Small baby

[Pawprints2017]

Hello,
Looking for other peoples experiences really.
This is my first baby and he has been consistently measuring along the line for the 5th centile.

He is fine otherwise and placenta has always been fine. However we have some questions. Midwife appointments are only every 3 weeks and I'm unlikely to be able to speak to consultant until it's time to make a decision.
If anyone would be able to answer any/ shine any light on any it would be very much appreciated.
Consultant has said if he does not catch up past the 10th centile by 37 weeks, that is when we will deliver. However if he is small, would it not make more sense to leave him in there to grow longer?
How is he likely to be delivered at 37 - induction/c- section? Since this is my first delivery and my body is likely not going to be ready, am I in for a long and hellish induction? Be honest with me please.
How small is he likely to be? Will he be able to come home with us straight away or are we looking at some time on a neonatal ward?
Can I refuse induction? What happens in this case?
Thank you to anybody who has taken the time to read this and/or answer any of my questions x

Hello! How far gone are you now? Realistically for an induction at 37 weeks I’d expect you to be consultant lead already and to have seen the consultant who would make the decision? Have you had growth scans or is the centile line based upon the midwife measurements?

I had a planned induction at 37+ 4 weeks due to static growth. DD was 2nd centile and her growth had become static.

I had consultant on the Tuesday and my induction was booked for the Friday. At my apt I had a sweep and she was born the next morning! As the sweep sent me into labour. She was 5lb8 and dinky, but totally fine. We stayed in a night as I had complications and we were home the next day.

She was my 2nd, my first was 6lb at full term.

Some people just have small babies 🥳☺️

For context I had the consultant every 2 weeks... so I’m surprised you aren’t booked in for another appt?

It seems there is some confusion about whose decision this is. Let's be clear, it's your decision OP, your body and your baby. Obviously you will seek and listen to the medical advice but it's for you to decide.

www.aims.org.uk/information/item/making-decisions

Hello, thank you so much for your reply! Currently 32+4. I've had phone call consultations (covid) with the consultant but not currently booked for another yet. She said to just keep going for weekly scans and unless he catches up, expect to deliver at 37. I have had so many scans. Growth scans and placenta ones on alternate weeks and always round to triage to spend time on the monitor every week. They are always fine though and everyone I see comments on how active he is. I think as you say he is just small made. It is actually a relief to hear your little one went home with you so quickly after birth. Hoping for the same!

All my children had severe IUGR. One was 1.5lbs. One was 1.7kbs. One was 2lbs. None were triplets. All single births

I had 3 emergency c sections.

All small now. But then I was very small till I was 35. A size 4-6.

Why would he "catch up" if he's always been on the 5th centile, surely if he has been consistently following the growth curve for that centile, he is growing normally? I would have thought it's only if growth slows or stops that it's an issue?

Also growth scans are notoriously inaccurate although I suppose you're having so many that if they're reasonably consistent it would suggest they are about right.

Thank you! I think I need to organise my questions and find someone to ask. If it really is the safest thing then of course it's what we will do but it's just difficult when nobody has explained why this is best or what the risks/benefits are.

Stupid covid makes everything so difficult but I definitely need to find someone to speak to!
Thanks again

@Pawprints2017

Firstly don't worry about baby being born at 37 weeks. 37 weeks is regarded full term

Now every hospital trust may vary slightly but this is how it went for me. My baby was v small. Under the 1st centile. I was induced at 37 weeks as they also could see no reason why and at that stage it is better out than in! (On delivery it was found my placenta was small. No way of telling that before and is most likely the reason why). My induction did fail and ended up c section however is was not a horrific experience like people tell u. It was v calm and I was v well looked after. Because baby was so small I was in hdu throughout so had a private room the 3 days it took for her to arrive!

The cut off in weight for nicu in my hospital was 2kgs. My baby was 2.07kgs!!!! (4lbs9) So stayed with me all time no issues until we were discharged

Afterwards I had a lot more HV check ups to weigh her to make sure she was growing as she should which she did no issues. She's now 11 months and just hit the 9th centile!! And still fits 3-6 month clothes!

You'll just have a cute tiny baby longer. Look at the positives ☺️

She said some babies have growth spurts towards the end! I truly think he is just going to be small though. No other issues so that's why I am struggling with why we are delivering "early" (I know it's technically full term but I dont think he will be finished cooking, being my first).
Happyheartlovelife your babies were so tiny! Glad they are all doing well now but that must have been so scary!

It's because once full term a baby will thrive better outside being fed milk and they can double check in case there is another reason baby is small that they can't tell on a scan. There's no "benefit" from baby staying in past 37 weeks.

Try not to worry. Baby will be ready. It just be hard not having seen your consultant who would have explained it all.

@PrayingandHoping, thank you! I'm actually not scared of a c- section but it is good to hear your experience was positive. So good to hear your little one was able to stay with you too!
I've honestly had nightmares about him being taken from us and us not being able to see him. I'm in Scotland and the restrictions are starting to creep back in sadly.
You are right! He might get a bit more wear out of those newborn clothes than we thought!

Some babies and better out than in, my DD has remained a dinky Dora like @PrayingandHoping‘s. She is 13 months and in 6/9 months and weighs around the 19lb mark.
My first is 5 and is also slim so some just have small babies!

Hello! This also happened to me and DD - identified as small for dates at 20 weeks and scanned every other week until I delivered. My DD was 3rd centile and pretty much stayed there, too.

I was induced at 38 weeks as I had high uterine dopplers and a 'thin' placenta which was pointed to as the cause for slow growth. In my case, this was probably the right thing to do as my placenta was abnormal and sent to pathology.

My DD was a healthy 6lbs, so I was happy with that!

Things I would ask if I was you:
What risks exactly are they trying to minimise with induction, since your baby has remained small but steady and there is no identifiable cause (ie problem) like in my case?
Can you have an outpatient induction if you have to be induced?

As someone else mentioned, scans are really inaccurate ways of measuring growth, although the only one we have - so try to not stress too much.

@Pawprints2017with both on mine newborn drowned them until at least 8/9 weeks, you need tiny baby clothes. Asda are great and Sainsbury’s we found too. Tesco tiny baby jut shrank!

Thank you for explaining this. Makes sense now you have said it like this. I think in my mind I was expecting to go to like 40 or over so 37 seemed early but I need to keep in mind it will be full term.

Oh yes! She's 18 months now and I'm still using some 9-12 month stuff. Tiny baby - good value on the clothes, I find.

@Pawprints2017 make sure u buy some tiny baby clothes! Newborn didn't fit my little one until at least 8 weeks old! Tiny baby swamped her at birth!!

A month ago (10 months) she only weighed 14lbs7!

My growth scans were spot on.... but I did have newborn clothes in the bag too... just in case lol!

So I don’t want to alarm you but between my 1st child and 2nd (big gap) the NHS has become more vigilant about the size of a baby.
Extensive research has shown that two overwhelming factors prevent late stillbirth.
One is following a baby’s growth, doing a 36 week scan and delivering smaller babies early.
The other is believing mothers when they report a change in foetal movement.

It is for this reason that there are growth charts now etc.

I had a baby who was born weighing 2.52 kgs. He was on the 9th centile. He still is. I always assumed I just have small babies but actually it’s now become clear after my second child that I have placental issues.

Hello OP. I was scheduled for induction at 37 weeks due to small baby. They offered a sweep at 37+2 before planned induction at 37+5. I didn't see the consultant until 36 weeks. Consultant said there was nothing that baby could do inside that they couldn't do outside after 37 weeks and it was best to deliver just in case there was an issue they didn't know about causing her to be small.

Well I had the sweep as planned and she came on her own the next day at 37+3 after a quick labour weighing 5lb9. Everything was fine and we were allowed home the next day. She's always been a little thing but she's now 13 months and running around all over the place.

Also I have had a baby in the NICU and while it’s not a great experience the nurses will try and give you all the access you need as a mother.
I have had two C sections for two small babies now and I have to say they were both great and I healed well. In the early days after birth HOW one gave birth looms very large on the horizon for most women. Understandably. But assuming your birth wasn’t horrific, by the time your baby is a bit older, it starts to be less overwhelming. (I have an 8 year old- the conversations at the school gate are v different from the ones in baby groups with the same mothers 8 years ago...). I am not minimising the birth experience at all, I am trying to just say that in the very long run it tends to even out (as long as you are treated with some dignity and your birth is not terrible).

OP if he has ALWAYS been 10th centile I would be asking some hard questions.

DS was 25th centile then dropped to 5th at 29w. (He is a twin.) That is alarm bells time. Even then they did not induce but kept up more regular scans with a foetal mat med consultant. He tracked around the 5th but one time I went in for reduced movement and issues flagged up with bloodflow to placenta, and THAT is when they started pushing induction.

Lots of things about my twins' birth were mishandled but that was just right, I think.

I'd not be delivering a baby at 37w without better reasons and whilst I am personally a huge natural birth fan and had drugfree hypno births x3, I would personally opt for section in your shoes if I did decide to go early. Chances are your body won't be ready for birth.

I had a small baby. Exactly the same situation as you. He was born 4lb 14oz but was perfect in every other way.

The risk of keeping a poorly growing baby in for too long is that there is a higher risk of stillbirth. This might not be the case for you as your baby has always been small.

Growth scans can be inaccurate but if you've had loads and they're all consistent it's likely your baby truly is a little small. It could be perfectly healthy.

37 weeks is term, prior to this it would be considered premature. So delivering after 37 weeks is a sensible plan as the baby doesn't need any further cooking.

Hi! My fourth baby was consistently along the 5th centile. After 28 weeks I had weekly growth scans and cord tests. He shot up to the 35th centile (it was something to do with the ratios between femur, abdomen and head circumference). Had two weekly checkups after that and a section at 39 weeks because he was stubbornly breech. Massively robust 3 and a half year old now. Big chested, spade hands and wears his 13 year old brother's hats. Incredibly clever and funny, just has his dad's build.