V small baby at 35 weeks

[Ellsiedodah]

Hi all, today I've been put on a weekly watch by my hospital because our baby is in the 6th centile for its gestation. Great to be looked after but as all its vitals are fine, placenta working fine and both our mothers having delivered tiny healthy babies I'm worried we're facing a cascade of interventions already as there's already talk of 'if it's not growing... Induction but prob C-section..' while I'd hate to put the baby at risk I'm a bit wary of the tendency towards 'just get it out' even when there are no problems indicated. Has anyone faced the same thing and managed the situation to a naturally timed, natural birth conclusion? Many thanks

Be guided by the professionals, sometimes the problems are only revealed when the baby is delivered. I would have lost a baby if I had not had C. Section at 32 weeks.

We had a baby flagged with growth issues at 29w. He was just under the 5th centile. We opted for a watch and wait policy with fortnightly scans. Everything was normal and he was "just small" till 35w, and then they observed that the blood flow through the cord was becoming problematic. They advised induction and we agreed.

The induction was fine and I was glad I listened as when he came out he was so thin and frail. Not just a small baby - I was 5lbs 12oz myself and DD1 is always on the 2nd centile. I mean, he looked drawn and starved. He clearly needed more nutrition and it was a relief to see him get it.

He is 12w now and full cheeks and subcutaneous fat so he has really filled out.

Key questions for me would be - are there indications he is suffering from intrauterine growth restriction? What are the cord blood flows like? Is he in proportion (DS had long legs but v v small waist)? I think I'd ask for regular scans to monitor those things.

Thank you both for responding. Blood flow was good, literally everything seemed as it should be including a good amount of amniotic fluid etc. They said it is probably just a "constitutionally" small baby. Guess we'll just need to see what occurs at the next scan. Welshmist were literally all your results / signs fine up to actually seeing your baby?

I was up at the hospital every week during my last pregnancy due to them saying baby was small and not measuring what he should, everything else seemed fine and I was allowed to give birth whenever I went into labour went a week over he was only 6lb but otherwise healthy. I've got have growth scans from 28 weeks onwards with this pregnancy as my previous was small I think sometimes the measurements can be abit off x

Every week in the last 5/6 week or so not throughout sorry x

One of my twins dropped to the 2md percentile and we were having twice weekly scans. She eventually stopped growing and her fluids dropped so they were delivered by c section at 36 weeks. I'd have been allowed a vaginal delivery if the babies had been head down though

When I was pregnant with ds2 they told me he was really really poorly.

I was on weekly scans from 30 weeks.. at 35 weeks they told me he stopped feeding properly from my placenta and he would be born with alot of problems. Breathing, physically, mentally. They thought he had DS, and told me he had extremely short legs. And they had strong suspicions he was going to be a dwarf with how small he was.

He was weighing roughly 2lbs on growth scans at 36 weeks.

They induced me at 37. He came at +4.

He was 6lbs.
Healthy and pink.
And there is absloutley nothing wrong with him what so ever.

My umbilical cord was extremely short, and he had his legs crossed so they looked smaller than what they were. So that caused all this problem.
I'll admit. He doesn't have the longest of legs. But they're normal. He just won't be a tall lad. But neither are me and DH.

He's also on the 95th percentile for his age.
He is 8 months and weighs 19 pounds.

I hope all goes ok for you OP.
And even if baby is born small, there are lots of things the hospital can do, and it doesn't always mean there is a problem.

And mine was a vaginal delivery.

Usually i baby is head down when being induced they let you birth natural

C secrions are only needed if there's a problem with baby, like cord wrap and heartbeat is dropping,or breach etc..

They said the same about my little boy @SendYouUpinFlames that he had small legs. He's 4 now and same size if not taller than his peers. I know they have to be cautious if they see things they think are off but I do think they cause unnecessary worry at times x

Slightly opposite scenario for us as our growth scans showed no issues, told blood flow was good etc. DS was born the next day at 35 weeks (induced due to PE) and the placenta was a gritty mess that was sent away for testing as it was so bad and he weighed only 3lb 14oz, not the 6lb we were told the previous day. Based on this I'd always err on the side of caution and I also had a very positive 4 hour induction with no other intervention so they're not always terrible.

I had a small bump, so was having weekly scans. They predicted a small baby, but at no point was induction or c section suggested to me. Carried on as normal, delivered vaginally at 39 weeks. He was 6lb, or 2.7kg, which I think is the 0.4th percentile. He has always been a touch small for his age, but he's happy and healthy so I'm not complaining. Listen to your health professionals and make decisions with your gut.

A lot depends on whether growth appears steady.

I was sent for growth scan at 34 weeks. Baby was tenth percentile which is fine but cord pressure was high. When I was rescanned 10 days later bloodflow in brain had dropped and a few growth measurements seemed to have stalled. I was pressured quite heavily to be induced at 37 weeks and after discussing it with the senior consultant I very reluctantly agreed. I had been planning a homebirth; what I got was a highly medicalised process involving constant monitoring, the syntocin drip and an epidural.

Honestly? I would have rather had my homebirth, but the induction was a positive experience too. I do wonder if I'd never had that scan or if I'd declined induction, whether I would have gone to 40 weeks and had a straightforward home birth. But perhaps I would also have ended up as a stillbirth statistic. The thing about indications of placental failure is that the next "sign" is often when the placenta fails totally.

DS2 was born at 6lb 2, more than expected, but he's grown so rapidly and moved up the centiles since birth that I do wonder if he had been growth restricted in there. In all honesty, now he's here and healthy the manner of his arrival really doesn't matter at all.

You can decline induction or section if you choose, it's in your hands. Just make sure you understand what you're being told and the risks. Good luck.

My daughter was flagged as 4th centile for growth very early on. I think it was at a 22/24 week scan. We were very closely monitored every week after that.

One week was growth, the following was Doppler scan to check the placenta. Once we had got to a stage of no growth for two weeks she was delivered by CSection.

She was tiny, and dry as the placenta and amnion failed. But they did monitor her closely. They said better in than out until they didn't have a choice, then it would be better out than in.

She came 25 days early so she did really well. She was born the size of an average 5 month foetus.

Hi OP. I'm not fully sure what you are asking.

Right now your baby looks to be very small. And while some babies are small and perfectly healthy and born without intervention or complications, unfortunately many babies with the same profile as yours do have health problems or are at high risk. So it sounds from what they are saying that you will be watched closely to determine as best they can which group your baby falls into. And in the case of doubt or if it isn't clear, the recommendation is likely to be to err on the side of caution and deliver early.

Of course it would be great if they could say with certainty whether your baby is just small and otherwise healthy, or whether it is actually at high risk. But the technology is not yet available to us that allows thay decision to be made right every time. If early delivery is advised, it's because your baby is showing signs of risk. It's not because of a cascade of interventions or a desire to interfere with natural birth. Of course it is entirely your choice to consent or not, but you should be fully informed. Of course, early delivery might mean some healthy babies are born early but it also means the survival of babies that otherwise would be in difficulty and at high risk.

Please ask to talk through all your concerns with your doctor, and best wishes.

Hi all, thank you so much for sharing your experiences. Sounds like some of you went through quite a tough time so I'm so glad to hear all happy endings for you all. @sycamore54321 thanks for raising some concern with my post (I get the sense that's your tone).. I didn't know that all signs could be good and you could still find yourself with a sick baby or worse. This one is moving so much (I've been up since 3:30 feeling it roll around in my belly as I often do) and the strength of its movements just feel like there must be a healthy little human inside me. Likewise I'm sure it responds to my voice and strokes when I engage with it etc ... I'm so keen for it to enter the world when it's ready and since all the women in my family have long pregnancies it just worries me that in this very over cautious world we live in today that they might want to pull it out before it's cooked even if there seems nothing wrong at all... I feel so grateful to have the care of professionals but I know that inductions are routinely encouraged past 40 weeks anyway which I've never liked so I guess it's that erring towards likely problems instead of likely success that I feel worried about.

I think our latest stillbirth research points to two overwhelming factors that may have prevented it. One is a small baby and the other is reduced movement. You have one and not the other. It would be hugely negligent of the Hospital to ignore the size of your baby.

I had one baby at 38 weeks weighing 2.5 kgs. I am Asian. I am tiny. I was born at 4lb10 so I though meh it’s my genes.
Next time I had a v premature baby at 26 weeks and my placenta failed. I had a similar thing happen with ds1 but on a milder scale. In hindsight I now wonder if we were spared a poor outcome with him by sheer good luck and he was actually being starved of nutrition.

I have also had two C sections. The second was very fraught because I was delivering at 26 weeks and I had placental complications that were so high risk that a vascular team was waiting for me in theatre. But Surgery for DS1 was calm, well organised and actually fun! One of the best things I have done. And I recovered quicker than most of my friends with natural births and tears. I would have loved to have pushed out a baby naturally but had I done so the baby would have died both times and I would have died the second time.

I used to find the ‘a healthy baby is all that counts’ HUGELY patronising. But having spent two months in intensive care with my premature baby willing him to fight, and watching so many others not make it (I saw over 10 babies die including several that were full term), I do get there is a grain of truth to that.

I had a good induction and birth with DS2 who was induced at 37 weeks after they started talking about it at 35 weeks. There was only 1 artery on the cord and he was going along the 10th centile.

The birth was better than my birth pool one with DS1 and DS2 came out a few lbs heavier than predicted. I am so glad he was induced though, since he's been born he's packed on weight and he now looks to be where he was supposed to be if that makes sense. He was such a little skinny thing with little skinny legs when he was born and now he has chubby thighs

Ah, too early. I meant a few oz heavier, not lbs!

DS was 2nd centile and they monitored me every second day in the last few weeks. They were desperate to get me to 'term' which they class as 37 weeks; they induced at 36+6 and DS was born at 37+1, a tiny little 4lb5. I was terrified when they said induction, was convinced I would end up with a c-section but actually everything went very smoothly and I was so well looked after. I too felt that it was all unnecessary- DH and I were both tiny babies and my Dsis had a full term 2nd centile baby 3 years ago. However, he was such a tragic skinny wee soul and absolutely thrived on the outside so I guess they knew what they were about. When I read later that they probably induced because of increased chance of stillbirth I hugged my little man very tight and was glad they made the decisions they did.
Good luck.

since he's been born he's packed on weight and he now looks to be where he was supposed to be if that makes sense. He was such a little skinny thing with little skinny legs when he was born and now he has chubby thighs

Same for DS2. He had a skinny bum and peaky little face when he was born, despite being classed as normal birth weight and going home straight away. He has shot up since birth and now looks sturdy and healthy rather than a frail little thing.

I have no regrets about saying yes to the induction.

Having had two small, IUGR babies, both times induced i would choose early intervention to get the baby out over waiting and the associated risk of stillbirth, or other complications. All my tests were normal, they couldn't work out what was causing the issue other than my uterus being a " hostile environment" for the babies.

The risk of stillbirth increases when babies are small and/or stop growing. The absolute risk is still low; but id rather eliminate that risk and have a healthy baby. Knowing people who've had stillborn or lost a baby soon after birth i would always choose to get baby out before its too late if that was the DRs advice.

Ladies, all your advice and experience has been invaluable to me, thanks so much. I feel calmer about any recommendations the consultants might make.

OP just to reassure further, my DS I talked about above who was induced was actually a twin. So DD2 had to come out along with him and there was no reason for her to be born early - I reckon she would happily have stayed in till term.

Do you know, she is fine. She probably would have liked some more cooking but the fact she didn't have issues meant she coped well outside.

So from that pov, if the drs are wrong and your baby is okay and they get him out needlessly early.....the fact that he us fine will probably mean he's okay iyswim!

My dc had IUGR and I was given a csection at 35 weeks. He was 3lb so way smaller than he should have been at that gestation.

I understand how stressful it is at this stage when the medical team are presenting you with various scenarios and you just can’t get your head round it all. But please listen. My baby would have most likely not survived if I’d gone to term. The docs have to balance keeping the baby inside you, with the fact that at some point it will be better off being born.