Surprise small baby!

[BuzzBuzz123]

Hi All,

I’m looking for a bit of guidance/reassurance. I’m currently pregnant with my second child. The first was a surprise small baby, in that we went for growth scans, they were completely average at every single one and they were then born on the 1st percentile for weight. A big surprise for everyone including the medical team and speaking to friends I can see that if they had known how small baby was going to be I would likely have been induced earlier. Instead I went full term and went into labour naturally, baby born healthy, just small.

Now I’m expecting my second, I’ve had my first growth scan and it seems to be the same story. Baby measuring average and sent on my way, another scan in 6 weeks.

I’m inclined not to believe the scans (in our case). The likelihood is this baby is also small and I’m a concerned about going full term when I know that (assuming she is small - could be wrong) if she was measuring her ‘true’ weight then likely we would be heading for early induction for baby’s safety.

I’d be grateful for any opinions or experience in this area! I’m currently torn between trying to push for an induction or just trusting the professionals and knowing that I can go in for reduced movements if I need to.

I would prefer to go into labour naturally over an induction...even if baby was measuring small on your scans, they aren't normally that fussed...they are more concerned about consistent growth. Its if they drop dramatically in growth between scans that they would then tend to induce you

I would look at research by Dr Sara Wickham. She gives evidence based clear information to support women to make informed choices.

My own personal view is you have already birthed a healthy small baby so it is likely that this is just normal for you and your body.

Look into why they recommend induction for small babies and then ask whether that's really necessary in this situation.

Also, look into different forms of induction and the associated risks. My personal experience of a hormone drip was not positive and reading more about made me determined not to have it for my second birth.

I was told my baby would be 9/10lbs. He was born two weeks early and was only 6lb 12.

First was measuring ok up until 37 weeks and then small (growth restricted) and I was induced
second- more frequent growth scans; growth tracked well all the way to term and was born a much healthier weight
so in my case, scans were accurate
I wouldn’t want an early induction unless medically indicated; not sure I would make decisions based on previous experience alone

Thanks everyone, I appreciate your messages and they’ve chimed with a few things I’ve heard from friends - especially regarding negative induction experiences.

I guess we won’t know how small baby actually is until they are here, it’s just frustrating to know that these scans can be so far out but they are effectively the gold standard!

Hi OP, I think the fact that you went into labour and gave birth naturally to a healthy baby is very encouraging because although she was on the smaller side, she was fit and strong enough to go though labour & delivery.

When I was pregnant with DS, I was monitored closely because DS was too small for his age. Short femur, low weight etc. I was booked for a C section because they said he might not be strong enough for a natural labour & birth. And bam, I gave birth via section to a perfectly healthy, bouncing baby boy on the 50th centile for both weight and height! So all my worry was for nothing, although I'm grateful they monitored me because it's better to be safe than sorry but just goes to show US is not always accurate for measurements.

This is just a side note, but since I was monitored and scanned every two weeks, one of the ultra sound ladies around the 32 weeks mark measured DS and according to her numbers, he shrunk! I insisted someone repeat the ultrasound because I didn't quite believe that, and turns out she just wasn't measuring him properly....of course...

Good luck xx

You have petite babies that is all. Baby was healthy so why get induced? Being induced earlier will also mean baby is smaller and might not cope with labour. And EDD is exactly that and estimate. Clinicians can be off by 1-2 weeks. It is known and verbalised.

My DS was petite on 4th centile. But this is genetic my DM had us all smaller and perfectly healthy 6-7lbs no larger. Wasn't an issue for us. My DS is now 2.5yea old taller then average and thriving very bright. No issues.
My DS2 is also measuring 10th centile and perite again I am 37 weeks. Placenta is working fine. Amniotoc fluid is fine. Movement's are great. I am in perfect health.

I would never ever do an induction unless there was a medical reason. I.e preclampsia, baby distressed. Reduced movements etc etc real urgent matters.

As a radiographer it is not the gold standard. Not sure which sonographer or Dr topd you that melarky.
We always say to patients we can be very off by a lot!
I have seen patients with 50th centile measurements then a baby is born on the 100th centile. Never will be good standard just and estimate. And as long as baby is healthy snd placenta is working best to keep baby inside growing and getting stronger.

@BuzzBuzz123 kind of similar - my son was born on 5th centile at 41+1 (6lbs15oz) - a complete surprise as he'd been 50th centile at the 20wk scan and never flagged up as small from fundal height measurements. I did develop gestational hypertension around 38wks and suspect my placenta started failing. It was monitored but didn't require further treatment and didn't develop to pre-eclampsia.

I never thought anything of it all until my current pregnancy progressed. Due to my son's SGA birth-weight I was told we would be having growth scans from ~28wks. In our case though, my current little one flagged as small at the 20wk scan (3rd centile) so they started the growth scans at 24wks. We have stayed 3rd centile with one or two slight slowing moments that have caused additional concerns. However Doppler checks of blood flow and amniotic fluid have remained good and so far, my bp is also perfect. Very much hoping I just make small babies, however we are having an amnio on Monday (will be 35wks exact) as our measures do seem to be skewed mostly by a smaller femur and though earlier screening was normal, genetic causes remain a possibility...

It's all been a lot of stress tbh and I can't help thinking ignorance was bliss in my first pregnancy. That said, I had some retrospective panic about my son as have heard risk of stillbirth etc is higher for small babies.. it made me feel super grateful that all was ok first time round.

They've told me they don't want this little one to stay in beyond 37wks. I'm seriously contemplating C-section over induction as can't see my body being ready at that stage. Also slightly concerned how Babba would cope with the induction process. They obviously wouldn't go ahead with that anyway if there is any change in terms of Dopplers etc, or if his heart rate reacted badly to the induction process. Smaller babies might struggle more.

I know I could ask for increased monitoring to push for a later birth date but I think my anxiety would render the benefits of that slightly obsolete. I've already become so hyper-vigilant regarding movements etc and just want him here safely now.

I think I detect some similar retrospective concern for your first born from your post. It might be helpful to request a birth review. I did one this morning and it was actually reassuring to see how well my son coped with labour (from the ctg) - he was small but mighty and never at risk of still birth. Sounds like you also have a further growth scan booked in? Hopefully they will keep an eye on things. The best I can advise is don't be scared to advocate for yourself and push for further checks - particularly if it is also impacting your MH. But also, know that these issues do tend to come with other signs. Scans aren't perfectly accurate by any means but as part of a bigger picture I think they tend to give a reasonable view. The thing to look out for more, over size, is probably growth stalling/slowing, and that should show even if they are tracking a larger centile.

Sorry that's a mega essay... But hopefully helpful to read of my experience. You are understandably concerned but it may well be that in your case, your second baby is just bigger or your placenta is coping better so far etc. 🤷🏼‍♀️ Best of luck!

Thanks you, re the gold standard, it’s just my impression given that major medical decision seems to be based off this information and there appears to be no better way to estimate weight.

Mega essays always appreciated! It’s good to hear that it happened to someone else too, I think you are right about the retrospective concern for my first. I’m glad to hear that you are being well cared for in this pregnancy. I think I will talk over all my options with my midwife and go from there.

2 small DDs here. DD1 5th centile and DD2 8th centile.

DD1 being small wasn't picked up until week 38. By that point we were in covid lockdowns. I had 1 extra scan and they said to come back in 2 weeks. I had her the day before this appointment. She was perfectly healthy and we went home the same day. She is still very slight at 4.

DD2 had all the extra monitoring and scans and was showing to be around the 25th centile but was born on the 8th. Also totally healthy and home a few hours after birth.

Myself and my side of the family are slight and I think for us it's just genetics. Though DD2 has moved up the centile graph after birth unlike DD1 and she's now fairly chubby. After birth they said my placenta etc was really healthy, no interventions in either birth. You may just be someone that has smaller babies x

How small is small though? both of mine were a little over 6lb which was quite different to what the scans indicated. Turns out I only have 2 vessel cords and it's likely to run in my family as I was tiny, my mum was tiny and so on. Both dc absolutely fine just petite and grew slowly, as adults are smaller than average but within normal range for adult women.

My first was unexpectedly small, born on the 3rd centile (6lbs), having measured around the 30th centile when I had scans at 22 weeks and 32 weeks. I was induced just before 40 weeks for reduced movements and ended up having an emergency C-section.

My second was closely monitored throughout pregnancy. She always measured bigger during pregnancy, around the 70th centile. When she was born she was about 7lbs, so bigger than her brother but definitely not on the 70th centile. My placenta was quite small apparently.

You might just be someone who makes small babies. I wouldn't go for induction unless it was medically indicated.

Hey 👋 i had growth scans throughout my last pregnancy because i have “small babies” apparently, i was pretty shocked when the consultant told me this, my first (now 14) was 7lb 8oz- she got stuck and had to have episiotomy and forcep delivery, personally i think my body learned from that experience and my next baby (now 12) was 6lb8oz- which is small apparently 🤷🏻‍♀️ i then had twins (now 9)at 37weeks 4lb7oz and 4lb9oz which is small, but i think they were good sizes for twins born 3 weeks early, and my last (6months) 6lb8oz, none of my “small” babies needed any extra help after they were born (twins were in neonatal for one night for monitoring but were fine) not had any feeding/eating issues and are all healthy happy kids- I didn’t expect with my last to be monitored for small babies, my nan never had a baby over 7lb, my mum never did either, i myself was only 5lb3oz when i was born, i figured 6+lb was normal size for a baby but apparently not lol xx