National child measurement programme: Desk research

The questions parents are likely to ask are likely to focus on clarification, help and reassurance.  Resources for health professionals devised by the Department of Health and Department of Children, Schools and Families should therefore focus on these three areas. 

Clarification Questions

Parents asked questions such as:

• Can you explain BMI to me further?
• How over/underweight is my child - exactly?
• Is the result accurate?
• What medical proof is there that my child is overweight?
• Aren’t all children different?
• Isn’t it just puppy fat?
• Could it be a medical condition?  Is my child sick?

Help Questions

Once parents are satisfied that the result is accurate and an acceptable reflection of reality, their questions become focussed on how they can help their child.  Parents wanted, and expected, clear details about where to go for further information and assistance. 

Parents typically asked questions such as:

• Who can I speak to in order to sort out my child’s weight?
• What can I do to help my child?
• What advice and tips can you (health professional) give me?
• Is my child’s weight going to get improve?
• How much work is required to get my child’s weight to a healthy level?
• Is my child susceptible to disease like heart disease, diabetes at this early stage?
• How do I explain to my child that they have a problem with their weight without negative consequences?

Parents also asked specific questions about what to feed their child:

• What are the best foods to give my child?
• What is the best breakfast that we can be feeding them?
• How often should my child eat?
• What time of the day is best for dinner?
• Should they stop eating at a specific time of day (for example, nothing after 6pm)?
• Are there any set menus that we could follow?

Parents typically felt that they would be more concerned that an ‘underweight’ result may be caused by a medical condition (for example,  overactive thyroid gland) rather than environmental factors (for example, that their child is not eating enough).

Faced by an ‘underweight’ result, parents felt they would ask questions such as:

• What are the likely causes of an underweight result?
• Isn’t my child too young (at reception age) to be considered underweight?
• Is it a medical condition? What can be done to find this out?
• What tests can be done?
• What help is available? (dietary, psychologically etc)
• What emotional support is available to parents?

Reassurance Questions

After parents’ concerns have been clarified – and the help and assistance available to them and their child clearly outlined - parents finally wanted reassurance that they are ‘not the only people going through this’ and that ongoing help will be provided.

Parents asked questions such as:

• Will my child be helped throughout the weight gain/loss, not just at the beginning?
• Can my child have regular check ups to monitor their improvements?
• Can I be put in contact with other parents going through the same thing as me?

PARENTS OF YEAR 6 CHILDREN

Parents of year 6 children asked similar questions to those asked by parents of reception age children.  Once again, questions can be grouped into those focussing on clarification, help and reassurance.  However, parents within this category were more pessimistic about their ability to change their 10/11-year-old children’s eating habits.

Clarification Questions

Parents asked questions such as:

• How certain is this result? (All children are different etc)
• Is it very overweight or just overweight?
• What is the scale we are working with?
• How accurate is BMI?
• Should I get a second opinion?
• He’s the same weight all his siblings were at that age.  Surely he/she’ll grow out of it…  Couldn’t it just ‘puppy fat’?
• Won’t it disappear when they (child) have their growth spurt?
• Could it be hereditary?
• How concerned should I be?

The questions that parents of children in Year 6 were likely to ask health professionals varied when presented with different results - underweight, healthy, over weight and very overweight.  If a very overweight result was received, parents’ questioning often became more anxiety driven:

• Is this extra weight affecting his/her heart?
• Could he/she have high cholesterol?
• Could he/she get diabetes?
• How can I prevent him/her from eating outside of the home?
• What help is available to convince him/her that he/she has to try and lose weight?
• What could happen if he/she doesn’t lose the weight?

If an underweight result was received, parents’ questioning was more likely to have a medical emphasis, especially if a parent genuinely considers their child to be a healthy weight:

• Is it an eating disorder?
• Is it a medical condition?
• What conditions can cause my child to be underweight?
• What are the consequences of being underweight? Are they permanent?
• Isn’t it just a consequence of a growth spurt?

Help Questions

Once the initial clarification questions are answered, parents generally focused on what help might be available to them from the NHS in order to improve their child’s weight situation.

Parents asked questions such as:

• Will my GP be supplied with specific information from DH/DCSF to give me or use his/her own judgement?
• What can my PCT offer my child to help improve his/her weight?
• Are there classes about living a healthy lifestyle I could attend?
• Will the NHS provide a dietician?
• Can we see a specialist? Will that be covered under the NHS?
• If it is his/her diet what can I do as a parent to improve it?
• How do you cope with a fussy eater?
• What specific foods should we feed him/her?

Reassurance Questions

Finally, parents wanted reassurance that everything that could be done to help their child would be done:

• Can medical tests be done to make sure there’s no medical condition causing the weight problem?
• If there is a permanent medical cause to the weight problem, is there any education or ‘child friendly’ support to help my child understand?
• Can a long-term plan be created to help my child?
• Can he/she have a special diet drawn up?
• Are they child weight loss groups he/she can join to make losing weight fun?
• Are there parents of overweight children organisations that I can contact?