Friday, September 20, 2013

What makes a baby have low or high birth weight?

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Katie


What makes a baby have low or high birth weight?
Like, why do some babies weigh 10lbs and birth, and others at 6lbs? Is it what you eat? How much you excercise? (I obviously know that drugs cause low birth weight, but I other then that...) I was just curious because my friend gained 20 more pounds with her 2nd child, and her 2nd child was 7lbs, and her first was almost 9lbs. So confused... Thanks!



Answer
The primary cause of low birthweight is premature birth (being born before 37 weeks gestation). Being born early means a baby has less time in the mother's uterus to grow and gain weight. Much of a baby's weight is gained during the latter part of pregnancy.

Another cause of low birthweight is intrauterine growth restriction (IUGR). This occurs when a baby does not grow well during pregnancy because of problems with the placenta, the mother's health, or birth defects. A baby can have IUGR and be born at full term (37 to 41 weeks). Babies with IUGR born at term may be physically mature but may be weak. Premature babies can also have IUGR - these babies are both very small and physically immature.

Any baby born prematurely is more likely to be very small. However, there are other factors that can also contribute to the risk of very low birthweight. These include:

race
African-American babies are two times more likely to have low birthweight than Caucasian babies.

age
Teen mothers (especially those younger than 15 years old) have a much higher risk of having a baby with low birthweight.

multiple birth
Multiple birth babies are at increased risk of low birthweight because they often are premature. Over half of twins and other multiples have low birthweight.

mother's health
Babies of mothers who are exposed to illicit drugs, alcohol, and cigarettes are more likely to have low birthweight. Mothers of lower socioeconomic status are also more likely to have poorer pregnancy nutrition, inadequate prenatal care, and pregnancy complications - all factors that can contribute to low birthweight.

Causes of a big newborn baby and management
Genetic: Mothers with heavy build are more likely to give birth to large babies but there seems to be no relation between father’s weight and baby’s weight.

Maternal diabetes: Hyperglycemia in the mother (increased levels of blood glucose) causes hyperglycemia in the fetus, as glucose crosses the placenta. The fetal hyperglycemia causes the beta cells of pancreas (cells responsible for producing Insulin, the hormone which controls the level of sugar in blood) to produce more insulin. Insulin also brings about increase in body weight. Hence an infant of diabetic mother will be a big baby at birth.

After birth the high level of insulin persists for some time in the baby and this can result in hypoglycemia (low blood sugar). Hence, such babies need to be monitored for some time, with blood glucose estimation at frequent intervals. They may require intravenous glucose if the level of glucose in the blood is low. Hypoglycemia can be dangerous because it can cause convulsions and brain damage.

These babies are also prone to suffer from polycythemia, a condition in which the blood is very thick and can clot inside the blood vessels. If it is severe the baby may require exchange transfusion with plasma or saline.

Congenital hypothyroidism: Deficiency of thyroid hormones in the baby causes increased body weight. These babies also have constipation, hoarse cry, diminished activity and dry skin. If there in any doubt blood has to be sent for testing the level of thyroid hormone and treatment started early if it is low. Delay in treatment can cause mental retardation.

Wiedemann-Beckwith syndrome: The baby will have grooves in ear lobes and large tongue. Some also have cleft palate and hypospadias (abnormal opening of the urethra). Chromosomal abnormalities have been demonstrated in some of these babies. They are also prone to develop hypoglycemia. Some also suffer from mental retardation.

Transposition of great vessels: This is a congenital defect of the heart. In this the blood vessels arising from the heart (aorta and pulmonary artery) are connected to the wrong chambers of the heart. The beta cells of the pancreas receive blood containing more glucose and oxygen and hence produce more insulin resulting in increased growth of the body and a big baby at birth. They also require frequent monitoring of blood glucose after birth and intravenous glucose apart from treatment of the heart problem.

How to be healthy while pregnant with twins?




Della


So I just found out I'm having twins today, and I want to stay as healthy as possible to make sure they grow properly, and are healthy, I just got married 2 months ago and these will be my first children, I want everything perfect.

So if anyone has advise please say how I can do it? I don't want to endanger them in any way.



Answer
What little I know comes from my friend's experience with twins. Eat well and eat often, and do it as soon as you can. One big issue with twins is that they are usually preemies. The faster you get help them gain weight, the better they'll do if that happens, so eat like it's a job at this point.

Cravings - if you crave it, as long as it's a food, go for it. Fat, calories, veggies, whatever. You often need something in that food. I would insist on getting your vitamin levels tested once or twice during the pregnancy - make sure you are getting enough for them, you know?

Take good care of yourself and rest when you need it. Don't push yourself to exercise if it's exhausting you - your need to be fat and happy is better than the need to be toned, you know?

PLAN. There's a good chance you might be on bedrest some time in the last trimester. It will relieve your mind if you have a potential plan in place, should this happen. The same applies for after the babies are born. You'll need help - arrange it now. Set up meals now or set up people to bring meals to the house for the first month or more. And think of how to do things when you'll have two babies. Look into how to breastfeed two babies at the same time (it's doable. My friend used to do it all the time, but it takes some practice), think about how to do X chore with two babies who might cry at the same time, or when they start to move, might crawl away at the same time, LOL.

Whether it's going to involve planning and organization you do, or help that you arrange to come to the house, having it set up ahead of time is one less stressor you have to deal with.

After the birth, breastfeeding is REALLY helpful. Mama's make special milk when they have preemies that they don't make with a regular birth - it's higher in calories and I believe it is also higher in disease/germ fighting properties than regular breastmilk, too, so it will really help your babies if they are born early. If they are too weak to suck, then pump and insist they feed it to them. You can do some research now on the issue - there's a lot of good research on the benefits of this. The best resource I know of for breastfeeding is the following: http://kellymom.com/ There is advice specifically on breastfeeding twins, I believe.

Another thing you may want to look into is how twins react if they are preemies and are kept together in the hospital. There seems to be some pretty compelling evidence that twins stabilize better, gain weight more, and are generally healthier if they are kept together after birth, in the same bed, if preemies.

A very famous and touching story about this type of situation is often referred to as 'the rescue hug.' It'll make you get all weepy and smile at the same time. http://www.planetdeb.net/spirit/rescue.htm
The picture here isn't photo-shopped. The little ones stayed in this pose long enough that one of the hospital staff was actually able to get a picture.

There was an interview with the family ten years later and the twins are both healthy and doing great. :-D

Co-sleeping might be something for you to explore. There's a lot of good information about how to do this safely, and with such tiny babies, you may want to keep them close to monitor them more closely. And so you can feed them without having to wake up too much.

Wishing you good luck - it's an amazing thing. I hope it all goes smoothly and you have your new little ones soon. :-)




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