The Paediatric Dietitian

We had a visit from Andrea McDougall a couple of weeks ago, a clinical specialist and Paediatric Dietitian. We were referred to her by Dr Christie because I was becoming increasingly concerned about Alfie’s weight gain. He’s always been a big boy and tall for his age, but in the last six months he has been putting on the pounds at an alarming rate. In fact he’s put on about 8 kilos in 6 months, which sounds incredible but is horribly true. Despite increasing his exercise – and though he loves his screen time he does, like most 6 year olds, live a fairly active life – he was still getting bigger. His appetite is healthy, he eats most things and is not motivated by sweets, chocolate or fizzy drinks. Like most people we limit these but in fact, even presented with the odd can of cola, he would only drink a bit of it. Unlike Oscar who would gladly mainline sugar in any form, Alfie likes the idea of treats, but after a few bites gives up. As evidence I offer up our Easter treats; witness some crumbs of chocolate and 1 dinosaur egg left from Oscar’s haul, whilst Alfie still hasn’t touched half his booty and has in fact forgotten about it entirely. Oscar on the other hand, keeps a hawkeye on the chocolate and sweet levels and knows down to the last tic tac what is left, gladly nagging for a treat before breakfast and carrying on all day.

huskyAnd despite being a properly middle-aged, middle-class mum with a fair bit of brainage I couldn’t work out what was going on. Alfie loves meat, sure. He would eat anything his Dad put on the BBQ and forgo sweets and pudding for more meat. Unfortunately he would also forgo the veggies but even then he’s pretty unfussy and will – albeit reluctantly – eat a good variety of veg.   Plus he’s an absolute fruit monster and has been all his life. So I was very keen to hear what Andrea had to say.

She came to our house and spent a good hour and a half chatting about Alfie and our eating habits. We kept a food diary for four days beforehand and used this to discuss his diet.   Here is what we found out;

  • School meals make up the bulk of his daily calorie intake and therefore dinner should be adjusted accordingly. Far from being nutritionally calculated and portion controlled, school dinners are the main source of fat and sugar intake! How naïve am I?
  • According to weight, Alfie should drink 1.8 litres of water per day. Yes, there is mathematical equation to work out how much you should be drinking! (Check out this Hydration Calculator Hydration Calculator
  • The main focus is to stop the weight gain. Weight loss can come later. For now we just need to put some habits in place to limit consumption. Drinking a glass of water before every meal, for example. Go easy on the sugary fruit. Encourage more veg in any way possible.


    Our Rainbow Plate.  Kids wouldn’t go near the beetroot and prefer their corn on the cob, but we keep persevering.

  • Portion control is easy – just look at the palm of your hand. Although she also sent through some interesting and informative sheets regarding portion control by age, Andrea showed us that the size of a portion is equivalent to the size of your palm. So if that heap of mashed potato resembles your head more than your hand, you are over the limit!
  • We are doing the right things. She commended us on all our efforts and said Alfie has the healthiest diet of any kid she’s seen in long while. Interestingly the focus is less on exercise (big kids do more exercise than their counterparts simply by carrying all that extra weight around) and more on calorie consumption.

Since her visit she has emailed us for an update, sent through several sheets of information and will schedule a follow up visit in 6 – 8 weeks. It feels good to have someone backing us up, even if there are no magic wands to wave.

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