preventing a "large" baby and doubt

[mommymidwife2b]

I am expecting #4 in April, and my midwife is suggesting that I change my diet in order to prevent the baby from getting too large. My first 2 girls were both about 8 1/2 lbs, but #3 was 10 lbs 2 oz. She was born at home after a 20 hour labor (much longer than my first 2, but it was also my first without pitocin.)  I felt like when we discussed this she was suggesting that my youngest was a "tight fit" baby. I never questioned my ability to birth another large baby up until our conversation, although I wouldn't mind this one being smaller. She just said I should cut out sugars and carbs. It is not so much that I don't want to change my diet, it is just causing me to be really stressed out. I don't feel as trusting of my body to birth my baby. I feel like if I screw up the diet, I will hurt myself or the baby if I birth at home. I know my midwife did not mean to make me feel this way, I will talk to her about it for sure, but now I just feel so much doubt that was not there before. I don't know if that makes any sense, but that is where I am at.  

Big babies do run in both mine and my husbands family, both our grandmothers had 12lbers vaginally. 

[Sharlla]

im surprised a midwife would recommend a lowcarb diet if you dont have GD
 

[mommymidwife2b]

Originally Posted by Sharlla 

im surprised a midwife would recommend a lowcarb diet if you dont have GD
 

I was never tested for GD last pregnancy, but I never had any indicators of it. I am just thrown off because I trust my midwife... so if shes concerned, I am thinking "am I too relaxed about it?"

[themothership]

My theory is that as long as I'm healthy my body won't build a baby I can't birth, especially if you've already had at 10+ pounder. I'd talk to her about why she feels worried about you having a "large" baby, explain that you don't want to worry about it if it isn't a huge concern.

My baby measured 10 days to 2 weeks ahead on measurements at my anatomy scan, my fundal height has been 4-9 cm big at every appointment but my midwife isn't concerned because this isn't my first baby. I'll let you know in about a month if he's going to be a "big" baby.

[skycheattraffic]

If you're worried, I'd suggest screening for GD to put your mind at ease. Can your MW give you a few strips to check for sugar in your urine from time to time? It's not invasive and could help you feel more secure. There's also the glucose tolerance test but I know not everyone is crazy about them. If you're free of GD and had a straight forward birth with a 10 pound baby, I think your body is very well equipped to birth any baby you may grow :-)

[mommymidwife2b]

I believe she checks for sugar in the urine at every prenatal.   I'll just discuss it with her, I want to make sure this isn't something that is going to cause a fuss as we get closer to the DD. 

[JudyC]

As a midwife in Australia I would suggest that you just make sure you have a good all round diet. Lots of fresh, preferably organic veges. Not too much fruit and fresh when you do. You need salt to taste and lots of protien. If a baby is genetically large and not large from diabetes you should be ok birthing. Birthing in an upright position is crucial, it gives your pelvis the best chance to expand to suit your baby. Lying on your back is the worst position and reduces the pelvic space. A large amount of shoulder distocia is 'bed' dystocia, caused by being made to lie on a bed.

My sister had a 10 lb 2 oz baby for her second one and the next baby was only 8 1/2 lb. Her smallest.

Don't panic, keep healthy and keep excercising so you can easily move around in labour.
 

[ChristaM]

I typically birth big babies (#3 was was 9lbs15oz, others have been right around there), and have never had GD.  This time around (#4) I've lost 50 pounds (since last baby), eat much healthier, exercise daily, and do not eat much in the way of refined or sweetened foods.  I've changed my habits and diet...and I've still gained 40lbs this pregnancy (20 more than usual!) and am measuring large. I think sometimes people are more genetically prone to making big babies. I was so concerned at my weight gain and size measurements this time that I bought my own glucose monitor to make sure that I didn't slip through the cracks on the GD test. 

I can understand your midwife's concern if you were going hog-wild with food, but if your'e eating a reasonable, healthy diet, than I wouldn't stress too much.  All that to say, something that has really helped me is to continue to track my food through MyFitnessPal. I'm not tracking to lose anymore, but I do make sure that I don't go over on my sugars/carbs, and that I maintain adequate intake of protein and veggies!

Best wishes! :)

[phathui5]

Have you had your blood sugar checked at all with this pregnancy?

[joycnm]

I'm a midwife and will attest to the biggest fear of any home birth midwife is a baby too big to be born.  I counsel all my women (all horse & buggy mennonites) to reduce/eliminate white sugar from their diets especially the last 2 months of pregnancy when the baby is laying on fat.  This does not seem to cause them undue anxiety.  There is no nutritional value to white sugar, it is just something to ingest for fun--it has no place in a healthy diet to build a baby.  All this discussion about gestational diabetes is a smoke screen (something to stop you from seeing the real point).  The real point being a healthy diet to build a healthy baby. The 3 largest babies I've delivered in my 13 years were 11 lbs, 11 lbs. and 11 lb. 1 oz. ---all to women without gestational diabetes.  They all followed a better diet the next time and had smaller (some dramatically smaller) babies.

Edited by joycnm - 1/5/13 at 8:21pm

[loveandgarbage]

I had the same diet with both my kids and no GD-- one was 11lbs 14oz and one was 8lbs 1oz. I think sometimes genetics take over, no matter how "healthy" you are being. I ate some sugar with both of them. I did eat more calories with my larger baby but I was SO unbelievably hungry that if I didn't it felt like I was starving myself. I think he was bigger from the start and needed mama to eat more food!

So I'm birthing at home this time and also have the large baby fear especially because I wasn't able to birth my large guy vaginally. But I'm feeling that this one is more of an average size based on my belly's size... so here's hoping.

[JudyC]

The largest baby I have assisted at home was 11 lb 4 oz. He was a genetically large baby. She did get out of the pool during pushing as she needed to be more grounded so she squatted beside the pool and hung on to the edges. A deep squat. Baby came out well. She had been tested for GD and was clear.

It can be done at home but the message about good diet is clear. It is better to cut out the sugar and cut down the fruit as it is fructose dense. Eating more protien and fat, not trans fats though, will help with the hunger pangs.

Birth position is of paramount importance for a big baby. As I said in an earlier, NO BED BIRTHING. The pelvis must be mobile and expandable.
 

[cynthiamoon]

I've been reading "YOU: Having a Baby" which is a holistic look at pregnancy from an evolutionary/research based perspective, and it cautions that eating the modern American diet can produce unhealthily large babies (pg. 88-109).

Obviously, if your family is all tall and ACTUALLY big boned, then hopefully your hips are matching in largeness and you should be fine. The issue is when an avg. to small framed person eats I un-healthfully and births a baby who is fat, not just big.

Overweight babies are at a higher risk of all sorts of complications, including a c-section. Of course a midwife would want to keep you in that "low-risk" category that will be less likely to need a hospital transfer.

The book is only $15, VERY informative, friendly to "alternative" methods like herbal remedies and home birthing, and makes ot a point to explain the whole pregnancy system with lots of anatomy and physiology illustrations.

Ideal fodder for nerdy mamas.

[phathui5]

I wanted to add: checking for sugar in the urine is not effective in screening for diabetes. Moms can spill sugar and not be diabetic and moms can be diabetic and not be spilling sugar. If you want to test your blood sugar, it needs to be a blood test.

[slimkins]

I've birthed two babies. My first was 8lbs 8 ozs and my second 11 lbs 2ozs. Both vaginally, and my pushing phase was an hour rather than 40 minutes with my bigger baby.
And shockingly, for both I was in a semi-reclined position in bed. For my 11 pounder, I labored in every position imaginable, and the only way I could use enough force to get push him was laying back. Guess that's my preference.
And I had GD testing for both, and gained 36 lbs with my first and 38 with my second. Ate the same, but was WAY hungrier, from the beginning, with my second. I definitely think he was a genetic big baby.
Not sure if any of that helps you OP, but I hope.
My big boy did have some bruising on his face. Tight fit, too.
But I think knowing you have birthed a big baby, without him getting stuck, should make you feel capable.

[Mom2acrew]

LOL, it's funny to me how some women's big baby is small to another.  There are just too many factors to consider.  I'm currently pregnant with my 8th baby.  My first was 10.2 lbs- I did make stupid food choices with her because I gave up my diet plan at 40 weeks thinking it didn't matter anymore, she would be born any day.  Two weeks later I found out I was wrong!  My midwife was very reasuring though.  "Fat squishes!"  I've had two others at or near 10 lbs.  By far though, my most painful births were a result of poor positioning of the baby and not their size.  When I have been actively doing my prebirth exercises like pelvic rocks with lots of hands and knees time and squating I've always had better experiences.  Now I fear little babies because they are harder to feel and push out IMO. (7 lb was hard for me!)

Remind yourself about all the ways to move baby into position before hand and stay active during labor.  Remember too that you are a pro at this.  If need be you could probably push a 10 lb'er out sideways if you have to because you know the payoff at the end!  :)

[southernmommie]

I hate the whole "your baby is too big to birth naturally" topic. Just in general. I was a tiny woman who gave birth to a 10 lb. baby in a hospital bed. It was hard. But I did it. I don't recommend a hospital birth much less giving birth on a bed even if the head of the bed is raised to any woman. There are precautions you can take to help minimize a large baby, but if you were meant to have a large baby then you are going to have a large baby. Delivery positions should be tried throughout delivery to help the descent and the birth, but its still doable.

[Youngfrankenstein]

Originally Posted by joycnm 

I'm a midwife and will attest to the biggest fear of any home birth midwife is a baby too big to be born.  I counsel all my women (all horse & buggy mennonites) to reduce/eliminate white sugar from thier diets especially the last 2 months of pregnancy when the baby is laying on fat.  This does not seem to cause them undue anxiety.  There is no nutritional value to white sugar, it is just something to ingest for fun--it has no place in a healthy diet to build a baby.  All this discussion about gestational diabetes is a smoke screen (something to stop you from seeing the real point).  The real point being a healthy diet to build a healthy baby. The 3 largest babies I've delivered in my 13 years were 11 lbs, 11 lbs. and 11 lb. 1 oz. ---all to women without gestational diabetes.  They all followed a better diet the next time and had smaller (some dramatically smaller) babies.