IUGR/Small babies

PinkPuffyHeart2

I had a position check ultrasound earlier this week and they measured my baby and her fluid levels etc... Turns out she is a little small, weighing approx. 4 lbs 10 oz at 36 weeks and 2 days. They did some additional tests. The doctor came and spoke to me and my husband, explaining that our daughter was in the 9th percentile for her weight. They did additional testing to check my placenta and her activity, and she is perfectly healthy from what they can tell at this point.

However, due to her small size, they wanted to keep tabs on her by starting twice weekly non stress tests and another fluid check in a week, then probably a growth check in 2 weeks. She had her first NST Friday and passed with flying colors.

I'm not overly concerned, seeing as how DH and I were both small babies, my siblings were all small (5 lbs ish) and two of my sisters kids were smaller too (5 lbs, 7 lbs, 4 lbs). Also, since she has passed her tests so far, I really should not worry.

I just have that lingering "mom worry" and wanted to see who else is going through the same thing. What has your dr explained to you about it? My dr never said she had IUGR, but that's what WebMD or some other medical site said they term babies in utero under the 10th percentile...  

The nurse who did the NST said if she fails the NST in 20 minutes, they will go for 40 minutes, and if she still fails she will go for a biophysical profile. If she does not pass that then I will probably be induced. My dr said basically the same thing, but also added that if I do not deliver on my own by 39 weeks and she is still small, they may just induce me due to her small size... (Don't know how I feel about that- unless there is a true problem, I would rather not be induced.)

Any input?

mikaelaandmichael

Im going through the same thing. 2 Fridays ago had a growth u/s and her tummy is 3 weeks behind the rest of her body. Had a NST monday and she was good. Had another u/s Friday and she grew 1week but still 3weeks behind. I have another NST this coming Tuesday then another u/s Friday. Doc says he wants to try to keep her in till at least 37 weeks but he said be prepared if she needs to come earlier. It is kinda scary, but they are just going to continue to make sure shes still growing. If she shows any stress or no growth they will induce me, but he definitely wants her out at week 37.

Oh and my doc sent me to LD to get the steroid shot for her lungs. So in case she does need to come out next week then her lungs will be more prepared. And about being induced, i dont like the idea but if she cant grow properly inside and can grow better outside then i dont care. Whatever is best for her.

PinkPuffyHeart2

Was the growth ultrasound just routine or did your OB want it because you were measuring small? I've been measuring fine, and the small weight was incidental.

handsonthewheel

A friend of mine recently measured small and was sent to the hospital for an ultrasound where they discovered the baby was too small and immediately induced her. She was 37 weeks exactly and had a great and easy induction and her daughter weighed exactly 5 pounds when she was born. They're having to keep a closer eye on her weight now but she's doing brilliantly and had no health issues apart from a bit of jaundice. 

mikaelaandmichael

He has never once measured my tummy or anything but I've had to have u/s's every couple weeks due to low fluid. So during the u/s he wanted he check growth. Is your babys whole body small? My little girls head is on track and femur on track. Just her tummy is 3 weeks behind.

Sorry bad punctuation. On phone.

PinkPuffyHeart2

Mine seems to just be small overall, since they didn't point out one body part being smaller than the other. Her fluid level was good though, so I guess it is just her weight.

So your dr doesn't measure your fundal height?

And to the pp whose friend was induced, were there other reasons for induction or just weight? 5 lbs doesn't seem that small to me.

mikaelaandmichael

No not at all. I thought it was kinda weird FTM but since week 20 I've had a u/s at every appt. to keep an eye on low fluid.

Jtaxson

mikaelaandmichael:

Im going through the same thing. 2 Fridays ago had a growth u/s and her tummy is 3 weeks behind the rest of her body. Had a NST monday and she was good. Had another u/s Friday and she grew 1week but still 3weeks behind. I have another NST this coming Tuesday then another u/s Friday. Doc says he wants to try to keep her in till at least 37 weeks but he said be prepared if she needs to come earlier. It is kinda scary, but they are just going to continue to make sure shes still growing. If she shows any stress or no growth they will induce me, but he definitely wants her out at week 37.

Oh and my doc sent me to LD to get the steroid shot for her lungs. So in case she does need to come out next week then her lungs will be more prepared. And about being induced, i dont like the idea but if she cant grow properly inside and can grow better outside then i dont care. Whatever is best for her.

I am in the exact same boat. We have asymmetrical iugr with the abdomen measuring 3 wks behind at the 8th percentile for the last couple of weeks. My dr is monitoring and have me resting 2 to 3 hours a day. If nothing changes, he will let me cook until week 39, if it gets worse, then they'll induce.

mikaelaandmichael

Jtaxson:

mikaelaandmichael:

Im going through the same thing. 2 Fridays ago had a growth u/s and her tummy is 3 weeks behind the rest of her body. Had a NST monday and she was good. Had another u/s Friday and she grew 1week but still 3weeks behind. I have another NST this coming Tuesday then another u/s Friday. Doc says he wants to try to keep her in till at least 37 weeks but he said be prepared if she needs to come earlier. It is kinda scary, but they are just going to continue to make sure shes still growing. If she shows any stress or no growth they will induce me, but he definitely wants her out at week 37.

Oh and my doc sent me to LD to get the steroid shot for her lungs. So in case she does need to come out next week then her lungs will be more prepared. And about being induced, i dont like the idea but if she cant grow properly inside and can grow better outside then i dont care. Whatever is best for her.

I am in the exact same boat. We have asymmetrical iugr with the abdomen measuring 3 wks behind at the 8th percentile for the last couple of weeks. My dr is monitoring and have me resting 2 to 3 hours a day. If nothing changes, he will let me cook until week 39, if it gets worse, then they'll induce.

Im on my phone, how far along are you?

Jtaxson

I'm 35 wks 3 days.

PinkPuffyHeart2

Interesting. Wonder why one body part would grow slower than the rest? Did they say anything about why that could be?

Did your drs give you a weight estimate?

mikaelaandmichael

Jtaxson:

I'm 35 wks 3 days.

FX that your baby continues to grow. I don't know why my OB doesn't want to try for week 39. Hes giving me week 37 at the latest. And he estimated her weight to be around 4lbs 5oz

PinkPuffyHeart2

4lb and 5 oz at 34 weeks?? Your baby is almost as big as mine and I am almost 37 weeks... (my ticker is 2 days off...) But I guess you have a different situation completely because of her fluid level and small tummy...

 

mikaelaandmichael

stephmill26:

4lb and 5 oz at 34 weeks?? Your baby is almost as big as mine and I am almost 37 weeks... my ticker is 2 days off... But I guess you have a different situation completely because of her fluid level and small tummy...nbsp;

Your situation sounds like symmetrical iugr, the whole body is small. Asymmetrical is where only the tummy is small.

mikaelaandmichael

Oh and try not to Google it to much. My husband and i did and it just scared us more. My doc said to eat alot and sleep as much as possible.

PinkPuffyHeart2

mikaelaandmichael:

Oh and try not to Google it to much. My husband and i did and it just scared us more. My doc said to eat alot and sleep as much as possible.

 

Yeah I always google more than I should

That's interesting advice from your dr. I wondered about eating/nutrition being a factor, like, for me I know that my placenta is functioning properly but my entire pregnancy I have not been a big eater, up until recently. I could not stomach much. And so, I haven't gained much weight but I was also overweight pre-pregnancy so I thought it was fine. My OB told me that even if I didn't eat much that babies tend to get what they need, so I didn't really need to worry about it unless I couldn't eat for 3 days... Now I am wondering about that... I do take a very good prenatal vitamin and DHA, and vitamin D... so at least someof the nutritional stuff is covered there, but I admittantly do not eat great (health wise)... I try but I pretty much just eat what I want and I can't help but wonder if that may have contributed to her small size. Also, I work a very stressful job and long hours, and only get about 7 hours sleep a night I think... unless i'm off work.

mikaelaandmichael

Most of the time they have no idea what causes this. Im small myself but i have gained 27 lbs so far. I eat about 75 healthy...the rest junk food and candy. Still the doc said he doesn't know why.

PinkPuffyHeart2

Do they anticipate any problems when your baby is born? Like did they say anything about long term effects from it?

Sunshine05

My first daughter had IUGR and they delivered at 37w bc of it. She started in the upper and continuously dropped each month after my anatomy scan total fluke that we caught it!. I had 2x a week NSTs, BPPs, AFI checks and monthly growth scans. They delivered at 37w bc there is an apparent link in placental abruptions as you get to be full term since most IUGR is due to crappy placentas in the first place. She had a bit of trouble keeping her temp up but we were able to avoid the nicu by keeping her wrapped up and held/kangarooed all the time.

PinkPuffyHeart2

Sunshine05:

My first daughter had IUGR and they delivered at 37w bc of it. She started in the upper and continuously dropped each month after my anatomy scan total fluke that we caught it!. I had 2x a week NSTs, BPPs, AFI checks and monthly growth scans. They delivered at 37w bc there is an apparent link in placental abruptions as you get to be full term since most IUGR is due to crappy placentas in the first place. She had a bit of trouble keeping her temp up but we were able to avoid the nicu by keeping her wrapped up and held/kangarooed all the time.

 

Oh wow, good info to have. So she was dropping weight each month? What was her birth weight at 37 weeks?

Sunshine05

Yep, she was in upper percentiles and dropped from 70s to 50s to 30s to teens and then singles every time they checked on her. When we left the hospital she was 4.5 pounds... just made the limits for our carseat Chicco keyfit 30... with some car seats she wouldn't have hit the minimum and we'd have to stay or get a new one! Something to consider if you haven't bought one already.

PinkPuffyHeart2

Awww what a little peanut... Hopefully we're not back tracking... my carseat is good for 4lbs-35lbs... So she can't get smaller.. lol... or else we have to go shopping.

Sunshine05

That's good! Oh, and to answer your other question, no long term affects. She was small and took awhile to gain so she was in preemie then NB clothes forever, but by six months she was chunking up and at 18 months was in 75th percentile for height and weight! Perfectly healthy!

PinkPuffyHeart2

Sunshine05:

That's good! Oh, and to answer your other question, no long term affects. She was small and took awhile to gain so she was in preemie then NB clothes forever, but by six months she was chunking up and at 18 months was in 75th percentile for height and weight! Perfectly healthy!

Oh that's awesome! I'm glad she was ok. I have a niece who had IUGR but she was always like below 0 percentile my sister said... And she has developmental delays and low muscle tone. She is such a sweetie. At 4 years old she is learning to say words and is not yet potty trained. She sees a speech therapist, occupational therapist, etc etc...... And was 4lbs at 37 weeks but was born at a gestational age of 35 weeks so she had stopped growing.... I know my situation is different from my sisters and I anticipate my baby will be like your first, and do just fine once she is born since right now they see no problems, she's just small.

Dani318

I am having similar issues, I have been having growth scans done due to baby measuring Small in the 7th percentile. My doctor has never called it IUGR and doesn't see any placenta, blood flow or placenta problems but is inducing me early just one size alone. My doctor suggested I quit working and increase my protien a couple weeks ago. I am a therapist and was on my feet lifting walking and pushing all day so she said I was burning too many calories and thought Restong more would help baby gain more weight. I have my next appointment at 37 week and she said depending on how things look she will induce me within a day or week. I am worried to as I just want my baby to be able to come home with me and not stay in the nicu.

Dani318

Also forgot to add that my doctor is doing weekly nonstress test.

handsonthewheel

stephmill26:

And to the pp whose friend was induced, were there other reasons for induction or just weight? 5 lbs doesn't seem that small to me.

If they discover genuine IUGR, it is dangerous for the baby to remain on the inside as they have stopped getting the nutrients they need to survive. Usually they can see if there is a cord flow problem on the ultrasound causing the low weight/pause in growth and I believe they did see that with my friend. And for weight comparison, her son was born at 36 weeks and was 5lbs 12oz...so 5lbs at 37 weeks was still considered small. 

Jtaxson

Sounds like we've all been ordered extra rest and cal intake. Try not to worry too much. As long as you're getting weekly scans for AFI, cord flow and placenta check as well as nst, we should be okay. The dr will yank them out if there is a red flag.

I see an MFM and always measured ahead at more than 60th percentile until a month ago. Now we are under 40 overall and at 8 for the abdomen. I have mthfr and anticardiolipin something or other so I'm guessing my placenta is starting to crap out. Hopefully it can hold strong a few more weeks.

Dani318

Well I am praying all our little babies grow as long as the can and come out healthy. Good luck everyone and keep me updated with your Growth scans and planned induction dates!

rmwt001

DD1 was born at 37 weeks weighing 4 lbs 10 oz.  We had no indication before birth that she would be small.  Having said that, she has no problems after birth and was cleared to go home in a normal amount of time, weighing 4lbs 4 ox.  The first few weeks were a little extra stressful - they had me nursing her every 2 hours and pumping in between and feeding her with an eye dropper to try and put weight on.  By 2 months she was up to the 25% for weight and has remained between 15-25% and she is now 2. Technically she was not considered IUGR because she had no problems.  This pregnancy they did send me for an extra growth scan at 28 weeks.  DD2 measured great, but since I had no growth scan with DD1 it's hard to have a basis of comparison - no way of knowing if DD1 was always small or if her growth slowed down.  Honestly, the hardest part was the comments from people.  One person actually stopped me in the grocery store shortly after she was born and scolded me for having such a tiny baby out.  Try not to worry so much.  Since DD1 was born I have met a ton of women who, like me, just have small babies!

PinkPuffyHeart2

Yeah I read in another message board how women were trying higher protein diets and rest/more sleep was suggested to help the babies grow. My dr didn't tell me to do anything. I'm still working and I've only just today tried to stuff my face as much as possible to hopefully maybe help her gain weight....

bumpuser8448316

DD has consistently measured small so I'm having monthly growth ultrasounds and they also started NSTs this past week. So far she's passed with flying colors and she looks fine, just small.

If it was me, I would push hard against inducing early for size unless they know for sure there is something going on with baby that would make it safer for them to be outside than inside. I know the case with IUGR is that at a certain point they are typically better off being outside the womb so they induce early.

I asked my OB if their concern was IUGR and she said that yes, initially it was but that as long as DD keeps growing and doesn't start falling being or stop growing, then she's likely just small but that they want to keep an eye on her any way.

Some babies are small for no reason...same for outside babies. Some are just smaller than others, someone has to be at the bottom of the growth chart, you know?

PinkPuffyHeart2

QueSyrah:

DD has consistently measured small so I'm having monthly growth ultrasounds and they also started NSTs this past week. So far she's passed with flying colors and she looks fine, just small.

If it was me, I would push hard against inducing early for size unless they know for sure there is something going on with baby that would make it safer for them to be outside than inside. I know the case with IUGR is that at a certain point they are typically better off being outside the womb so they induce early.

I asked my OB if their concern was IUGR and she said that yes, initially it was but that as long as DD keeps growing and doesn't start falling being or stop growing, then she's likely just small but that they want to keep an eye on her any way.

Some babies are small for no reason...same for outside babies. Some are just smaller than others, someone has to be at the bottom of the growth chart, you know?

 

Yeah I agree, I don't want induction unless she is in potential danger... They said she is totally healthy as far as they can tell, just small... I guess time and testing will tell if she continues to do well, or not. I hope I just go naturally before any problems come up- then I will know her birthday is just "meant to be" and not feel like I am going against nature and possibly putting her more at risk by my own decision.