Am I being oversensitive?

[IABUQueen]

I’m currently pregnant with number 2. My first born had good development inside the womb but his development struggled between 32 weeks-36 weeks. Was referred to consultants but cause never found. Was born at the second percentile. I had attended constant hospital appointments because my weight wasn’t increasing and alarmed doctors of my concerns about baby growth but they were complacent. I had never taken it lightly but I was assured that prenatal vitamins were enough and I took their advice st face value.

Ever since I’ve been religiously going to the health visitor. Received help from lactation consultant on my insistence. Stayed at home as a SAHM so I give him the best food.. I’m just so paranoid and blamed myself and cried for ages because I felt it was me who didn’t get Well nourished in pregnancy even though I was healthy but struggled with nausea (had severe nausea).

My parents know this. I take him monthly to the health visitors and they’re happy with his progress as he is still on the curve.

Now I’m 32 weeks pregnant, I’m feeling nervous and told my father (who is a biology teacher) to please wish me luck that this time round my baby doesn’t stop growing in the womb like the previous one. I asked him for advice on what I can do to make sure this doesn’t happen (in the womb).

So my dad went on to say that my baby’s weight is to do with my breastfeeding, food and sleeping. And that if I look after these there shouldn’t be a problem..

I don’t get on with my dads wife, she has been constantly putting down my breastfeeding when I visit. When baby cries at night she says to my dad that I’m not producing enough milk. My dad is a biology teacher but has no clue about those issues and his wife is uneducated. She has not been able to breastfeed her kids and I feel she is purposely obsessed with trying to make it out that I am not doing s good job.

So I feel upset at my dad. We had this conversation many times before. He seems fixated on the idea that I’m not a responsible parent despite the fact I keep telling him I’m going to health visitors and my child is on the curve and they’re happy with his progress and it’s just that he started of small.

I just replied that I’m confident with me looking after my child who is now a 2 years old and is perfectly healthy but that he will remain below the average weight and that it is not within my control.

I already struggle to accept that I had a baby inside me who was malnourished and I couldn’t do something about it and I feel sensitive that my father’s only form of support is to make me feel like I’m not doing enough as a mother.

AIBU?

Re growth for SGA infants born at term. Most of the catch-up growth occurs during the first year and is near completion by 2 years of age. For those born preterm, the SGA infant can take four or more years to achieve a height in the normal range.

It is also worth noting that those born very prematurely and with more severe degrees of growth restriction, especially reduced birth length, are less likely to reach a stature within the normal range, whereas those with taller parents are more likely to reach a normal adult height.

Re weight infants born SGA have have low lean mass and may have increased body fat. Rapid weight gain is known to increases the risk of obesity, so in summary as long as baby is gaining weight and following the centile there’s nothing to worry about.

It sounds like your 2 year old is doing just fine.

It also sounds to me as though you're hoping for a kind of support from your father that, however well-meaning he is, he isn't able to provide. I think my own dad would struggle to find the right words too.

You've identified anxiety and birth trauma as problems too, here. Are you getting any support for that? If not, contact your midwife and let her know what's going on and access anything/everything they offer you. Good luck.

Your anxiety sounds overwhelming OP, and I would urge you to seek some support from medical professional.

My DS was born at 38+2 and weighed 5lb4oz which put him on the 0.2 centile. He is now 10 months old and on the 75th centile. He is formula fed and also eats lots of solid food. If your child is 1 and has only gone up to the 9th centile, maybe he could be eating more to help increase his weight? Maybe your SM is trying to help and not just criticise. Could it be that he isn't getting enough nutrition from his diet and breast milk?

If your child is 1 and has only gone up to the 9th centile, maybe he could be eating more to help increase his weight?

But you imply there is something wrong with being on the 9th percentile when there isn’t.

All centiles are within a normal range and as along as the child continues on the same percentile line there is no problem.

The percentiles are not there to be ‘climbed’.

It’s isnt as though every child has to climb up to at least the 50th centile otherwise they are underweight.

I just assumed that if the health visitors who were seeing his charts every month, indicated that they’re happy with his progress and there s no concerns then that should be enough for whoever asks me to stop bringing it up again. But it appears I’m misunderstanding?

My health visitor specifically told me to stop worrying about him jumping curves and that it would in fact be a concern if he did a sudden jump to the 50th centile from where he is at. And that if he is following the curve then that’s perfect.

And in fact she said the height charts are irrelevant. I have asked her if I should do weight vs height and she said they stopped doing that. What they do is weight vs age. So I haven’t actually been measuring height as I didn’t want to worry myself about something if the health visitor told me not to.

But he is quite a strong baby. Very active. Very happy and pleasant. Has his days where he is a fusssy eater but is grazing all day usually on healthy foods. Breastfeeding is only for the night and nap times. He also takes cows milk.

He is just lean in his physique and doesn’t have much fat. Me and his dad were not SGA.

He wasn’t diagnosed with IUGR. It was mostly me who followed this up. When I was losing comsiderable weight in pregnancy I chose to go for a private scan at 32 weeks where he showed he was spot on average. But upon My visit to GP at 34 weeks my fundal height which was usually measured spot on was 2 weeks behind but she seemed to brush it of. So then I went to the maternity care when I suspected baby was not moving like before and thats when they referred me to a scan which took a week to schedule and at 36 weeks they found that his abdominal circumference was disproportionate to his cranial and other measurements which was not the case in previous scans.. and that his weight hadn’t increased as expected from his 32 week scan. The technician seems concerned but they said I was 36 weeks and so a bit too late for them to do anything but referred me to a consultant.

I was referred for a consultant the following week... but I delivered the day before my appointment. And I didn’t end up attending as I completely forgot it in the chaos of birth.

During my birth baby had aspirated Meconium and was stressed for oxygen and so they had to deliver me quickly with induced labour and I had terrible fears during labor about him not being able to withstand it all. The midwife didn’t seem to understand my concerned and things were rushed. Baby was born at an acceptable but low weight. The only issue is this was not predicted to be his percentile throughout the pregnancy and he made a sudden descend during his 32-36 weeks.

All in all I wasn’t at all happy with the medical care I received as I felt I kept raising concerned to deaf ears until it was too late, and never ended up finding the outcome.

I am going to see a consultant at 34 weeks. So I will discuss with them finally my concerns.

I did have recurrent miscarriages before my first pregnancy. So it is possible that I developed trust issues around my ability to carry a baby to term and it might be clouding my judgement.

I guess I am being oversensitive. I had just wanted reassurance and wishes of luck from my father for this pregnancy . I had discussed with him how health visitors are happy with sons progress many times before. But I guess not everyone believes this is enough.

Thanks everyone for your advice. Especially those that shared their experiences with SGA or IUGR babies.

Do you mind me asking, what was it that your consultant was able to help with during pregnancy when they found out there was developmental issues in utero?

And did your following pregnancies have the same issue? Or was it a one off ?

@IABUQueen I’m sorry that you feel that you weren’t listened to during your last pregnancy and labour, and felt unsupported by the healthcare professionals involved in your care. These factors along with your previous MCs and continued feeling of guilt that your son was born small, sounds to have caused you to become increasingly anxious which is understandable.

If you look at my original response I’ve tried to briefly explain the reasons why SGA can occur, and in addition to this there are also other maternal risk factors such as age above 35, BMI below 20, obesity, smoking, drug use, high blood pressure, pre-eclampsia, first pregnancy amongst others that are known risk factors for SGA babies. Also because your son was born SGA there’s a 2 fold risk of your next baby being SGA so this is why you receive umbilical artery Doppler and growth scans from 26-28 weeks gestation in subsequent pregnancies.

In summary, there is absolutely nothing you could have done differently to prevent your son being being born SGA or increased his growth whilst in utero. There’s also nothing you can do in this pregnancy to prevent your baby being SGA other than try and eat healthily and try and relax a little.

Re the guidelines for monitoring a SGA baby. When you go to your midwife appointments the midwife will measure your abdomen to ascertain the fundal height. If it’s found that you’re measuring small or large for dates you’ll be referred for a scan which is what you had. If it’s found that the baby is SFA or in fact large for gestational age further scans will be carried out up until delivery. No medication is given to women to help the baby grow, it’s a case of monitoring the baby’s growth through scans and if any other issues occur the plan would be to deliver the baby earlier. The only medication given to women with SFA babies is medication to manage any medical conditions which has occurred/or are pre existing such as women who have pre-eclampsia or high blood pressure.

Re meconuim amniotic fluid during labour this is common. Around 15-20% of babies are born with meconium stained amniotic fluid. It happens for a number of reasons such because their digestive system has reached maturity and the intestine has begun working, it also happens as a physiological response to labour itself and is not necessarily related to the baby being distressed, it’s also common in SGA babies. If there is lots of meconuim stained amniotic fluid during labour the baby will be/should be closely monitored and you should be placed on a CTG to monitor the babies heart rate.

Re asking for other people’s advice around their SGA babies ect. I understand that you just wanting to know what is normal. But normal is different for everyone. All babies are different as are women’s pregnancies and subsequent pregnancies, and I don’t think asking questions around weight ect on here is helping your anxiety, as you’re getting a lot of conflicting information based on opinions not facts.

You are correct re the big jump across centiles, yes it would be a concern. If a baby had suddenly jumped to the 50th centile my first question would be what is the baby was being fed? Is the baby having hungry baby mill, being early weaned ect. So i’d take those comments with a pinch of salt and listen to your health advisor about his weight not an online forum. As long as he’s continuing to thrive and is happy that is the most important thing. It sounds like you’re doing a great job, you need to be kinder to yourself.

Re your anxiety I’d speak to your midwife about how you feel and arrange some counselling. Or if you don’t want to do that try some online mindfulness or you could look NHS moodzone website.

www.nhs.uk/conditions/stress-anxiety-depression/understanding-panic/

Sorry SFA should be SGA and I was also going to suggest why don’t you also consider looking at hypnobirthing.

Blah, as much as your post is very informative you let your self down on one point.... no one suggested a child who was under weight should suddenly jump centiles from low single figures to fifty, that's ludicrous and would of course be concerning,

What was said was there was no reason a child born under weight should still be significantly underweight at two, unless there is a medical issue. Or the child is not being fed adequately.

The op is under the impression that her child at two is under weight because they were born underweight, people are pointing out this is not correct. The father and his partner are saying rhe child is not adequately fed thus causing rh child to still be under weight. The op is saying this is incorrect, they are under weight at two because they were born under weight.

The Biology thing doesnt mean he's an expert on childhood growth & development. I think there's an existing relationship dynamic of you having low self esteem & wanting his love & approval. If your toddler is just a little small now but eating well he'll probably make it up in a later growth spurt. Try not to worry & don't make your Dad the oracle on child development. Having an opinion doesn't necessarily make someone an expert.

@Bluntness100 the 50th centile comment was in response to the op. I was agreeing it would be a concern.

My health visitor specifically told me to stop worrying about him jumping curves and that it would in fact be a concern if he did a sudden jump to the 50th centile from where he is at. And that if he is following the curve then that’s perfect

op , sometimes things just happen. Please do not blame yourself for your sons birth.
There are so many charts and such and many just cause distress.
I have an adult son who was born well after due date ( days before scans) he had the same meconium issues and other, despite a 9lb birth weight . At one stage I was told he was too tall for the chart.
Don't beat yourself up and tell your father and his partner to shut up and stop making negative comments which they clearly know nothing about.
If anyone has failed it is your father for coming out with this and not supporting you.
Btw .son 6ft 1ins and fine .

I just assumed that if the health visitors who were seeing his charts every month, indicated that they’re happy with his progress and there s no concerns then that should be enough for whoever asks me to stop bringing it up again. But it appears I’m misunderstanding?

You’re not misunderstanding - but if you’re going to take advice from a biology teacher (biology teacher really does not = child development expert) over your HV, what’s the point in seeing your HV regularly? It’s not your dad you need to convince I think, it’s yourself. Your DS doing fine from what I can tell. My DS was born on the 9th percentile I never saw this as an issue or that he was underweight - he’s jumped a few percentile now but we know plenty of babies that are much smaller than him - again I’ve never considered them ‘underweight’, babies just come in different sizes. I think your main focus should be getting help with your anxiety.

I really wasn’t going to take advice form my dad.

He is a biology teacher with a PhD in thyroid glands and the point is he is usually passionate about discussing science. His research was on the effect of thyroid glands on fetal development so he isn’t exactly alien, but a bit outdated. I wasn’t after any advice, I just informed him what the health visitors told me many times before. I was taken aback that he would listen to his wife who is a primary school drop out and constantly tries to shame me and my parenting.

I was just having a discussion and asking him to wish me luck in this pregnancy. We don’t have much else to talk about. I did tell him I was nervous because this is the time when my first baby stopped growing, that’s how it all started. I told him I was nervous because I had a growth scan and that I’m hoping i did things right this time and that since the gestational curves show a huge jump in weight during the following three weeks I’m hoping I do everything by the book so that I don’t end up blaming myself and I asked him what he suggests (in hindsight maybe I shouldn’t have asked). Really I was just expecting him to say take ur vitamins and eat more protein and drink milk. I guess I just wanted to get a conversation going.

I don’t look up to him as some scientific god. My background is also in research, and I have studied IUGR and SGA in my modules.

I do think I have a complicated relationship with him.

I was just posting here today to work out whether my other issues are clouding my judgement and im being over sensitive. Just to help myself unpick things from real issues.

It does seem that his response isn’t entirely odd and so I should expect it and just avoid the topic with him next time.

To clarify how the growth charts monitor growth. And what’s deemed as over and underweight in a boy aged 0-4 years.

In summary - children over 2 with a BMI above the 91st centile suggests that the child is overweight; a child above the 98th centile is very overweight (clinically obese). BMI below the 2nd centile is unusual and may reflect undernutrition.

What do the centiles mean?
These charts indicate a child’s size compared with children of the same age and maturity who have shown optimum growth. The chart also shows how quickly a child is growing. The centile lines on the chart show the expected range of weights and heights (or lengths); each describes the number of children expected to be below that line (e.g. 50% below 50th, 91% below the 91st). Children come in all shapes and sizes, but 99 out of 100 children who are growing optimally will be between the two outer lines (0.4th and 99.6th centiles); half will lie between the 25th and 75th centile lines.

Being very small or very big can sometimes be associated with underlying illness. There is no single threshold below which a child’s weight or height is definitely abnormal, but only 4 per 1000 children who are growing optimally are below the 0.4th centile, so these children should be assessed at some point to exclude any problems. Those above the 99.6th centile for height are almost always healthy. Also calculate BMI if weight and height centiles appear very different.

What is a normal rate of weight gain and growth?
Babies do not all grow at the same rate, so a baby’s weight often does not follow a particular centile line, especially in the first year. Weight is most likely to track within one centile space (the gap between two centile lines). In infancy, acute illness can lead to sudden weight loss and a weight centile fall but on recovery the child’s weight usually returns to its normal centile within 2–3 weeks.

However, a sustained drop through two or more weight centile spaces is unusual (fewer than 2% of infants) and should be carefully assessed by the primary care team, including measuring length/height.
Because it is difficult to measure length and height accurately in pre-school children, successive measurements commonly show wide variation. If there are worries about growth, it is useful to measure on a few occasions over time; most healthy children will show a stable average position over time.

Why do the length/height centiles change at 2 years?
The growth standards show length data up to 2 years of age, and height from age 2 onwards. When a child is measured standing up, the spine is squashed a little, so their height is slightly less than their length; the centile lines shift down slightly at age 2 to allow for this. It is important that this difference does not worry parents; what matters is whether the child continues to follow the same centile after the transition.

Children aged 2 and above
In a child over 2 years of age, the BMI centile is a better indicator of overweight or underweight than the weight centile; a child whose weight is average for their height will have a BMI between the 25th and 75th centiles, whatever their height centile. BMI above the 91st centile suggests that the child is overweight; a child above the 98th centile is very overweight (clinically obese). BMI below the 2nd centile is unusual and may reflect undernutrition.

www.rcpch.ac.uk/sites/default/files/Boys_0-4_years_growth_chart.pdf

Blahblahblahnanana

Thanks a lot for your detailed advice. I’ve book marked it so I go over it again. It’s been really beneficial for reassurance as i am struggling to get a conversation going with the midwives and the consultants just rush through things.

Thank you

Bluntness100 but if he’s on the 9th centile he isn’t actually ‘significantly underweight’, is he? Someone has to be on the lower end of the curve. The HV’s aren’t concerned about his weight.

I don’t look up to him as some scientific god. My background is also in research, and I have studied IUGR and SGA in my modules

Ok, so you have some awareness around why it can occur, and from your research should recognise that there was nothing you could do to prevent it happening in this or your last pregnancy? So yes, eating healthily, taking care of yourself and attending your midwife/scan appointments and repeating to your dad and step mum that your son is thriving and is not underweight is all you can do.

I still think you need to discuss your anxieties with your midwife.

@Bluntness100 the OPs son isn’t underweight he’s on the 9th centile.

Thanks again..

So I’ve just thought I’d mention all the percentiles I’ve been talking about are not my sons BMI, not measured against length.

It is simply just his weight against his age.

I think maybe I should start plotting his length myself. I had been confused and assumed it’s unnecessary as the health visitor said they stopped doing this and I was worried to make myself anxious over yet another thing so haven’t been measuring any length/height.

I guess most pp taking about change in percentiles we’re talking about BMI?

@IABUQueen glad I could help to reassure you. Perhaps if you’ve got questions write them down for your next appointment so that you can go through them. And you could also ask for a debriefing for your last labour if you think it will help.

talking, were

Sorry autocorrect