Dr. Bernadette Carr answers your questions on overweight children and nosebleeds

Q. My nine-year-old daughter is very fond of her food and I find it difficult to refuse her a second helping at mealtimes.

She’s beginning to look a little chubby so how do I know if her weight is OK and are there particular foods I should include in her lunch box to keep her from feeling hungry?

A. One in four children in Ireland are now overweight which can lead to big problems in later life such as type 2 diabetes and heart disease if not managed. 

BMI or body mass index is one way of measuring growth in children based on their weight and height. A “normal” BMI is considered to lie between the 5th and 85th centile on the growth chart.

Diet and exercise play a big role in managing weight in children. It is recommended that children have at least 60 minutes of activity a day. 

It is a good idea to limit screen time to less than two hours a day and encourage more active pursuits, incorporating exercise and physical activity as part of their normal daily routine.

Incorporating exercise and activity into family routines can be an ideal way to encourage children to get active and lead by example.

Portion size can also be a problem in maintaining healthy weight for kids. Children do not need as much food as adults and this should be kept in mind when considering serving sizes.

Structured meal times and encouraging kids to eat at the table rather than on the couch or while on the run can also help to develop good eating habits.

Encouraging children to try new varieties of fruit and vegetables early, incorporating fruit, fresh soups and salads as part of school lunches as well as increasing the vegetable content of kids’ dinners are all helpful ways of increasing their intake and ensuring they make their ‘five a day’.

The food pyramid provides a good guide for how much of each food group to include in a child’s diet. 

It includes healthy carbohydrates, vegetables, protein and calcium sources as staples, with treats, fats and oils to be kept to a minimum.

Including a small piece of fruit, a matchbox-sized piece of cheese or a yogurt in lunchboxes is a convenient way of ensuring kids are getting adequate calcium and vitamins in their diet.

Plain milk or water are best to drink, limiting fruit juices and fizzy drinks which provide empty calories to a child’s diet and can contribute to tooth decay.

For further advice and guidance about your child’s weight as well as monitoring overall growth and progress, your GP can help you chart your child’s weight and height as well as BMI and can make referrals to a dietician/ paediatrician if this is necessary.

Q. My 10-year-old child is having quite a lot of nosebleeds lately and I am a little concerned if this is a serious problem and how best this should be treated.

He is a very active boy enjoying outdoor sports and it would be great to know what causes them so frequently?

A. As your child has had a number of nosebleeds recently, I would advise that you bring him to your GP, who will examine him and suggest some measures to take and arrange a referral to specialist if appropriate.

Many nosebleeds are from an innocent cause such as:

* Picking the nose

* Blocked stuffy nose

* Inflammation of the nasal passages as a result of a cold or flu

* Blowing the nose very hard

* Hay fever or other allergies.

However, nosebleeds can also indicate a more serious underlying problem and should not be ignored.

Most simple nosebleeds (those with no underlying serious cause) can be treated at home. Make sure your child sits down and leans slightly forward, don’t let him tilt his head back. 

With your thumb and index finger, pinch the soft part of the nose firmly (just above the nostril openings but below the bridge of the nose) and hold for at least 10 minutes. 

If the bleeding continues longer or there is a significant blood loss, get medical help immediately. Once the bleeding has stopped don’t let your child do anything that might restart it such as blowing his nose.


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