Small for dates .... advice ... just in case !!

[chelseaxxx]

I'm 37 + 2 and "very" small for dates apparently. Doctors briefly mentioned early delivery (not very happy with hospital staff and their explanations )
Was jut wondering whether anyone has had similar experiences and what option they chose - being induced ? caesarean ? i'm a bit scared about being induced as google (ever to be relied on to scare the out of someone!) said small babies often struggle. also spinal block or epidural for caesarean ?
thanks

I was told i was small for dates, have you had a groth scan?

DD came on her due date, she was 7lb 9oz so it turned out she was'nt small she was just curled up in a ball in my tummy.

Chelseaxxx - get the hospital staff to explain to you fully what their concerns are and what their suggested plan is. You cannot make decisions without proper information. I have seen many women have successful inductions with small for dates babies. Babies are monitored closely during induction and if there were any causes for concern then a C/S would be done. I have also seen small babies be delivered by elective C/S. Discuss it further with your caregivers who have a duty to inform you.

thanks guys, waiting for a phone call from a new consultant so hopefully he/she will explain things a bit better for me. have had 2 growth scans so far, 2 weeks apart and baby only put on about 4oz (is now about 4lb5oz) - so baby is growing, just not enough ! trust my baby to be awkward

I was told at 35 weeks that DS was very small for dates and would weigh 4lb at term. He was born at 35+6 weeks weighing 5lb 2oz. He was very compact tho, and had to wear 3-5lb clothes.

Chelsea, I was told dd was small for dates and had several growth scans from about 30 weeks onwards. Early delivery wasn't mentioned in my case and she arrived 3 days early, weighing 5lb 9oz - vaginal delivery.

In my case, the midwives didn't seem to accept that 2 smaller than average parents are going to produce a smaller than average baby.

Good luck

chelsea - I had a small for dates baby - spotted at 22 weeks and so I was monitored/scanned and early delivery was often talked about. At 37 weeks dd hadn't grown in two weeks so I had to stay in from that moment and was induced. It didn't work for me and I ended up with an emergency c-s. From what I have since read, they will leave the baby put until growth has really slowed and then deliver. As you are already over 37 weeks you're in a pretty good position. DD was eventually born at 37 + 3 and was 4 lbs 9 oz. She had to go to SCBU for a couple of hours to heat up but was otherwise fine and at 17 months you really wouldn't know she had had an issue.

I think they prefer to induce pre 39 weeks as before 39 weeks there is a slightly higher risk of breathing problems in the baby.

I had a spinal block for my c-s on the recommendation of the anaesthetist. In fact, I was having syntocin contractions (pretty painful) for a few hours before the induction was stopped and I was asking for an epidural and the anaesthetist talked me out of it as he preferred to give spinals for c-secs and it was heading that way.

In hindsight, I would have tried induction but not for three days. I only got to 1 cm dilated on the pessaries and so I think the signs were there that it wasn't going to work for me. However, someone else I know had induction at 36 weeks and it worked perfectly.

Sorry for going on !!

I think as long as the baby is continuing to grow they won't induce you or advise a c section. I was small for dates - discovered at 34 weeks and was monitored. Eventually went into labour naturally at 41 weeks - DS was delivered by emrgency c section but I was never told that was due to size. Had epidural by the way. He was 5lbs 4oz at birth and was fine - no need for any special care - again the health professionals don't seem to accept that small parents will have small babies ! Good luck - try not to worry

Deffo chase up your mw / consultant team so that you are fully informed of 'next expected checks / steps' IYSWIM. They'll decide with you the best course of action; often this will involve more frequent scanning than normal, so they might want to (or you might request) a scan to keep an eye on things. My dd was IUGR (following maternal hypertension) and was born at 4lbs 4oz by elective (medically required) c-s at 36+1 IIRC.

FWIW, I remeber at the time (say around 34 / 35 weeks) things really starting to 'speed up' re: the urgency of the situation IYSWIM (until then we'd kind of been expecting a term / natural delivery etc.)... the fine-tuning / monitoring of the baby really stepped up around this time, so don't be too shocked if soon people start talking dates and options ! (Oh, and dd just turned one and is a fine size !)

below the 10th centile is small and worrying. A retrospective study of "unexplained" 38 week stillbirths showed the one thing they had in common was being very small for dates (was in the BMJ a couple of years back).

I don't mean to scare the living daylights out of you, just to reassure you the medics aren't just being defensive or awkward.

How big are you and your dh? How big were you both when you were born? I got given loads of grief in both pregnancies because of my "small-for-dates" babies. Dd was born on the 2nd centile and is still on it (she is 4 now). Lots of hassle in hospital about feeding her formula and extra vitamins and stuff, with me muttering "she was not IUGR, she is petite". When I was pg with ds they wanted to do extra scans in case he was "too small". I said "have you seen my husband? I'm not expecting a big baby!". And then didn't show up for the scans...

I also know a lot of people who have gone through induction or cs because their baby was "too small" or "too big" and then when the baby was born - actually, it was a perfectly average size. Scans are notoriously bad at showing how big the baby is.

If the baby is small, then it isn't going to grow as much each week as a bigger baby. Its a percentage thing.

Get them to tell you exactly what they're worried about and why. If they want to induce you, or whatever, ask:

what are the Benefits
what are the Risks
what are the Alternatives
what if we do Nothing

BRAN is good for you...

Hiya, I did a feature on this a while back for Junior Pregnancy & Baby - can send it to you if you want. Just CAT me. Good luck xx

If your baby is still growing then i am sure everything is fine, my fuzzy brain seems to remember my midwife telling me that babies have a growth spurt in the last month of pregnancy, this certainly was the case with my DD2 and DS3.

Find out as much info as you can. I found it easier to write down a list of questions beforehand.

baby is way below 10th centile but that's another thing i don't understand !? will definitely be writing a list of questions for my new consultant, i'd rather be awkward at this stage than wait until the end and panic thanks for all your help guys - will let you know when i know more myself - don't know what i'd do without mumsnet, i'm now almost worry free

My first baby was born 6lbs 2oz - had small bump and extra scans but decided to leave me. He was 41 +1 weeks at birth so would have been very small if born early. I would just ask for regular scans and if baby is growing then maybe leave it as indeed they do often grow more in the last few weeks. However obviously its a case of balancing the risks. Good luck wiht the birth, when it comes.

Hiya Chelseaxxx

The Drs might be worried about the possibility of the placenta not performing properly. I lost my 2nd at 20 wks due to placenta failure. My DS was induced at 38 wks as there were possible signs of the placenta aging at that point. And at 38 wks you are considered full term anyway. So safer out than in my Consultant said. After 35 wks most risk factors drop dramtically. So just another question to ask about

BTW -- my induction went well DS born in about an hour after waters broken (but then I have fairly short labors) and he was a whoping 8lb 3oz (!!! good thing he didn't go full term !! _

Hello

Apparently the interpretation of growth scans can often be up to 15% out. I had a scan at 36 weeks last time, and was told that my baby might just make it to 7lbs. She was born at 39 weeks, and was....9lb 10!

Baby James was small for dates but was overdue and i was induced. He was 6lb 6oz. The reason for him being slightly small was a knot in his umbilical cord. Thats not too small anyway. Dont bbe scared of being induced... i went into labour after one lot of (painless) gel... and trust me - epidurals are great... i have a MASSIVE needle phobia but had one after both a water and active birth were out of the question.

Hi, I am 37 weeks today & also measuring small for dats - about 3-4 cms smaller. I am 5ft 3 & weight 9st 11 (normally about 8st 4). We paid to have a scan at 35 weeks & was told that baby was around the 33rd centile (average babies being 50%). I had another NHS scan last week & baby is following the smaller curve - have they presented this info to you ? calculations are that baby was 5.5lb at 36 weeks. DD was born ( previous pregnancy) at 39 weeks & was 7lb 4.
I think they one takes after me & DD takes after 6ft 3 DH !

Ask the midwife to measure your fundus & get them to refer you for a scan, then they can put your mind at rest.

chelseaxxx - when I had my 1st dd I was told she would be very small & may have to be taken away from me to special care as she was so tiny - she was a healthy 7lbs 12oz, dd2 also caused concern & I had to have extra scans to monitor her growth - she was 8lbs 2oz, every-one commented on my small bump with 3rd dd but she came in at a whooping 9lbs 11oz - the medical profession don't always get it right! Good luck!!

My second baby was 'sfd' and my consultant insisted she would not let the pregnancy go to term. But she went on holiday and I stood my ground with her stand ins, opting for weekly scans, as I am small myself and small babies are common on both sides of the family. There was no evidence that my baby was in any danger from the scans and foetal monitoring. When she returned from her holiday she insisted I be booked straight in to be induced having gone a few days over but luckily my daughter arrived hours before the appointment at 6lb 2oz. I was then told had she been any smaller they would have insisted on supplementary feeding! I had a difficult time from health visitors because she continued to be small, settling on the 0.4th centile where she remains age 4 and constant monitoring/tests reveal her to be nothing other than very petite. Unfortunately the medical profession seems to have a problem accepting anything other than average.

chelseaxxx, the scan can not give very accurate readings so there is a HUGE margin of error allowed.
However, it doesn't mean you shouldn't take it seriously, just that it's perhaps not as bad as it looks.
Write ALL the questions that are going through your mind before going to see the specialist. Otherwise, you will probably forget most of them. If you have a doubt, don't understand, ASK. I have been told on numerous occasions that I was a pain with all my questions but when I came out, I knew what was the situation/problem.
Also, have trust in your specialist. I know that the care you recive in hospital is not always perfect but I've never had issues with a poor diagnosis as such more with an doctor that looked in retrospect too cautious.

DD1 was small for dates - as I am 6' and had gained 4st they were most concerned - she was eventually born by CS 10 days late after monitoring showed she was beginning to be distressed.

She weighed 5.11 (it turned out that DH weighed 6lb at birth; his mother is only 5' tall) and stayed below the 10th centile until she was about 14 when she finally grew a bit and ended up at 5'7.

What was your DH's birth weight, chelsea?

ds was small for dates (he weighted 4lb 11oz at birth)....I was induced at 38 weeks (thou' he was well ready as gave birth in less than two hours.) Was very closely monitored all through the labour including near C' section (his heartbeat dropped...) He was perfectly okay - just small (but I come from a family of small babies...)

hi, just to say that i had twins and they kept saying that they were small, had a million checks and scans...one was 51/2 one was 6!! they were born at 37 weeks and although small and b/f was a bit difficult(did not latch on properly for about a week) and Millie had to be fed by a tube for the first few days they were absolutely fine. Dd was in an incubator for 24 hours just to keep a check on her but really was all o.k. Had them naturally( epidural and lots and lots of gas and air!!!!). They were small for ages but then it is quite nice as all too soon they are big and that newborn stage lasts for ages when they are tiny!!! dd wore a newborn t.shirt as a dress and they had to be weighed by fishing scales!!! but now they are whoppas!!!! good luck with everything and dont be afraid to ask as many questions as you want to x x