So I wrote a letter to our Headteacher…

NCMP Scan of original letter censored… and I’m very pleased to say that he replied. He expressed his concern about the letter I’d received. There will be a note in the school newsletter next week to parents on the topic and he is going to raise it with the Local Authorities at the next Headteachers Forum.

The letter I wrote to him is below, a tiny bit anonymised. I’ve forwarded this on to my MP Vince Cable and the contact in the Obesity Team at Public Health England that Civic Centre lady gave me. I wonder if I’ll hear back from them?

Dear Headteacher

I wanted to drop you a line to let you know about our experience with the National Child Measurement Programme and the letter we received a week or so ago with the results of my son’s measurements. In essence, I think it was irresponsible. And I think the school ought to consider distancing itself from the letter and offering parents some proper support.

We were rather shocked by the letter, and then quite concerned and I hoped to talk to you about it. The letter was ostensibly from the School Nursing Service and rather baldly informed us that according to them, my son is very overweight.

We were very upset and followed the links in the letter to two NHS websites. There was no tailored information on those sites about four year old children, specifically nothing to describe what an ideal weight should be for my son.

It did inform us that he is considered obese. And as such, he was likely to have health problems such as diabetes, heart problems and cancer. The sites linked to information about calorie counting. But nothing specific about portion size – just advice to use ‘me-size’ portions, whatever that means. It left me thinking I need to put my son on a diet, but it didn’t explain how much he should lose per week, or what his goal weight should be.

I phoned the number supplied in the letter for ‘free local support’ and spoke to a lady in the School Nursing Service. When I asked her why I’d been sent a letter informing me my child was obese, she explained that the letter had not been sent by them but by Public Health Richmond. She had no advice she could give me and made it plain that the Nursing Service had opposed sending the letter. She promised me that she would ask the Stanley School nurse to call me, which she did.

The Stanley school nurse reiterated that they had opposed the letter but that the Government had insisted it be sent out. The nurses had not been briefed or supplied with appropriate support advice. They could not tell me how the Government had calculated that my son is apparently obese. Further having weighed him herself, the Stanley nurse said that my son is a big boy – 98th centile for height – and he has a weight to match. According to the School Nursing Service then, who have actually met my son, he is physically in proportion and doesn’t have a weight problem. Moreover, they do not advise that an overweight child should go on a diet – medical advice is not to put children on a reduced calorie regime. This was not explained at all on the NHS sites linked to in the letter we received. The nurses apologised that we’d received the letter at all.

When I asked for the name of whoever at Public Health Richmond had sent out these letters, both of the school nurses I’d spoken to gave me the contact details for a lady at the Civic Centre in Twickenham.

I followed up with this lady to find out why I’d been sent this letter. I had a lot of questions for her and some feedback too. I explained that I’d inferred, from my visits to the NHS websites supplied in the letter she’d sent, that my son should be put on a diet. That there was nothing specific to work with to help manage his supposed obesity. She echoed the nurses in saying that they did not advise restricting a child’s calories. And did actually helpfully point me at this resource which does make very plain the portion size we should offer our children at different ages. (http://www.cwt.org.uk/publications.html scroll down for the pictorial guides).

I explained to the lady at the Civic Centre that I did not think my son is obese. That he is a very active boy. Very tall for his age. That fifty per cent of his meals are supplied by Richmond Council. And that the vast majority of his waking life during the week is spent at school or council supplied wrap around care – presumably offering him an appropriate level of physical activity. I told her that the School Nurse had said that he is a big, well proportioned child. On that basis, I asked the lady if she agreed with me that it sounded like my son probably did not have a weight problem – she agreed. And then I asked her if, on that basis, the letter she had sent me was irresponsible – she agreed it had been.

The lady at the Civic Centre did apologise for the letter and asked my recommendations for how it could be made better. I suggested that the approach the School Nurses had taken previously was preferable. They have always measured the child. They put that information in context, referring to the child’s growth over time as well as family members’ build and height.  Using various information sources they made an informed assessment. If a result is noteworthy – out of kilter with the ‘percentage of population’ style growth charts – they would contact the child’s parents in person. They don’t believe in giving a verdict based on just one BMI-based datapoint. I also suggested, if the Health Service is going to send out letters, it must ensure the letters contain links to medically sound, practical and appropriate information, tailored to that child’s age.

Of course the Civic Centre lady was also simply following orders from ‘Government’. I pressed her for someone higher up the chain who had approved the letter. She gave me the email address of someone in the Government’s Obesity Team and I will be following up with her to see if I can get to the bottom of this.

I am still very angry about all of this, as you can probably tell. I think it might be an idea for the school to put those National Child Measurement Programme letters in context. And to explain that if parents are concerned about their child’s weight they should talk to the school nurse. But that dieting is not recommended for children. And that the Caroline Walker Trust has helpful information about child portion size, even if the NHS does not.

The letter we received was inflammatory, ill-conceived and potentially quite dangerous.

I’m sure we won’t be the only parents to receive such a letter. But others that have received a similar letter might not follow up with the School Nursing Service and Public Health Richmond. They might just put their child on an unhealthy calorie restricted diet. And given the Government’s next ‘intervention’ isn’t until our children are measured again in Year Six, I would think such a diet could cause quite some harm in those intervening years.

Jane Franklin, Tony Whybrow

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