When does big become too big?

[McKayz]

I am going to be having a big baby. I had a growth scan at 30+4 due to a 4D scan at 29+2 saying the baby was weighing 5lb and I have always measured big. 30cm at 28 weeks, 34cm at 30 weeks, 35cm at 32 weeks and now 38cm at 34 weeks.

My growth scan at 30+4 said that baby weighed 3lb 14oz so not as big as the 4D one. That put baby on the 95th centile.

MW today said she would estimate that baby weighs about 6lb now as they usually put on 0.5lb a week. She said that from next week they usually put on 1lb a week so she thinks I will end up with an 11lb baby.

DS2 was 10lb 5oz and labour was fine, born at home, tiny tear, no stitches and I would say it seemed easier than DS1 who was 7lb 2oz.

I do have another scan booked for 36 weeks to check growth and presentation but MW said that they don't like babies getting too big but didn't elabarate on that.

How big is too big? What sort of weight would they then start talking about induction?

Thanks

Bump

At my local hospital anything over 4.5kg is considered big and induction would be discussed for 38 weeks, however the consultants can be a bit vague on this as they say the size of baby that a woman can deliver varies so much !

DS2 was 4.6kg but we didn't know he would be big.

Just one more little bump.

Mine was measured at 5lbs 7oz at bang on 34 weeks. Think that equated to being 34+4 by their calculations. The consultant said that wasn't 'overly big' and he had no concerns about the eventual size because the margin of error at this stage is up to 1lb either way (so could be anywhere between 4.7 - 6.7lbs) and the margin of error apparently increases with the size of the baby...so the further along the baby is the more inaccurate the estimated weight.

Sorry...that didn't answer your actual question at all!

the induction guidelines do i believe state that induction should not be recommended purely because the baby is thought likely to be large.

[[http://publications.nice.org.uk/induction-of-labour-cg70/guidance#information-and-decision-making-2 1.2.10 Suspected fetal macrosomia
1.2.10.1 In the absence of any other indications, induction of labour should not be carried out simply because a healthcare professional suspects a baby is large for gestational age (macrosomic).]]

The MW said when I saw her at 30 weeks that if they thought the baby was going to be another big baby then they would look at induction. She gave no indication of how big 'too big' is.

So that is obviously going against NICE guidelines.

With DD I had a growth scan at 34 weeks and they told me they thought I would have an 11lb baby, I left the hospital in tears. At 4'10 they had always said I may struggle to get a baby out and with a big baby even more so. She was born by emcs weighing 8'9 so they got it vastly wrong. Due to complications I had to have an elcs with DS and they predicted at 34 weeks he would be 9-10lb, he was 7'11 so again miles out.

I have learnt to take hese growth scans with a pinch of salt and with this baby will not even listen to what they predict, I'm thinking of even refusing the 34 week scan, it's not worth the stress.

sadly i suspect the two reasons for that NICE guideline are -

1. predictions often wrong
2. induction increases the risks as much/more than size.

i would welcome any of the HCPs on these boards clarifying, can't find detail on the NICE site.

Sorry, but I just don't buy any of those 'the baby is too big for you to have it vaginally' load of crap. We are designed to have babies! I know, I know - things do go wrong - placenta previa, accretia, abruptio, etc, etc, but the vast majority of babies are grown perfectly normally, in a perfectly normal uterine environment, to be delivered vaginally by the mums carrying them. Really.

Maybe read up Ina May's book on childbirth? Her CS statistics are in the 1-3% range (sorry can't remember exactly) and I think that's about right - that covers the true emergencies that make us so blessedly thankful we have CS as an option, but dispels a lot of myths about the definition (and impact) of dystocia during labour, size of baby, etc.

Induction is messing with labour and the natural process in any event - is not to be undertaken lightly (speaking from experience: had one induced labour, one spontaneous labour, currently preg with DC3 - we'll see how that goes!)

Best of luck to you, and a healthy and happy baby at the end of it all.

given you delivered a big baby before and all was fine i wouldnt worry tbh :)

my biggest was 10lb 13oz delivered in a pool in an hour! he was no 4, bizarrely with no 5 they were worried about baby being big i KNEW the baby wasnt as i could feel that it wasnt as big as ds4 had been, but they insisted i was wrong and a scan said at least 9lb+ i said NO not that big and the daft consultant just looked at me (5 2 and petite) and said if the baby is 9lb YOU wont be able to deliver naturally as you are small.

i then pointed out that my babies had ranged in size from 9lb 3oz up to 10lb 13oz and ALL had been delivered naturally so even if baby was 9lb i was pretty sure it would be fine! he then said that was just 'luck' and wanted me to have a c section, i politely declined and baby no 5 was born naturally weighing a teeny 8lb!! teeny for me she was the smallest of my 5! her labour was actually the hardest! but that was because she was back to back.

anyway growth scans are notoriously crap, my big babies were predicted to be 6-7lb, yet were all 9lb+!! so very wrong, i always measured small for dates and yet had a big baby each time. you may just have a lot of fluid, or yes your baby may well be big but as you have previously delivered a big baby then it should be fine :)

good luck to you :)

According to my family, my DM's cousin's 3 children were all delivered naturally and weighed, in order of birth, 10lb, 12lb and finally 14lb.

I'm so glad I'm measuring 2-3 weeks behind my dates...

5madthings EXACTLY!!!!

God, I love being proved right!

I'm being hassled too. Baby measuring consistently 2cm bigger than weeks.

They want me to go for a growth scan but haven't given a sensible reason why except of to threaten risk of SD. But a scan won't lessen the risk so a bit

I'm half way through the Ina May book. It was the first thing I downloaded to my kindle when I got it.

It is shoulder dystocia they are mostly worried about. Well the MW I saw at the hospital after the first growth scan breezily said that my home birth was still fine and as long as baby is in the right position it's all fine. Normal MW seems a bit more worried.

The thing that worries me is the measuring big. I never measured big with DS2. At 36 weeks I measured 34cm but apart from that it was always spot on.

I'm not worried about the birth but I am worried about them wanting to induce.

Well for me induction isn't an option at all. Either the baby is in danger or he isn't.

I don't know a lot about SD except that it is MORE likely in an induced birth, so am a bit about any kind of suggestion of it.

I know 8 people in real life who have been induced and 4 ended up with episiotomys and forceps and 3 had emcs and 1 was fine. So to me it's pretty scary.

I might print of the Nice guideline and then can show anyone who says induction.

I was told DD would be normal weight, 7-8lbs, no big baby worries. She was 9lbs6!

Cousin was told all along baby would be big and was booked in for a section at 39 weeks. Baby was less than 8lbs.

Print off the guide, highlight the bit at the front where it says about explaining things and gaining consent too!