IUGR / Small for Dates babies

The lady at Plunket said today that normally babies grow to fit your pelvis. So those that produce small babies at full term will do so for babies after that. I dont think that would apply to IUGR or prem babies though

Bobbie that's very interesting because my twin sister was a 4lber at full term , I was 7lbs.

It was the blood flow reduction in the placenta that was the final decider for my c-section also.

My placenta got sent away for analysis, I've yet to hear the results. It'll be interesting to see what they are though

Oh and thanks for the kind word too girls

How are the girls doing now Tishy, specifically little Aoife? I thought I'd revive this topic as recently I asked a question in the "ask our experts" section & got this response:

Question
My son (7 months) was born at full-term but was quite small (2.3kg). I see on my hospital discharge papers that he was classified as "IUGR - unspecified". I didn't have any scans past 20 weeks so it was a bit of a shock & surprise when he was born. I have started to think ahead to baby #2 & am wondering what will need to be done diferently next time.
Can I still use a midwife as my LMC & is it simply a case of having a growth scan(s) to check on baby's rate of growth during the later stages of pregnancy?

Answer
Obstetrician Dr Anil Sharma replies:
The average birthweight for (assuming) european babies is 3.5kg so yes, he was small. Obstetricians are trained in the detection and management of IUGR pregnancies.
There are many causes in general including poor nutrition during pregnancy, smoking, drugs, pre-existing medical problems including antiphospholipid syndrome, excessive exercise and pregnancy associated problems (eg pre-eclampsia and diabetes). There can also be placental problems and infections and finally fetal problems including abnormalities. There are also many, many cases where a 'cause' is never found out.
An obstetrician will be able to advise you about preconceptual blood tests you may need and the need for prophylactic treatments such as aspirin. Obviously your future pregnancy will require close surveillance.
In New Zealand you can use a midwife LMC but to be frank, you are asking an obstetrician, so I would advise that best practice involves an obstetrician. If a private one such as myself is outside your budget, then a midwife LMC should refer you for a plan to a public one, but bear in mind that tests and any prophylactic treatment need to be initiated before pregnancy and in early pregnancy respectively.
best wishes
Dr Anil Sharma

TBH this worries me a little. I was thinking that I'd use a MW again & just have some more scans past 20 weeks . Does anyone have any idea how you go about having the tests he mentions before you get pregnant? I don't think we can really afford an OB so I'd prefer to use a MW who will refer me to one at no cost (is this even how it works? - I could be completely wrong). I tried talking to DH about it but he doesn't really think it'll be a huge issue. I didn't really think so either but after reading Dr Sharma's reply I'm not so sure. Eeek. Maybe Liam can be an only child

jack wasn't 'classed' as IUGR but was only 2610grms at birth and was on the 20%percentile on the IUGR growth chart.........i had no special care during my pregnancy with charli and she was 3350gms at 41wks

Yep Jo I think it does take longer, my baby wasn't IUGR at birth but was in utero until a growth spurt at 38 weeks so was OK when he came out (3.4kg) but had a really small tummy which meant he was hungry. I gave him a dreamfeed so he slept through at 9 weeks but has woken up at 5am for the last few months due to hunger.

You could try and shove as much milk in to him during the day as possible? I think they *can* sleep through from about 6kg or something, but it really depends on the baby unfortunately.

Sally I see the clinic our MW's worked from offer an 'elite' package where you can get Janet and Paul together. Maybe you could check into it. I'm guessing you'd just pay for the OB since the MW would fall under the gvt funded LMC?

Anyway those were the two I had last time around and I highly recommend them both - they're lovely.

Janet mentioned that for me to get Paul just for the birth would be around $2000 which isn't bad really.

oh my gosh if you have twins again I will worship the ground you walk on supermummy

My son was IUGR because he had stopped growing and was born at 35w 5d via emergency caesarean after a 12 hour labour. He is now 5.5 and is in the 50% percentile for his height and weight.