Student nurses

Managing weight in under 5s

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Child weight management is an important public health issue for which no single organisation has responsibility.

Organisations can however work together and every professional who has contact with the under 5s can take responsibility for their part in supporting families and children. The modules in this online resource have provided you with information on why child weight in the early years is important, how to identify weight issues in young children, and how to communicate with parents/carers about their child’s weight and related lifestyle issues (i.e., physical activity and diet).

By pulling together this information, you now have the evidence-based knowledge and skills to support families to promote a healthy weight in pre-school children.

Whether you work in healthcare or early years services, try asking yourself “what can you do to help this family manage their child’s weight?”

Promoting healthy child weight involves both:

  • universal care to ensure every child develops healthy eating behaviours and stays physically active
  • targeted care for children whose weight becomes a concern

Steps you can take to promote a healthy weight for every child

Here’s a summary of the steps you might take to provide universal care to the children and families you see. See Communicating with Parents About Child Weight and Behaviour Change Technique modules for further guidance on how to foster motivation in parents/carers and how to support families to make healthy changes.

  1. Embed regular conversations about physical activity and diet within your routine contacts.
  2. Ask the parents/carers about the child’s physical activity/diet and provide relevant information that might help them.
  3. If appropriate, support parents/carers to set an action plan to improve either physical activity and/or diet.
  4. Consider whether any onward signposting (e.g. HENRY, local physical activity or nutrition programmes) might be helpful for the family.
  5. Follow up conversations and let parents/carers know they can approach you with questions at any time.

Steps you can take to support a child when weight becomes a concern

Below is a summary of the steps you might take when you’ve identified a child as living with under- or over-weight. See Assessing Weight in Young Children, and Communicating with Parents About Child Weight modules for further guidance on how to have these conversations.

  1. Identify the extent of the child’s weight issue and any potential medical concerns.
  2. Ask parents/carers why they feel the child might have over- or under-weight.
  3. Ask parents/carers about the child’s physical activity and diet and provide relevant information that might help them.
  4. Support parents/carers to set an action plan to improve either physical activity and/or diet.
  5. Consider whether any onward signposting (e.g. HENRY, tier 2 service) or referral (e.g. to GP) is appropriate at this stage. For early years practitioners, you might refer to a health visitor or GP for further support. For health professionals, it is important to find out if there is a local child weight management pathway in your area that provides guidance on when to refer and who to refer to. For guidance on what this might look like, see:
  6. Arrange a follow up meeting and continue to support the family as appropriate.

Supporting parents/carers own health and behaviours

Whilst the focus of HealthyWEY is on the health of the child, a young child cannot change their behaviours in isolation. Therefore it is important to approach healthy lifestyle change as a whole family process.

Much of the information within this toolkit is relevant for helping parents/carers change their own physical activity and dietary behaviours, therefore you can support them to make changes by considering their lifestyles within your conversations.

It might be helpful also to find out about local adult services in your area that could offer additional support. For example, the NHS often offers weight management services for adults living with obesity.

Other sources of support could include your local leisure services (for physical activity opportunities) and national initiatives such as parkrun that offer free and accessible activities for the whole family.

Weight, physical activity and diet can be emotive topics and there may be times where you have concerns for parents/carers’ emotional health. In such instances, you can support parents/carers by suggesting they see their GP or signposting them to organisations such as MIND.