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

Oh he was 7lb 13. So small compared to my others but a different father. Big kids were 10lb 75 at 40 weeks and 8lb 13 at 38 weeks.

'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.'

They may recommend to try for VB first as that is what happened to me. They induced at 37 weeks because they deemed c section as higher risk due to the higher risk baby could have fluid on the lungs and it wouldnt be squeezed out like it is in the birth canal. I went on to deliver naturally and baby came home after a short stay on SCBU.

You could ask about your Bishop's score and then decide between induction and c-section.

Or you could try the "gentler" induction methods and then if things don't progress, go for a c-section rather than having to struggle on with an induction that could fail and end in an EMCS anyway.

So try an induction but have a low threshold for switching to c section instead.

Hi I had the exact same experience as yourself and I was induced at 37+4. I had 2 pessarys 6 hours apart which got me to 3cm with no real pains, they then broke my waters and my daughter was born 2 hours later! She was 5lb 3oz and perfect in every way. Definitely try the induction route over a C Section. Good luck!

My DD was noted to be small at a scan I had 37+4weeks. She was measuring under the 1st centile - all very sudden (the flaws on no routine scans post 20weeks)
We were induced 2 days later as consultant said safer in than out.
Induction was fine, unpleasant but got things going. Ended up in emergency section due to foetal distress.
Born on the 2nd centile, no need for NICU and discharged three days later.
She's 21months now 20lbs tall(75th centile) and thin (9th).
I read all round me in the two days before I was induced and it's safer for small babies to come earlier - they don't always cope with labour and slightly more likely to need a section. PM if you want a chat

My brother was small when he was delivered 48 years ago, there wasn't any scans but my mum was induced at 37 weeks, he was 4lb, after having a rough month in special care starting in an incubator he came home weighing 5lb on Easter Tuesday, by his christening in July he weighed 21lb, he is 48 now, 6'5 tall, well built, father of twins who were born weighing 4lb, didn't need special care who are 13 now.

Thank you everyone! Lovely to hear so many stories of tiny babies doing so well and going home so quickly. I honestly thought we might be in for a long hospital stay with him. Definetely lots to think about over the next few weeks.

OP length of hosp stay depends on various things.

So smaller babies often have trouble regulating their temp and feeding. My twins ended up being fed 12% dextrose solution intravenously for a bit. Then they went on to milk through an NG (nasogastric) tube.

It sounds horrid, but it was actually fine. They reverted to normal feeding after 5-6 weeks and gradually learnt to bf.

They went on to bf for almost a year and these days they are sturdy, robust toddlers - DS on the shorter side and not much fat, but they are both strong, alert, normal and eat and sleep well.

Whatever you do, it'll be okay. And remember - it's your decision.

Thought I would update this in case anyone in a similar position ever finds it in future and it helps any.

We have decided to accept induction at 37 weeks so have an appointment in a few days. It really was the last thing we wanted but he has dropped to around the 3rd centile now and his movements have steadily decreased over the weeks. If I'm honest i hardly notice him anymore and he was always very active throughout the pregnancy. I've given it my best go and its heart breaking because i dont know what I'm getting wrong but i think baby is almost done and there really isn't much wiggle room left.

I need to remember how blessed we were to be in this position in the first place given my medical history and to try to hang on for another week when realistically there isn't much to be gained for us seems pointless because we will be right back in exactly the same position in a few days but the risks will be higher.

He has only gained around 200g in 2 weeks and still weighs approximately 4.89lbs at 36+5. I'm obviously aware the growth scans can be miles off and these are really just guestimates but they are all we have to go off of and we have had so many now, I think it's a pretty good estimation of how things are progressing/not progressing.
I've had steroid injections to help his lungs develop faster this week and have been to the hospital quite a lot for monitoring.

Can only hope for this to go well now and I suppose the silver lining is that we will meet him a little sooner than planned.

My experience is slightly different, but for me my baby had been growing consistently until 36 weeks. I had growth scan at 36, 38 and 40 weeks where they told me she'd barely grown at all in any of them and I had to be induced on my due date. I was very worried and the midwife made it sound quite serious so I thought she'd come out tiny and have problems but she ended up being a perfect 7 pound healthy baby and we were home the next day!

Hope your doing ok OP, you sound like you're being really hard on yourself! You haven't done anything wrong, there's nothing you should have done differently. Your baby just appears to be small! Just keep reminding yourself that 37 weeks is full term, there's nothing to be gained by baby staying in longer. If there's any suggestion of something not being quite right they tend to get them out once they're full term - lots more they can do for them outside of the womb if it turns out there is any underlying reason for them being small.

Hi OP. Just wanted to message you as our baby boy was measuring on the 2nd centile as my placenta stopped working properly. They delivered him by csection at 34+6 as the pregnancy was getting riskier and riskier. He weighed 3lb 8oz when he was born, he spent 5 days on NICU but was healthy and just needed to out on weight. Its sometimes better for the baby to whip them out so they can out on weight.

Dont beat yourself up its just one of those things.

Good luck x

Thank you again everyone. Driving myself crazy with all of the unknowns today but you are all right! He will be here so soon and i do know we will both be fine. If only someone had a crystal ball!

Hi OP, just seen this thread and your update. My first was 5lb 7oz, but there had been no indication prior that she was going to be small. All the newborn size clothes I had brought to hospital swamped her and my mum had to nip out for tiny baby size! We stayed in 2 nights while we got breastfeeding established and she had some formula top ups, she did really well and didn’t need tube feed, heat pad/lamp or any of the other things some of the other small babies on our ward needed. I think it was the 2nd centile she was born.
I’m now 20 weeks pregnant with second baby (another girl) and due to low weight last time am under consultant, it was also picked up at 12 week scan blood screening that I have low Papp-a so am taking aspirin for that (can be a precursor for pre-eclampsia, low birth weight, pre-term labour). I have growth scans at 28, 32 and 36 weeks. So I’ll just wait and see what happens.
I am prepared with tiny baby size clothes and hats to take in this time!!
I had a water birth last time (as there’d been no indication she was small) and would really like one again this time so fingers crossed.
I did notice at my 20 week scan, I was 19+4 based on dates given at 12 week scan but when the sonographer was doing measurements they said 18+6- not a huge difference and the sonographer didn’t say anything but when I asked she said that was no concern and that there’s a two week variance either side with measurements, plus all the measurements were in the same range (I.e. all 18+4 to 18+6 not any much bigger or much smaller) but it did make me think hmmm I wonder if that’s the start of being dinky.

All the best Op!!

@LittleRa I hope your pregnancy is still going well! Tesco we found was the best for the tiny stuff. My midwife said if I ever had any future pregnancies I would be put on daily asprin so maybe not a bad thing!
Final update! He is here!
I had 3 pessaries over 24 hours and made it to 2cm myself with pretty regular contractions. They gave me an extra day to see if I would progress myself but never did. After 3 days of this I was put on the drip and my waters were broken. 11 hours later and he was here!
All of my worries were for nothing. He is perfect. 5.7lb so actually quite a bit bigger than expected. Still in tiny clothes so thank you for everyone's recommendations. He didn't need any extra help and is getting chubby already from just being breast fed. He is only five days old and already gaining weight. Over all I cant believe how positive the experience of pregnancy and birth has been (and I'm the last person I thought would say that).

That being said, there will not be any future pregnancies for me as it just seems to be how i make them and knowing the impact all of the monitoring and worrying had on my husband and myself and that we would definitely go through it all again means it wouldn't be right for us.
I am so in love with this little man though and loving every minute of this newborn stage!
Thank you to everyone who took time to reply and share their stories here. It really helped me through x

Congratulations op so happy for you! Enjoy 😊

Lovely update @Pawprints2017 Congratulations!