Baby measuring small at 30 weeks - what next?

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Was referred for a scan yesterday after registrar thought my bump was measuring small for dates. Had same in first pregnancy, was sent for 3 extra scans and at one point growth rate seemed to have slowed slightly (albeit staying within normal range) but in the end DD was just off 8lbs.

But yesterday's scan showed this baby is definitely small for this stage in pregnancy - less than 5th percentile - whereas at 20 weeks I think he/she was about or just below average. Placenta/blood flow etc were checked and all fine but I've got to go back to be rescanned in a couple of weeks. What are people's experiences of this? What happens if baby is still small at next scan?

Thank you

Any thoughts/experiences? Things I should look out for? Don't want to be too paranoid but should I, for example, be monitoring my own weight gain?

My first baby measured small althouhgh still considered in normal range, not sure what centile he was on when they scanned me (had a few growth scans) but he was born 9th centile at 2 weeks overdue. He is 2 now and still 9th centile for height and a little less for weight but perfectly healthy

I am pregnant again now and at the 20 wk and a repeat scan at 27 wk they said this baby is measuring a week smaller than dates.

They have just said they'll keep an eye on how my tummy measures and I am too keep an eye on fetal movemement (which there is plenty of at the moment).

It's hard to advise you, I just wanted to give you my experience really.

I would say that your weight gain almost certainly has no effect unless you were starving to the extreme, baby will take what it needs from you to grow.

I suppose it depends on what they see at your next scan, some babies are just smaller than others but perfectly fine.. They will be checking to make sure there isn't any other reason for the growth being slightly slower for eg: problems with placenta.

My final growth scan for my first baby showed that he was still small but not for any particular reason. The only action that resulted from that was for them to advise me to give birth at the hosptial rather than the local midwife led unit as they said sometimes smaller babies are more likely to become distressed during labour. He didn't become distressed btw and good great apgar score straight away. He was 6lb 5oz at 42 weeks.

Sure someone will be along shortly with better, more specific advice, just didn't want your post to go unanswered.

Thanks Dalyrmps - much appreciated. I suppose what concerns me more isn't the small for dates thing but the slowed rate since 20-week scan.

The other reason I'm asking is that I'm booked in for a c-section at 39+5 but might reconsider trying for a VBAC if it would give the baby longer in the womb and more of a chance to put on weight.

Certainly not starving myself - mince pies r us at the mo...

Ah I see, maybe you should ask the midwifes to clarify what the reasons could be for the slowed rate? Might put your mind at rest.

I'm sure I once read that up until a certain stage in pregnancy all babies grow at the same rate and thats how they can measure them and give you your EDD. I'm not sure what stage that's up to though? Was just thinking, if it was around 20wks or so that might be one way to explain the slowed rate of growth or rather your baby finding it's own centile so to speak? Just an idea.

I would try and get as much info as you can from the professionals really. If baby is just small cause he/she is meant to be that way then maybe a little more time inside wight be good. However, if the growth is anything to do with the placenta not functioning at 100% then they may advise baby to be born when you had planned rather than later...

I hope that it's just the case that this is how you grow babies and you get the news you want at the next scan, either way it's good they're keeping an eye on you

Try not to worry (easier said than done I know!)

Thanks Dalrymps that's really helpful. And a v good point about this maybe just being the way I grow babies!!

Well, i'm no expert but just trying to think about it from all angles. Fingers crossed for the next scan

Hi - I had this with DS, he started to measure smaller for dates from about 32 weeks. This was the advice I was given.

• Do keep an eye on fetal movements. From 28 weeks, babies have routine times they move. Keep an eye on those movements and any reduced movement needs to be checked out. The reason I say this is because your LO could be fine, but as Dalrymps has said, it could be an indicator that placenta function is not operating great. And reduced movement is the earliest indicator that all may not be 100% with bub.
• Eating lots will not help you. In the nicest possible way, our babies are parasites and will take everything they need from us. Your weight gain is not related to this.
• When they rescan you in a few weeks, see if they also have the equipment to do a doppler scan (checking your blood flows etc)
• Have your hospital bag ready and take it to appts / traces with you, just incase.

DS continued to measure small and I did have lots of episodes of reduced movement. I went in for a trace about 36 weeks and although the scans were still showing everything was fine - they were getting worried about the number of incidents I was having re.reduced movements and nearly took me in for a csection there and there.
As it was they booked one in for 37 weeks (wanted to get me to full term if poss), but with the caveat that if I had one more episode of reduced movement, baby was coming straight out.
DS was delivered at 37 weeks, was only 5lbs 1oz but perfectly healthy. He was simply a small baby. I have to say that having this with DS didnt make the final few weeks particularly stress free, but he is absolutely fine.

HTH.

Hi - I have been through similar experience with current (3rd)pg and to a lesser extent was the case with DS who was DC1, who sounds similar to your DC1.

It is difficult to advise you but this baby was measuring v small at 20 wks so was extremely worrying, I think that the doctors were doubtful then that we would get through at all - they tested by amnio and blood tests for infection and genetic problems (all negative although a genetic problem is still a possibility for us) but said that the most likely cause was placental insufficiency and that their goal for delivery into neonatal was about 28 weeks and 600g for them to be optimistic about a good result (ie no long term problems such as cerebral palsy). So firstly, put your case in perspective, you are past those milestones - did they give you an estimated weight? If the dopplers and fluid and movement are fine then that is good - they will just continue to scan and as others have said, make sure you keep an eye on movements. Growth will most likely continue but may slow down - if dopplers change/fluid reduces/movement slows then they may deliver early but that is the point where the baby would do better in an incubator than inside you. I'd have thought you should have a really good outcome now, I don't think your situation is very unusual as others have shown. I am much more positive now after months of stress - we have made it to 35 wks and baby is estimated at 3lb 12oz, so about 2-3 wks behind normal size but consultants seem pretty relaxed about outcome even if they have to deliver any day now and they are scanning weekly.

Btw I was told at the 20 week scan/tests that diet and rest make no difference whatsoever, if your placental function is impaired then there is nothing you can do to affect it unfortunately. I thought they could at least have recommended a few lie-ins!

Good luck

Sorry - have been offline a couple of days.

sleepwhenidie and mistletoekisses - thanks v much for your input. I finally got to speak to the midwife today who said more or less what you've both said that in all likelihood they'll just keep monitoring me with scans every couple of weeks but in rare cases they decide to deliver early. Was just a bit alarmed at the possibility that I could go in for a routine-ish scan in a week and a half and be told that they will deliver the baby then and there. I know it's very unlikely but I suppose it's possible.

They gave an estimated current weight of 2lbs 12oz I think, so that does give me a lot of comfort and the midwife did say that early deliveries are v unusual in these cases.

mistletoekisses - they did check the placental bloodflow at the last scan (is that the same as doppler scan?) anyway they said it all looked fine.

Thanks again for your feedback, just helps to hear about other people's experiences

I'm currently measuring 33 at 35 - and my MW wasn't too bothered. I also measured small on my scan to check the placenta had moved.

She did say that a lot of women keep on pushing themselves to keep doing lots of things right up till maternity leave (definitely guilty of that) and the minute they stop and rest the baby packs on weight in the last few weeks.

Hello Fibilou - it's weird, it seems like the measurements vary depending on who does them as well. Midwives seem to measure my bump as being bigger than doctors! I was 5cm or 6cm behind in first pregnancy and this time 4cm or 1cm off depending on who is doing the measuring. I was told they didn't worry about 3cm each way so i thought maybe doc was being over cautious and wasn't too bothered until scan showed the baby's estimated weight as below the 5th percentile (down from about 45th percentile at 20 weeks I think).

V interesting what your MW said, the man who scanned me said there was nothing I could do to make any difference i.e. resting was immaterial but it's true that DD put on a lot of weight in the last few weeks of my pregnancy with her though (when I stopped running round like a mad woman) so I can well believe there's something in it.