Small baby at 29 weeks - worried

[junebug121]

Hi ladies

Just looking for some reassurance I suppose. We went for a growth scan at 28 weeks because I have arthritis and found out our little guy is measuring below the 5th percentile.

We went for a follow up scan today and they're mentioning potential chromosomal issues. We did get a high combined risk but then we had the Harmony which was low. So now I don't know what to think.

I'm finding it all so overwhelming. It hasn't been an easy pregnancy, worrying about the initial high risk and then I've had a couple of small bleeds. Now we have this.

So I'm living to the next scan to see if he's grown. All I can think is that there is something seriously wrong and I'm stressed every time he goes a bit quiet. He's an IVF baby, so we had such a journey to get here and I just need him to be healthy.

Has anyone else been made to worry only to find out everything was ok?

I want to reply to you, even though my story isn't great, sorry!

Our son measured small from an early stage, plus I had a high DS risk factor, so we had additional scans from 20 weeks onwards. The scans showed a blood flow issue (notching). At 28 weeks the flow virtually stopped, so I had steroid jabs; at 29+1 I didn't feel movement in the morning and so went to hospital. Our son was born that evening by emergency c/s, he weighed just 1lb 6oz which is well below the 0.4th centile (let alone the 5th!)

NICU were fantastic, he survived, grew, and came home just two days after his original due date. That's the good news part of the story. I met a number of Mums on the unit whose babies were even earlier than ours and their children don't have any issues.

The not so good news is that our son is deaf - which might be as a result of being ventilated when he was on NICU - and he is autistic with severe learning difficulties - which we know came from subsequent epilepsy, but we don't know whether the epilepsy came from his prematurity.

Thanks so much for replying and don't worry about it not all being good news. Sorry things didn't turn out how you expected for you and your son. My sister has Down syndrome, so I can relate on some level.
I don't think it is an issue with blood flow as they seemed to think that was ok. I think that's more why they keep mentioning chromosomes, which conjures up all sorts in my mind. The not knowing is so tough but I don't see the point in the amnio at this stage, it's not going to change anything.
How old is your little boy now? I guess asking how difficult it has been to deal with is a bit of a stupid question. I know I can't prepare myself fully but I feel like I need to think about it a bit in case.

Hi! I can relate as I had a very premature baby who born around that gestation. He was about 1lb8oz. Sorry you're having to go through such a stressful time at the moment. I just wanted to say that 1) weight estimates can often be wrong in utero, and 2) my tiny preterm baby is absolutely thriving now!

I also wanted to say that sometimes, low Pap-a levels can give a high risk in the combined test (this happened to me): HOWEVER these low levels are also sometimes caused by placenta issues, restricting your babies growth (IUGR). This is what my baby had.

Have you seen a consultant yet? Good luck to you.

Hi OP,

I've been where you are, and it was the most agonising time of my life. My DD was also a high risk for Down's syndrome with the combined test so we did the harmony and it came back very low risk. All was good until we had a late pregnancy scan and they said she was measuring small for gestational age. She was predicted to be on the 5th centile and I was going out of my mind googling outcomes etc. They followed up with growth scans and she was still hovering on the 5th centile so they sent me in for an induction at 39 weeks. The main concern was either an infection caught in pregnancy I.e toxoplasmosis or the placenta wasn't nourishing the baby properly. (They didn't actually mention chromosomal abnormalities). Thankfully I didn't have any infections and the Doppler tests always came back normal so the placenta seemed to be working. Anyway, baby was actually born smaller than they thought and was on the 0.4th centile, she was born perfectly healthy just small.. we were able to go home a day later. She's now a perfect 8 month old meeting all her milestones and is on the 25th centile. Please try not to worry, plenty of women have small babies that are absolutely perfect and I'm sure you will too. Good luck

Thank you for the further replies.
So we got the high Downs risk due to the nt measurement being on the larger side rather than Papp-a. They seemed to have got a bit transfixed on this. They have twice mentioned an amnio but I just don't see the point.
I'm not sure why he can't just be a small baby. Obviously that's what I hope for and that he'll just continue to grow on his own trajectory.
As you know it's just meant to be such a happy and exciting time and now it's stressful.

He can just be a small baby Babykoala1's child was born on the 0.4th centile and is now on the 25th - so they can grown and catch up. Our son was born below the 0.4th centile but is following his own curve on the growth chart, he's now 8 years old and is still just below the 0.4th centile Sometimes they even just get the measurements wrong, I've heard of baby's being estimated as small (at 6lb) and coming out at over 8lb

We didn't see the point of amnio either. It wasn't going to make a difference to our decision. Our son had chromosome testing just after birth, he's since had genetic testing, but nothing was found.

My DS measured small. Had a scan at 32 weeks predicting his weight as being quite low and he was due for lots of monitoring, which wasn't needed because he decided to arrive early 4 days after the scan weighing a respectable 4lb 4, which was a good 2 pounds more than predicted and not at all bad for a premmie. Scans are useful to a point but they aren't infallible.
A point someone made to me and the time (which I found quite helpful) was that someone has to be at the lower end of the range. Otherwise there wouldn't be a range! It doesn't always follow that something is wrong. Best of luck to you x

I think that is great advice about the range. I just wish Dr's would lead with this kind of pragmatic outlook rather than always seeming so negative. Surely worrying a pregnant lady isn't great!
It just sends my mind spiralling with all these terrible possibilities. Like the fact that of the three measurements his head is smallest, so now I'm sure something is wrong with his brain/head. Also they said maybe a vein in his brain is dilated too much or not enough, I'm not sure. But then they say it's too early to know if that means anything. So I just think, why tell me? Now I keep thinking about it
I wish I could just switch my brain off for a bit.

My DD was born at 35wks and was below the 0.4th centile. I had to have regular scans throughout the pregnancy and had been told that due to measurements there was a possibility she could have dwarfism. She was a very small baby but is now on the 50th centile with no health issues at all.

My DD measured small the whole way through but was fine she was born 6lb4 in the end ! She's now in the 75th (I think)

Hi
I am sorry you are going through a stressful time. I had ds in March. We had a growth scan at 36 weeks (as the hospital are doing a study so all babies are being scanned at this stage) and I was informed he was on 10th centile. I had been told by my midwife that fundal height indicated he was on 95th centile. Confusing! He was born on 25th centile in the end.

I really hope we have an outcome like you ladies. I'm praying for small but perfectly formed. Just need him to grow!

Hi again! Just read your update about the baby's head is measuring smaller, my DD's head was also measuring the smallest, her head was measuring at 31 weeks when I was 38 weeks! They kept on asking me if there was any possibility I had caught the Zika virus which worried me so much as my partners dad had caught it when they went to the Dominican Republic. (There was actually no way I'd have been able to catch it this way but the doctors still kept bringing it up and worried the life out of me). I was expecting the baby to be born with problems and as I said in my PP she was actually perfect, her little head didn't look weird at all and caused no developmental delays. She has always had a smaller head and even now her head is on a much smaller centile than her body but you wouldn't know! The only times I knew it was small was when it was measured and it was always quite a bit behind what other babies heads should be. I've attached a pic of her at 4 months to show you how normal a baby with an unusually small head looks! Obviously doctors are extra cautious for a reason but your story sounds very similar to mine and the outcome for us was just fine and I urge you to try and not worry so much as it's very likely that you will have the same outcome as us.

Thanks so much for reply Babykoala, your little girl is gorgeous I pray we have the same outcome.
Our stories do sound very similar. They took my bloods to test for infections yesterday and so I'm hoping they will all be fine. They sound horrendous when you read about them but I can't imagine when I would have caught any.
I'm just going to do my best to rest and hope bubs continues to grow.

Hi @junebug121 just wondered how you got on? Hope everything is working out okay for you xx

Hi whyhastherumgone, well my little guy continues to grow but he's staying below the 3rd percentile, so they still seem very concerned about it. I'm now 34 weeks and they're talking about inducing between 36 and 37. I'm sort of in two minds about it because I've read they put the most weight on in the last few weeks. We have yet another scan on Wednesday and then we're meant to talk to a consultant and decide what to do.
Are you going through or have you been through similar?
x

Hello glad to hear all is going okay and you've made it this far :) whether you get induced or not i hope it all goes smoothly for you.

I've found out i have low papp-a - 0.245 mom so quite low - but think i have to wait til my sixteen week midwife appointment where they will discuss my results so just trying to get an idea of what to expect and how others have got on.

We had combined screening done at the fetal medical centre which came out quite low risk for the trisomys and downs and now just waiting for results of harmony.

Hey @whyhastherumgone - did your midwife recommend anything for the low Papp-a? I was told to take low dosage aspirin throughout my pregnancy (75mg daily) since I had low pappa in a previous pregnancy which sadly ended in a loss at term.

Also good luck to you junebug - hope you get baby home safe and sound!

Really sorry to hear about your loss :(

I haven't seen my midwife yet as had the tests done privately - have my sixteen week in a few weeks but unsure whether I should make an appointment before then? when did you start taking aspirin?

Was the loss down to the low hormone did you find out? I hope your next pregnancy went smoothly for you xxx

DS1 was born at 35 weeks as I developed pre-eclampsia, but from 28 weeks they were concerned that he was small for dates. In the end he was 5lb exactly (had a scan the day before and that estimated he'd be 3.5lb so big difference!). He was in Neonatal for 10 days due to low blood sugar and temp at birth, then jaundice. But then he came home at 14 days old and has had no issues at all since. He actually grew really fast and piled weight on, he's 12 now and towers over me! So some babies are just small.

My cousin had her DS at 26 weeks due to a blood flow issue with the placenta. He was 1lb 3oz and was in NICU for a long time. He's now 9 and other than being short for his age and mild asthma he's had no long term problems.

Hope all goes well for you, OP.

A positive story! From 24 weeks had scans which showed very small, poor blood supply and eventually delivered at just over 31 weeks. A scrap at 2.5lbs. Was below every centile on growth chart for years (about 6 or 7). Lots of bumps along the way - terrible reflux, chesty to name just a couple - but equally lots and lots of normality. Now 13, strong, sporty, clever. So, hang in, roll with the punches as best you can when they are little and hopefully all will be well. I always thought of it being like a little fire that you just can't get going and suddenly it roars. If the babe does turn out little, when the time is right I'd make sure there is lots of physical activities as I think my chap effectively self medicated through sport.

That's lovely to hear albertschoice

We don't know the reason for the loss, was an unexplained stillbirth, although he was always around the 5th centile in terms of size from early on.

This time around my consultant has me taking aspirin from v early on - about 4-6 weeks (ie right after the positive test) as a precaution anyway, and will continue until 34 weeks at least. I'm 26 weeks now and baby looks to be doing well on the growth charts etc so just keeping everything crossed.

No one seems to really understand what low Papp-a means but I'd speak to a midwife soon to see if you can start taking aspirin - might be worth it just to buy it OTC and take it depending on their advice.

Hi OP,

What a worry for you! I've just been through something similar. I'm 38 weeks at the moment. At the 30 week scan they said baby was 3rd percentile (tiny) and I had extra monitoring, but at 33 week scan he was 45th percentile. At my scan last week he was 90th percentile! I went from having a tiny baby to apparently carrying a sumo wrestler.

In summary, I doubt how reliable those scans are.