Dear Parent/Guardian, 

Your child's growth and development can be influenced by many factors. Some of these factors include genetic makeup, overall state of health, dietary intake, and exercise. 

Being either overweight or underweight can put a child at risk for developing certain health conditions.  A child who is overweight has an increased risk of developing serious medical conditions that may include diabetes, heart disease, and high blood pressure.  A child who is underweight has an increased risk of developing serious medical conditions that may include cardiac issues, loss of bone mass, and anemia.  An underweight condition may also be a sign of an underlying eating disorder.  The emotional component that may accompany these conditions is another aspect that should not be overlooked. 

In light of the vast amount of research that has been done on the growth and development of children, Pennsylvania has given this topic high priority and has made it part of our state law under the state mandated school health program. 

In order to comply with the state's mandated health program, your certified school nurse on an annual basis assesses your child's height, weight, BMI (body mass index), and vision (Kindergarten through Grade 12), hearing (Kindergarten, Grades 1, 2, 3, 7, 11), and scoliosis (Grades 6 and 7).   

The calculation of your child's body mass index is a mathematical calculation that is performed using your child's height and weight measurements.  The body mass index (BMI) is gender and age sensitive.  Your child's BMI is compared to the BMI of other children in the US of the same gender and age.  This calculation comes to you in the form of a percentile.  For example: If your child's BMI is in the 60^tth percentile, this means that compared to children of the same gender and age across the United States, 60% have a lower BMI than your child.

                                             According to the Center for Disease Control:

• A BMI percentile of 4.99% and below is thought to be underweight
• A BMI percentile of 5%-84.99% is thought to be healthy
• A BMI percentile 85%-94.99% is thought to be at risk for overweight
• A BMI percentile 95% and above is thought to be overweight

Because your child's growth is a process, these numbers (height, weight, BMI) are constantly changing.  The BMI that your nurse calculated is based upon your child's height and weight measurements at the time of your child's school health screening. 

Your child's BMI is influenced by genetic makeup, state of health, dietary intake, and physical exercise.  Serious athletes may have a higher than expected BMI due to their increase in muscle mass, as muscle weighs more than fat. 

Because this is Pennsylvania State Law, your school nurse must calculate this measurement each year as part of your child's growth and development assessment.  It is meant to be one indicator, along with many other indicators, of your child’s health and development.  Your child is NOT given this information at any time. The certified school nurse makes the calculations after the child's health screening session and notes this information in your child's school health record. This medical record is kept confidential. Your certified school nurse will send a letter home in the mail with the screening results.  This letter will be addressed to the parent/guardian of the child.  The letter is intended to be informative and helpful.  It emphasizes that the BMI should be considered as one screening tool and should not be considered as a definitive measure, as the indicator does have limitations. 

Your child's health care provider knows your child and your family history.  He/she is the best person to evaluate whether or not your child's measurements are within a healthy range. Your health care provider can assist you in planning for a healthful diet and exercise program for your child. 

We encourage you to discuss this issue with your child’s physician.