IUGR / Small for Dates babies
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Topic: IUGR / Small for Dates babies
Posted By: tishy
Subject: IUGR / Small for Dates babies
Date Posted: 02 April 2008 at 3:32pm
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Are there any others out there?
Aoife & Eimear were born at 35w4d due to Aoife being small for dates and some other problems also. She was 3lbs10oz/1.6kgs when born (Eimear was 5lbs/2.2kgs). At 2 months now she's 7lbs14ozs/3.55kgs and in the 3rd percentile while Eimear is in the 50 percentile. She's tiny but perfect in every way. I get the impression we still need to wake her every 5hours at night time still ( she can and has slept longer than this before) until she gets bigger. We've also got plenty of follow up appointments with the hospital to monitor her progress. Eimear gets checked up as well just for the sake of it 
I'm just wondering at what stage do they stop monitoring the baby so closely? |
Replies:
Posted By: Bobbie
Date Posted: 02 April 2008 at 4:53pm
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Rowan was an IUGR baby but only just (born 2.5kg at 38 weeks). We were not allowed to stop waking her every 3 hours for feeds until she hit the 3kg mark. Then we were able to demand feed at night but still had to do 3 hourly in the day.
But as I say she wasn't THAT small by comparison to other IUGR babies so there wasn't a lot of monitoring or intervention. A rambling way to say that I think it may go by weight? -------------  
 
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Posted By: BellaBoo
Date Posted: 02 April 2008 at 5:23pm
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Bella was an IUGR baby. We were induced and she was 5lb 7oz and 50cm when born but had 9 and 10 Apgars and blood sugars were great. Nobody told me to do anything different but in saying that she put on weight very quickly and has caught up (and then some in her length!). She now weighs 6.5kg and is 66.5cm long.
I would continue 3hrly feedings during the day and just let her sleep for as long as she wants at night-afterall she needs sleep to grow too. Just my opinion as I am no expert. ------------- http://lilypie.com">   http://lilypie.com">
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Posted By: emz
Date Posted: 02 April 2008 at 5:25pm
Jack was IUGR, but luckily had a growth spurt (stopped cutting off his umbilical cord silly boy!) at about 39 weeks, so was eventually born 40w3d at 3.48kg. He dropped from the 75th% to 35th% in 7 weeks, and just kept dropping. They were meant to induce at 37, 38, 39, 40w but the hospital was far too busy to worry about a baby that was being deprived  
I think they go by weight. We had to do 3-hourly feeds and demand feeding until he could drink 120ml at most of his feeds (was about a month old). He's still not growing fast, would have grown faster if he got out early but his tummy which was 4 weeks behind still has some catching up to do  He's getting there though.
My cousin is oz had twins just 2 weeks after me and there was about a lb difference in size so she was induced. Apparently its quite common for twins? Aoife's doing so well! You must be stoked! |
Posted By: emz
Date Posted: 02 April 2008 at 5:27pm
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I have a feeling if they whip them out earlier than letting them go full term (like they did with me) that the babies put on weight quite quickly. If you leave them too long they don't - hence Jack's slow growth now too.
I second what Topsy said - maybe you could set an alarm and if she hasn't woken after 5 or 6 hours you could feed her? That's what I had to do for Jack (mostly demand-fed, but yeah if he went over 5 or 6 hours I had to get him up). |
Posted By: sally belly
Date Posted: 02 April 2008 at 5:49pm
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Liam was born 6 days early weighing 5lb 1oz (2.3kg). It was only when I was at home reading over my hospital discharge papers that I saw they had IUGR written on them.
No one ever mentioned to me that I had to do anything differently due to his small size  (my MW wasn't the most helpful after I gave birth though). But Liam has absolutely thrived since birth & has gained weight since day 1. He's now in the 50th weight percentile, up from the 3rd percentile at birth.
I too would say they'll keep monitoring until she reaches a specific weight. Her weight is comparable to a newborn who would definitely be waking up overnight for food. So it sounds to me that you're doing the right thing for her. -------------    
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Posted By: BellaBoo
Date Posted: 02 April 2008 at 7:29pm
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Funny that all the replies are December babies! ------------- http://lilypie.com"> http://lilypie.com">
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Posted By: sally belly
Date Posted: 02 April 2008 at 7:34pm
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I was thinking that very thing -------------
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Posted By: Kazzle
Date Posted: 02 April 2008 at 8:20pm
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well i will just have to change that...lol
When Rhiannon was born at 38 wks, she was 2.4kgs (5lbs 40z) and i knew before her birth that she was IUGR as she has stopped growing at 35wks. I had to feed her every 3 hours 24/7 the first 4 wks she only put on 200gms, i stopped breastfeed, as she was obviously starving and within 4 days of being on formula she had put on 500gms...and has thrived ever since.... ------------- http://lilypie.com"> 
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Posted By: Bobbie
Date Posted: 02 April 2008 at 9:08pm
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Rowan's still small - around 5 1/2 kg and 58cms. She looks like a chub though.
Speaking of which - I better get her weighed and measured again. I just realised it's almost been a month since I did it last (hence the estimates) -------------
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Posted By: jack_&_charli
Date Posted: 02 April 2008 at 9:56pm
what is IUGR? ------------- http://www.alternatickers.com"> 
http://lilypie.com"> 
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Posted By: Bobbie
Date Posted: 02 April 2008 at 10:39pm
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Intra- Uterine Growth Retardation (I think). It means the baby isn't growing properly in the womb.
Oh and I meant to say before - they're all the Dec babies because they were being considerate and getting out so the mummies could have New Year's drinks  -------------
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Posted By: tishy
Date Posted: 02 April 2008 at 11:10pm
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Haha! Considerate Dec babies!
Aoife was 42.5cms when she was born, she's now about 47cms I think. She scrunches up into a tiny ball when you hold her so she looks even smaller.
We were discharged from Neonates after 10 days with 2 teeny babies. Was never so scared in my life. Both girls were just back to birth weight. We had to top them up with EBM after every feed to fatten them up. We're still feeding every 3 hours during the day which is why I think they last longer at night time. We're going with 5 hours for the moment and will see from there. emz - I think it's pretty common. When my Mum had me and my twin sister there was 3lbs between us. I'm pretty sure if I'd gone to term I'd have had about the same difference. We're back for another Neonatal follow up at 12 weeks so I'm sure they'll let us know then if they're happy. |
Posted By: BellaBoo
Date Posted: 03 April 2008 at 9:06am
Your doing a fabulous job Tishy! I really dont think I would cope with two. You are a  ------------- http://lilypie.com"> http://lilypie.com">
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Posted By: monster
Date Posted: 03 April 2008 at 9:22am
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That's interesting Sally Belly - same for me - I just read it in my notes (IUGR/SFD). However since my boy was born at 39 weeks and was 7lb 1oz I don't think we really qualify compared with all these other wee babes. -------------   
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Posted By: Bobbie
Date Posted: 03 April 2008 at 12:07pm
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Just took Rowan into plunket today 5.56kg and 58 1/2 cms so my estimates above were almost bang on! -------------
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Posted By: tishy
Date Posted: 03 April 2008 at 1:36pm
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Good guessing Bobbie!
sally belly - I think that's the hike in weight that the doctors would like to see from Aoife. I get the impression that if she hasn't left the 3rd percentile at our next appointment ( @ 12weeks old) that he'll be suggesting a formula feed. Not that I have a problem with using formula, I'd probably welcome the excuse
However I believe that as long as she's gaining weight at a steady rate that she's fine as she is. |
Posted By: emz
Date Posted: 03 April 2008 at 2:30pm
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I think its the rate of growth that we as mothers are more concerned about, like you said. While most babies are classed as IUGR/SFD if they are a certain size, there are others (like Jack) who were a normal size yet were IUGR. I was just lucky (or unlucky because of the stress) that the growth was monitored so I knew why he wasn't growing so fast. My boy's still in the 35th% but is growing at a steady rate so the nurse isn't worried.
I think you're doing such an amazing job Tishy. I fully commend parents of twins - I have 2 cousins that have twins and see some of what its like - you guys must be amazing at multi-tasking lol! |
Posted By: sally belly
Date Posted: 03 April 2008 at 3:31pm
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Well done Rowan (& Bobbie for your guesses).
Does anyone know if you have one IUGR baby are you more likely to have another? I remember my MW saying to me that I'd be likely to have another small baby. I never thought much of that at the time... But next time I'll definitely be insisting on a growth scan(s) so any probs could be picked up. Although like emz eluded to, is it really worth the stress of knowing your baby isn't growing?? I think I'd like to know all the same. Tishy, I second (or third) what the others have said about you doing a wonderful job with your precious little girls. Parents of twins deserve gold medals   -------------
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Posted By: Bobbie
Date Posted: 03 April 2008 at 5:04pm
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My mum and my gran both had small babies. Rowan was doing fine up until the end when suddenly the bloodflow through the umbilical cord dropped and she was at the bottom of the percentile range.
I reckon that probably it's a hereditary thing in our family and just wasn't picked up in previous generations. So yep I think Rowan's sibling will probably be small as well. But I have no idea if there's any scientific evidence. -------------
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Posted By: BellaBoo
Date Posted: 03 April 2008 at 5:44pm
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The lady at Plunket said today that normally babies grow to fit your pelvis. So those that produce small babies at full term will do so for babies after that. I dont think that would apply to IUGR or prem babies though ------------- http://lilypie.com"> http://lilypie.com">
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Posted By: emz
Date Posted: 03 April 2008 at 5:53pm
| From the research I read about it, it is diff for iugr and prem, as opposed to just making small babies. Apparently iugr babies are usually from a number of factors that are specific to that pg, so doesnt mean you will get an iugr baby 2nd time around. sorry, one handed typing with jack in my arms! |
Posted By: tishy
Date Posted: 03 April 2008 at 8:47pm
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Bobbie that's very interesting because my twin sister was a 4lber at full term , I was 7lbs.
It was the blood flow reduction in the placenta that was the final decider for my c-section also. My placenta got sent away for analysis, I've yet to hear the results. It'll be interesting to see what they are though |
Posted By: emz
Date Posted: 03 April 2008 at 8:50pm
| OMG Tishy, Eimear and Aoife are so cute in your new ticker photo! Just delicious! |
Posted By: tishy
Date Posted: 03 April 2008 at 8:54pm
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Oh and thanks for the kind word too girls
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Posted By: Bobbie
Date Posted: 03 April 2008 at 10:13pm
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Wow Tishy they look like they're doing so well. I love the photos of them. -------------
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Posted By: sally belly
Date Posted: 05 September 2008 at 12:08pm
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How are the girls doing now Tishy, specifically little Aoife? I thought I'd revive this topic as recently I asked a question in the "ask our experts" section & got this response:
Question My son (7 months) was born at full-term but was quite small (2.3kg). I see on my hospital discharge papers that he was classified as "IUGR - unspecified". I didn't have any scans past 20 weeks so it was a bit of a shock & surprise when he was born. I have started to think ahead to baby #2 & am wondering what will need to be done diferently next time. Can I still use a midwife as my LMC & is it simply a case of having a growth scan(s) to check on baby's rate of growth during the later stages of pregnancy? Answer Obstetrician Dr Anil Sharma replies: The average birthweight for (assuming) european babies is 3.5kg so yes, he was small. Obstetricians are trained in the detection and management of IUGR pregnancies. There are many causes in general including poor nutrition during pregnancy, smoking, drugs, pre-existing medical problems including antiphospholipid syndrome, excessive exercise and pregnancy associated problems (eg pre-eclampsia and diabetes). There can also be placental problems and infections and finally fetal problems including abnormalities. There are also many, many cases where a 'cause' is never found out. An obstetrician will be able to advise you about preconceptual blood tests you may need and the need for prophylactic treatments such as aspirin. Obviously your future pregnancy will require close surveillance. In New Zealand you can use a midwife LMC but to be frank, you are asking an obstetrician, so I would advise that best practice involves an obstetrician. If a private one such as myself is outside your budget, then a midwife LMC should refer you for a plan to a public one, but bear in mind that tests and any prophylactic treatment need to be initiated before pregnancy and in early pregnancy respectively. best wishes Dr Anil Sharma TBH this worries me a little. I was thinking that I'd use a MW again & just have some more scans past 20 weeks . Does anyone have any idea how you go about having the tests he mentions before you get pregnant? I don't think we can really afford an OB so I'd prefer to use a MW who will refer me to one at no cost (is this even how it works? - I could be completely wrong). I tried talking to DH about it but he doesn't really think it'll be a huge issue. I didn't really think so either but after reading Dr Sharma's reply I'm not so sure. Eeek. Maybe Liam can be an only child  -------------
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Posted By: emz
Date Posted: 05 September 2008 at 1:44pm
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Sally, I really wouldn't worry about it too much. Under our health system, if your LMC feels you need an OB, you will be referred to a public one. I was for IUGR (also saw a private one for a while but couldn't afford it anymore) and they were better than my private one to be honest. My one was $150 per ten minute appt and then if you conceived, it was $75 for every appt after that. Being there for the birth was $2500 so hence I had a public OB there.
You will probably just be referred for scans every 2-4 weeks from 20 weeks until you reach about 30-32 weeks then fortnightly until birth to monitor. But as that response says, most IUGR is specific to the pregnancy and doesn't mean it will happen next time around. Our reason I think was Jack was restricting his cord when he starting turning breech to normal. So yeah I wouldn't worry about Liam being an only child. They will take care of you as its your right as a NZ citizen. Just talk over your fears with your m/w and if you plan on using the same one next time maybe give her a call now to talk over it. I can understand why its hard though cos you never had an answer as to why Liam was IUGR. And I guess the thing is because you carried so normally (not like me or Topsy where it was obvious we didn't have big babies) that you should be referred for scans as obviously the FH thing they do from your belly button wasn't very accurate. Anyway, hugs! So many things to think about for next time ay? |
Posted By: jack_&_charli
Date Posted: 05 September 2008 at 2:06pm
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jack wasn't 'classed' as IUGR but was only 2610grms at birth and was on the 20%percentile on the IUGR growth chart.........i had no special care during my pregnancy with charli and she was 3350gms at 41wks
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Posted By: josephnia
Date Posted: 05 September 2008 at 3:17pm
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Blake was induced at 36 weeks because he was IUGR - was 2080gm at birth and spent 2 weeks in SCBU. My mw said it was because my blood pressure went up at around 30 weeks so I was monitored from then and it was found that he wasn't growing well.
I hadn't considered doing anything different if and when we have another child, I asked my mw about my chance for subsequent pregnancies and she said that if it's another child with the same partner then your chances of an IUGR baby go down because your body is 'used' to it, but with a different partner the chances are the same. I would be happy under mw care again though because my mw was super on to it and looked after me really well and from then I was under hospital care as well anyway. Blake is now 14 weeks old and probably around 5kg and goes generally 5-6 hours at night - I'm guessing it might take longer for him to sleep through until his weight comes up more? How old or how much did your baby weigh before they were sleeping through? I know it must vary hugely but it might give me something to go by! -------------  
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Posted By: emz
Date Posted: 05 September 2008 at 5:06pm
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Yep Jo I think it does take longer, my baby wasn't IUGR at birth but was in utero until a growth spurt at 38 weeks so was OK when he came out (3.4kg) but had a really small tummy which meant he was hungry. I gave him a dreamfeed so he slept through at 9 weeks but has woken up at 5am for the last few months due to hunger.
You could try and shove as much milk in to him during the day as possible?  I think they *can* sleep through from about 6kg or something, but it really depends on the baby unfortunately.
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Posted By: lucky3rdtime
Date Posted: 08 September 2008 at 11:46am
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Gabrielle was a small baby at 3.02kg and was a week overdue, not specifically IUGR, but there was a concern during my pregnancy cos at the 20 wk scan they discovered that her umbilical cord only had two vessels ie one artery and one vein instead of two arteries and one vein. Therefore we had about 6 scans towards the end of the pregnancy the last one was at 38 weeks and three visits to the obstetrician at the hospital. She was at about the 25th percentile for everything but was growing okay.
Her cord when she was born was pretty fragile though. She now is up to around the 50th percentile for her weight and height. Your midwife sounds like she was pretty onto it anyway and I don't think an obstetrician could have done anything else other than monitor your bp and the growth of the baby, the midwife can refer you to an obstetrician if she thinks its necessary anyway, then it won't cost you anything but you will get peace of mind. It sounds like you know the reason for the IUGR too which can be helpful for future pregnancies. ------------- http://lilypie.com">  
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Posted By: Bobbie
Date Posted: 08 September 2008 at 8:14pm
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Sally I see the clinic our MW's worked from offer an 'elite' package where you can get Janet and Paul together. Maybe you could check into it. I'm guessing you'd just pay for the OB since the MW would fall under the gvt funded LMC?
Anyway those were the two I had last time around and I highly recommend them both - they're lovely. Janet mentioned that for me to get Paul just for the birth would be around $2000 which isn't bad really. -------------
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Posted By: tishy
Date Posted: 08 September 2008 at 10:03pm
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There's now just 150gs between Eimear & Aoife. Aoife is a greed for solids so I'll be interested in their next weigh in as I'm weaning them onto formula currently too.
You wouldn't even know that Aoife had been so much smaller at birth. They're both around 6kgs now. They dropped to the 10% percentile at their 6 month NICU checkup. (had been 50% & 25%) They had just started solids and had a cold for 2 weeks so not really concerned. It does mean we get another checkup with the Paed before Xmas though
My Obs told me that Aoifes IUGR was as a result of twin pregnancy. So if I had a singleton pregnancy I'd be unlikely to have a small baby. I'd be happy to go back under my Midwife again if I had a singleton pregnancy. If it's twins however, I'll be going for a private Obs. I don't fancy doing the public system with 2 toddlers in tow
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Posted By: Bobbie
Date Posted: 08 September 2008 at 10:04pm
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oh my gosh if you have twins again I will worship the ground you walk on supermummy -------------
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Posted By: callalily
Date Posted: 09 September 2008 at 4:24pm
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my baby was born via emergency c-sect at 38 weeks due to distress. He was 2.1kg so around 4 and a half pounds, it was as he was being pulled out that the ob said "looks like he stopped growing 6 weeks ago". I was under a team of obs (sally you know who!), and none of them picked up that he had not grown (and i was seeing them weekly due to problems i was having with crohns disease at the time).
at my 6 week check, i asked if there was anythng they would do differently for pregnancy number 2, and the reply was no, its just one of those things!
anywho, my little man is not on the 50th centile for head, length, and weight! so he was caught up well (bless him!). Up until about 3-4 months (from memory) i was feeding 3 hourly during the day and on demand over night. Before that it was 3hrly day and night (i shudder at the memory!).
Looks like there are a few IUGR babies on here! ------------- http://lilypie.com"> 
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Posted By: kiwigal
Date Posted: 09 September 2008 at 8:15pm
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My son was IUGR because he had stopped growing and was born at 35w 5d via emergency caesarean after a 12 hour labour. He is now 5.5 and is in the 50% percentile for his height and weight. |