Height, weight and BMI percentiles.
  • A summary of their weight history (eg any changes in BMI percentiles).

Where to refer

The number of referrals to primary care (GPs, community dietitians), secondary care (local hospitals) and tertiary care (specialist hospitals) for overweight children currently outnumbers the services available. However, the following list includes some other health care professionals which may assist with the promotion of a healthy lifestyle for children:

  • Community Dietitians
  • Private Dietitians
  • Hospital Dietitians
  • General Practitioners

Community Dietitians covered by Medicare are relatively rare, but where available are an excellent resource to assist in the management of a child’s weight. Community Dietitians are able to see families individually or provide group education sessions. Hospital Dietitians tend to see patients with acute illnesses and do not often manage young children who are overweight, except in specialist clinics. For these reasons, Private Dietitians are often the best option to help a family make positive lifestyle changes to help manage a child’s weight. The Dietitians Association of Australia provides a list of Private Dietitians available in Australia.

General Practitioners can also provide advice on healthy lifestyle choices for families of young children, but most do not have specific training in management of childhood overweight. GPs are able to refer to other specialists where necessary.