Expectant women worry about everything imaginable. Is the baby growing? Will the baby be healthy? Can I handle labor and delivery?
Who can fault a mother-to-be? She is, of course, bringing a human being into the world. Which is a HUGE responsibility. One common worry new mothers have is whether or not their baby is too big or too small. This is challenging because each mom carries each baby differently. Some have tiny bellies, others have larger bellies. And this doesn’t always indicate the size of the baby.
To make matters worse, ultra sounds can be off on the weight of the baby by as much as a pound. At the beginning of my second pregnancy I was being monitored by a specialist because he thought my baby was too small. Part way through we found out I had gestational diabetes. Then my baby was being monitored in case he got too big. Confusing, right?
As much as we’d prefer it not to, size does matter for babies. Many times it can indicate a problem or a future problem. Babies weighing less than 5 lbs 8 oz are considered low birth weight. Babies weighing more than 8 lbs 13 oz are considered high birth weight (also referred to as Macrosomia for Big Baby).
Continue reading to find out 15 reasons baby’s size does matter. #1 is true for both large and small babies so make sure to check it out.
15 Mom Will Have A Longer Labor
One major concern with having a large baby is labor and delivery. I mean that baby has to come out some way, right? Your birth canal isn’t getting any bigger just because your baby is! 10 centimeters is roughly the size of a bagel, so just try to imagine how it's going to feel squeezing 10 plus pounds through something the size of a bagel.
The problem is that there is no way to tell how big of a baby you will be able to birth.
Doctors can take measurements and make estimates about it but until it happens they won’t know for sure.
Part of it will depend on the mother and how much she is able to relax and allow her body to open up. Tense muscles and a fearful mind won’t allow a baby to pass as easily as relaxed muscles and a peaceful mind.
14 More Blood Loss
A mother may experience more blood loss after the birth of a large birth weight baby. This is also referred to as postpartum hemorrhage. Post partum hemorrhage happens when the mother is bleeding uncontrollably from an event that happened during labor and delivery.
This could be due to several factors. The mother may have had a larger episiotomy or perineal tear. There could have been difficulty delivering the baby causing internal tears. In some cases, a heavy weighted baby will be delivered by c-section, this might also result in blood loss as well.
With heavy bleeding, immediate measures need to be taken to slow or stop the bleeding. Mothers with heavy bleeding are at risk of going into shock or even dying if it isn’t controlled quickly. In some cases mothers will receive a blood transfusion to recover their blood loss.
13 Severe Perineal Tear
Along with a more difficult labor, a large baby may create a larger perineal tear.
Of course, no one is jumping in line to sign up for this one! Tears can vary widely in depth and may run either in the front or in the back. Perineal tears are common in many deliveries, not just in the delivery of larger sized babies.
This is a concern but not something that will necessarily happen with a larger baby. A lot also depends on the ability of the midwife, nurse or doctor to work with the mother, direct the baby and use other techniques to make the perineal tissue more pliable.
Some doctors try to do an episiotomy to reduce the size or extent of a tear. More and more this procedure is being deemed unnecessary except for in certain circumstances.
12 Shoulder Dystocia During Birth
A large baby may be especially difficult to deliver when it’s time for the shoulders to come out. Shoulder Dystocia is when a mother is having a vaginal birth and the baby’s shoulders get stuck in the mother. Ouch!
It happens in large babies, but can also occur with average sized babies whose mother's birth canal is to small to accommodate their baby.
Shoulder Dystocia happens more commonly to women who have diabetes or are carrying extra weight. If labor is induced or she receives an epidural these can also contribute to shoulder dystocia. It also happens more often if forceps or a vacuum is used to move the baby through the birth canal.
Doctors or midwives can help to deliver a baby in this situation by changing the position of the mother or turning the baby’s shoulders inside of the mother.
11 More Likely To Be Induced
A mother with a baby that is measuring large for it’s gestational age is more likely to be induced. Healthcare providers may try to avoid the risks associated with delivering a large baby by inducing labor.
By delivering baby earlier, they can at least ensure that the baby won’t get any bigger therefore making it more difficult to deliver.
Women with larger babies may be monitored more frequently to assess how quickly baby is growing. Healthcare providers will be able to make an assessment about baby’s weight and size and may induce before baby becomes too big.
As baby grows bigger and takes up more space in the uterus it becomes more difficult to measure baby and assess its weight. Weight assessments based on ultrasounds may be off by as much as a pound (which makes a big difference in a baby!)
10 Need For A Cesarean Delivery
Cesareans become more probable as baby grows larger than average. Healthcare providers may try to avoid complications from delivering a large baby by recommending a cesarean.
This may be done as a preventative measure –assuming that baby will be too large to deliver vaginally.
It may also be performed as an emergency procedure if mom is laboring for too long or baby becomes stuck in the birth canal.
Cesareans take away the concern that baby may not be able to fit through the birth canal. They also keep mom from having a large tear or episiotomy (except of course she’ll have a large incision from the Cesarean).
9 Restricted Growth
Restricted growth or Intrauterine Growth Restriction (IUGR) is when a baby is not growing at a normal rate. Growth is restricted and the baby is smaller than it should be for its gestational age.
There are many reasons for restricted growth during pregnancy, including failing placenta, decreased oxygen to baby, mother’s nutrition, and smoking or drug use to name a few. Sometimes the cause of the growth restriction is not clear.
Babies with restricted growth will be monitored more frequently to ensure the health and safety of the baby before the delivery date. For one reason or another, baby is not growing as it should (unless of course its just that mom and dad are tiny themselves.). Often more frequent ultrasounds or fetal heart rate monitoring is done to ensure baby is still healthy.
8 Decreased Oxygen Levels
Babies that are born with lower birth weights may have issues adjusting to life outside of the womb. The next 7 numbers are common issues of newborns with low birth rates. Make sure to keep reading to #1—it has common issues for high birth weight and low birth weight babies.
Low birth weight newborns often have decreased oxygen levels. This can be a sign that baby is struggling outside of the womb.
Many times low birth weight babies are also premature. If this is the case, baby’s lungs might not have had enough time to fully develop. Making it more difficult for baby to gain the normal oxygen levels in their blood.
Babies with decreased oxygen levels may need to spend time in the NICU until their oxygen levels increase.
7 Low APGAR Scores
The APGAR test is given to newborns immediately after they are born and 5 minutes following to assess how well they are doing outside of the womb. This is a normal test that lets the care provider know how well the baby is at birth and whether the baby requires any interventions.
APGAR stands for
- Appearance (meaning skin color)
- Grimace Response (crying or contorting face with a negative stimuli)
- Activity (movement and muscle tone)
- Respiration (breathing rate and effort)
Scores range between 0 and 10 (10 being the highest). A baby can get up to two points for each area of the APGAR test. Low scores mean that the baby is struggling with one or more parts of the assessment.
Depending on the score or the struggle in each area a baby with low APGAR scores might need an emergency procedure or specialized care in a NICU.
6 Low Blood Sugar
Low blood sugar can happen to babies born with low birth weight and high birth weight.
Sometimes women with gestational diabetes have high birth weight babies. If these moms have high blood sugar levels before the baby is born the baby may experience a sudden blood sugar drop once it is born. Babies born to mothers with gestational diabetes are often monitored for glucose or blood sugar levels.
Low blood sugar can cause several problems for babies. They may have breathing problems, poor feeding, listlessness, difficulty maintaining body temperature, tremors, sweating or even seizures.
Breastfed babies may be given formula to help boost their blood sugar levels until the mom is able to produce enough milk for baby. A sugar solution can also be given to the baby intravenously. Treatment will continue until the baby’s blood sugar levels stabilize and the baby is able to maintain sufficient levels on their own.
5 Difficulty Maintaining Body Temperature
Babies with low birth weight often have difficulty maintaining body temperature. These babies usually have less fat on their body which makes it more difficult to maintain warmth.
There are several ways to treat this problem. Baby and mother may be encouraged to have more skin to skin contact as mother’s body temperature will increase to meet the needs of baby.
A warming light may also be used to increase baby’s body temperature. This is a radiant light that is over baby in an open bed. A closed incubator can also be used to increase baby’s body temperature.
Keeping the body temperature high enough is especially important in low birth weight babies. If baby is struggling to stay warm, it will burn more energy (perhaps leading to blood sugar issues), have more difficulty gaining weight, and will even have lower oxygen levels.
4 Too Many Red Blood Cells
Too many red blood cells can also be called polycythemia. This can happen in both low birth weight babies and babies born to diabetic mothers (some of which may be high birth weight babies).
Babies with too many red blood cells may have a deep reddish to purple coloring. They may also have difficulty feeding, lethargy, rapid breathing, jaundice or low blood sugar.
Many of these symptoms are similar issues with low birth weight babies. Therefore, a blood test is needed to assess whether or not the cause is polycythemia.
If polycythemia is the cause, doctors may remove some blood or use a partial exchange transfusion where they slowly remove and replace a portion of the baby’s blood volume.
3 Respiratory Distress Syndrome
Respiratory distress syndrome is when a baby has difficulty breathing. This is usually due to the fact that the baby’s lungs are underdeveloped.Usually the baby doesn’t have enough surfactant (a slippery material that helps the lungs fill with air and keeps them from deflating).
Risk factors for developing respiratory distress syndrome is premature birth, diabetes in the mother, rapid labor and multiple pregnancy.
Symptoms of respiratory distress syndrome include a bluish color in baby, rapid breathing, shallow breathing, apnea or grunting when breathing.
Depending on the situation, doctors may choose several treatments. Extra oxygen or extra surfactant may be able to help the baby breath better. A ventilator may also be used along with several other treatments.
2 Bleeding In The Brain
Bleeding in the brain can also be called intraventricular hemorrhage or IVH. It usually happens within the first 3 days of birth.
Many brain bleeds are mild and resolve themselves. Others may be more serious and cause fluid to build up in the brain. This can be a more serious problem that leads to brain damage.
A more serious brain bleed may be treated with medicine or by draining the fluid with a tube inserted by a surgeon.
Brain bleeds are diagnosed by an ultrasound.
1 Problems Later In Life
Babies with both low birth weight and high birth weight may have more problems later in life.
Some of these problems include diabetes, heart disease, high blood pressure and obesity.
When trying to avoid these lagging issues, prevention is supremely helpful.
An expectant mother can receive routine prenatal care, maintain a healthy diet and lifestyle, and avoid drugs, alcohol and cigarettes.
But sometimes a mother does all of these things and still has a low birth weight or premature baby or a high birth weight baby.
Careful monitoring of both baby and mother’s health during the pregnancy can give health care providers the best shot at keeping baby and mother safe and healthy.
If you're carrying a smaller or larger baby, let us know. Have you in the past? Comment below with how you felt during your journey through pregnancy.