20 wk scan => smallish baby, help pls

[SoftFroggie]

I am fairly short, and my husband is slight, so we were never expecting large babies.

When expecting our first baby, I moved and transfered GPs and hospitals at 36 wks. As I was planning a home birth, concern was raised by new GP that I was small (1m52 / 5'2" = not too small), so at 37 wks I was sent in for a hospital clinic check, where the mw measured my bump as much smaller than anyone had before, sent me for a scan, which showed DS was smaller than the bottom curve on the graph they plot on, though within the curves my previous hospital used. There were no other concerns at all. I saw a registrar, who immediately told me i'd be induced that night. Further discussions with consultant, and we agreed a programme of fornightly scans, and a further induction date. I subseuqnelty went into natural labour at T+9, giving birth normally (at hospital) at T+10 to a very healthy, smallish (6lb3) baby boy. He is still small at 20 mo, and still very healthy.

After my 20 wk scan with my current (2nd) pregancy, the baby plotted smaller than average (no surprise there) and the sonographer said that my mw might send me back for a growth scan at 34 wks. I don't really want this - unless there are other issues - as I really don't want to go through the stress of being thrown onto consultant-care, negotiating out of early inductions, and having frequent and pointless scans etc again. I don't object to the scan per se, but all the fussing, the increased liklihood of being forced into an unneccessary early induction and subsequent potential labour intervention. I expect I will have another healthy but small baby, and don't need extra intervention just 'cos it's small.

If my mw does want to send me for a 34 wk growth scan (I'm seeing her later today, currently 21 wks), how can I best approach this? Is it really necessary? I don't object too much to being pushed to have a hospital rather than home birth, but I really don't want either an induction, or the stress of negotiating against one.

Many thanks, and sorry for the length of this!!

Both mine have been small and ds1 was induced for that reason. I was given steroid injections at 38 weeks and then induced. He was 5lb 15oz and perfectly healthy. He didn't need special care and I was home in two days. Small babies are cute and cuddly for longer.

You have to do what you are comfortable with. I got messed about with ds2 no end. I must have had more than a dozen scans and I was induced with him at 37 weeks mainly because my waters had broke a month earlier. At my 20 week scan he was small and I had to have a scan a month later where he was on target. then another month later he was below target. So I think it just depends on the growth spurt. Ds2 was 6lb 5oz.

Good luck. I hope everything goes okay.

Mine was a dink too (4lb 15) and I was induced at 38 weeks - first child...he's fine and health - hit the 9's on his scores.....
Personally if I had a second I would resist the induction, and keep the scans to a minimum unless there were other issues.

my first baby was prem because at 33 weeks they said he was too small and in distress. i had him four days later by c section and he was 3lb 10oz. because of this i had many scans with my second. they all said she was growing fine and my last at 36 weeks, they said she would be about 6lb-7lb when i had her. she was 5lb 5oz. growth scans are not always that accurate, and if mine was right then she would have hardly grown since my last one yet she was a perfectly healthy baby. a friend of mine also was advised to have a section as they said her baby would be too big....she did and baby was only 6lb....she went absolutely mad. just to add that all the way through my second pg, my bump was exactly the right size.....it really doesnt reflect on the baby's size in my experience.

Sounds like you breed small ones. If the baby is small because its small, the last thing it needs is to be forced to be born early! dd was 5lb 9 and they gave me no end of hassle in the hospital about how much she (wasn't) feeding. But she was born on the 2nd centile and is still on it, aged 26mo. Some people are small!

Why is your midwife suggesting the scan? Is it purely because the baby is small or is there some other cause for concern? I thought it was only a problem if growth stopped or slowed right down - if your baby is growing steadily, its not a problem is it?

Froggie, I believe that in my country the average height its very similar to yours and a 6 lb baby is not small at all, I was only seven pounds when I was born (and huge for the standard). I'm 1m75.
I have 2 friends who are around 1m50 and their 3 girls weight was around 4lb at birth and are doing brilliantly, they don't seem small at all now they are in their teens.

I think that it will be worth to have the check ups just in case, but agree that you need to negociate to get to term unless there's a very clear indication that something is really wrong with your baby (other than under average weight)

At the opposite end of the scale - a friend of mine was told that her baby was average size when she insisted that he was big and she couldn't breath, bend down or even turn over anymore. She was left until 42 weeks and then had a planned C section. She'd beeged from 8 weeks for it to be done earlier. During the section the baby was so big they had to cut her double the normal width and they also dislocated the babies shoulder (he still has problems now with his shoulder) .

He was 11lb 11oz. Ds2 was five months when he reached that weight.

Here we go again.
Bump has been measuring small for the last 8 weeks, and just 2cm growth in last 4 weeks. Midwife is "monitoring it" and I suspect I'll be sent for a growth scan after my next midwife appt unless there is VERY GOOD growth. (think I only didn't this time cos the last baby was small).
Can anyone really tell me is there a good reason to induce a small baby? What should I be thinking / asking about? I remember last time some suggestions about asking for the waters to be measured - does anyone know more about this? I'm worrying that either I'll be pushed into consultant led care, loads of scans, early induction etc, OR that I'll manage to refuse all those things, but actually should have them and the baby isn't growing OK...
I have slight odema this time (rings don't fit anymore, but not hugely puffy), but everythign else seems fine.
Thanks for any reassurance / information!

All I can remember from ds is that they look at the head, leg and waist measurements - the head gets the nourishment first (so ds was small, but still had an 'average' sized head...). With ds they were worried because he dropped off the chart and was going in a straight line on his waist measurement (he was - and still is - a skinny runt). They checked the water - is there enough - and the blood flow through the cord, which was fine. In the end I got to 38 weeks and they figured 'better out than in' as we could get some milk down him...
When I was measured two different members of staff would do it to check it was accurate (have to say on the 'estimated' size they were pretty much spot on)

My doc measure me as small, and she said if I can lie on my left side more the blood flows into baby better, helping growth apparently.

Dont know if this will help, I was told to take lots of rest and lie on my left.

in my previous thread I posted that all my family and my DS were small.

Softfroggie - When pregnant with Dd2 I measured small on several occasions and was reffered for growth scans. I had 2 done by my consultant as it was his specialist area and he concluded that I was just carrying a small baby but that baby was fine, just not gonna be big.

I went into labour at 35 weeks and she weighed 4lb 14oz. My consultant was quite happy with that and said had i gone full term she would of been between 6-7 lbs.

I wouldn't worry, i think they are a bit over cautious sometimes.

Thanks for your comments.

I'll try to rest more, and lie on my left (I could do with the rest - but it's hard with a lively toddler and largely absent DH). I eat well, and have never smoked, so not sure what else I can do to encorage growth.

Nutcracker - do you know what it was that helped the consultant to decide it was just small, no problems? I'm more worried about over-cautious consultant making me have it early, than about a small baby.

Erm i think he just looked at the baby and the blood flow through the cord which was fine both times and suggested that as Dd1 was only 6lb 8oz and that i wasn't big myslef that i just wouldn't have a big baby.

They won't deliver you early just because the baby is small. They will be checking for sign s that the baby isn't growing more than that it's just small. They will check blood flow therough the cord and if that is fine then baby should be growing o.k., but could still be small iyswim.

Hope it all goes o.k

I'll get the blood flow checked, and ask for repeat growth scans if necessary.

When this came up when expecting DS, I had one scan then went in to see registrar, who just said "right, let's induce tonight" at 37 weeks so he was prepared to induce just cos small on the basis of one scan, and that's what I want to avoid. In the end we saw his consultant and got the induction plan stopped! Sounds like I was unlucky though and am making more of a mountain of this than I should. Thanks.

Will go away, try to rest more and send "growing" thoughts to baby, and stop worrying.