Preventing a big baby

[BetsyS]

Has anyone had any luck following a specific diet/nutrition plan during pregnancy? Something like the ADA diabetic diet? Counting calories?

While I appreciate the thoughts behind "fat is squishy" and "your body won't grow a baby too big", I didn't find this to be true in my case. I ate whatever I wanted during pregnancy, really only focusing on having at least 5 servings of fruits and vegetables every day. Late in pregnancy (the last 6-8 weeks), I really upped the protein intake. Never 100 grams a day, but probably double my normal intake. I had borderline high BP and a few symptoms of pre-eclampsia, and the increased protein helped manage that somewhat.

I carried him until 41 weeks, went into labor spontaneously, and eventually ended up with a c-section. He weighed 11 lb, 14 ounces : , was persistent OP despite all the spinning babies stuff, and never really descended past -1 station.

I went to the best midwife in town. The hospital has a 23% c-section rate. They truely are not ones that push unneccessary surgery, although I'm sure it happens. I refused an ultrasound to check size late in the pregnancy, although I feel like some rapid growth happened in the last 4-5 weeks.

Anyway, just looking for suggestions on creating a petite 10 lber.

[MichelleAnnette]

Did you eat a lot of sugar? I monitor my glucose for that reason. The only time in my life that I haven't been able to eat whatever I want without ill effect (apparent ill effect, that is) is during pregnancy, although I will permanently decrease my sugar intake for the rest of my life now that I know my body doesn't handle large amounts of it well (and most people's don't - that's why the type II diabetes rate in America is so high). I have heard things about eating a lot of dairy leading to larger babies, but I'm not convinced on that one. I do eat organic, though.

[SublimeBirthGirl]

IT's probably more position than size that cause the problems. Posterior babies are hard to get out. I second the idea of eating healthy and watching sugar. Make sure to watch for hidden sugar-just about every prepared food you buy in the store has sugar in it. Soft drinks, teas (prepared), etc.

[Defenestrator]

I think that using a home glucometer can be really helpful. Testing your blood sugar after meals and snacks can give you a good sense of how the food that you are eating is impacting your blood sugar and help you to avoid foods that trigger a big jump.

When someone that I am working with has blood sugar problems or is trying to limit the growth of a big baby, I usually recommend limited sugar in general, limited fruit juices, limited liquid milk (lactose is a simple sugar and will cause spikes in blood sugar for some people -- cheese is ok and yogurt is also ok in moderation), whole grains, fresh fruits, lots of vegetables, and lean protein. Combining proteins and fats with your sugars slows the release into your bloodstream and also helps keep you from having a blood sugar crash that makes you want to eat more sugar. So, have an apple as a snack, but have it with a handful of almonds or a slice of cheese.

[bryonyvaughn]

Originally Posted by BetsyS

Has anyone had any luck following a specific diet/nutrition plan during pregnancy? Something like the ADA diabetic diet? Counting calories?

I've followed the Brewer Diet in my first with an emphasis on the food distributions discussed in What to Eat WYE, eaten instinctively (mostly raw vegan at the time), and followed the blood type diet.

While I appreciate the thoughts behind "fat is squishy" and "your body won't grow a baby too big", I didn't find this to be true in my case.

Well fat IS squishy but not all macrosomic babies are fat. At birth my 10lber was the weight of the average 1 month old, the length of the average 3 month old, and had the head circumference of the average 6 month old.

I ate whatever I wanted during pregnancy, really only focusing on having at least 5 servings of fruits and vegetables every day. Late in pregnancy (the last 6-8 weeks), I really upped the protein intake. Never 100 grams a day, but probably double my normal intake. I had borderline high BP and a few symptoms of pre-eclampsia, and the increased protein helped manage that somewhat.

The Brewer Diet recommends 100 grams of protein a day to prevent pre-eclampsia. If you are spilling any bilirubin in your urine, I'd recommend increasing protein AND eating according to Blood Type Diet. As your body can consume its own muscles as a protein source, IMO eating the wrong protein for you will cause problems quicker than simply not eating enough protein.

I carried him until 41 weeks, went into labor spontaneously, and eventually ended up with a c-section. He weighed 11 lb, 14 ounces : , was persistent OP despite all the spinning babies stuff, and never really descended past -1 station.

I agree with PPs that position can cause far more problems than size. I struggled for hours birthing my 7lber in lithotomy position. My 17.5" head circumference kid's labor was 50 minutes start to finish.

I went to the best midwife in town. The hospital has a 23% c-section rate. They truely are not ones that push unneccessary surgery, although I'm sure it happens.

While that is a notably low c/s rate for the US, according to the WHO that is 50% over the ideal rate. It's about 800% higher than the rates of the birth attendants I admire.

Discussions of the necessity of a particular c/s is very complicated. There are many c/s that are unnecessary for the mother and babies health at the time they are performed. IMO there is a far greater percentage that only become "necessary" only due to poor decisions made earlier in pregnancy and/or labor. Beyond this are many c/s that are theoretically unnecessary but become necessary in a particular circumstance due to lack of skills and training of the birth attendant. This category is getting larger all the time as c/s becomes the "treatment" for breech, twins, pre-eclampsia, post-dates pregnancy, gestational diabetes, vacation scheduling, impatience, etc.

I refused an ultrasound to check size late in the pregnancy, although I feel like some rapid growth happened in the last 4-5 weeks.

U/S for weight estimation is wildly inaccurate. Many U/S techs give their weight estimates with a +/- 2lb range. If they say the baby's 8-lbs, they get credit for being right if the baby weighs anywhere from 6 to 10 lbs. Does that sounds like a carny con to you?

Anyway, just looking for suggestions on creating a petite 10 lber.

My best suggestion is to eat and live healthy, if you choose an attendant find one that is supportive of your moving in labor into whatever positions are most comfortable. IMO the position in which you are most comfortable is the position in which your body offers the least resistance to the baby's passage.

Originally Posted by MichelleAnnette

Did you eat a lot of sugar?...

Instinctively I think a high carb diet is more likely to make a fat momma than a fat baby and certainly not capable of producing a large boned baby.

Originally Posted by SublimeBirthGirl

IT's probably more position than size that cause the problems. Posterior babies are hard to get out...

I agree the baby's position makes a difference but, IME, the mother's position during labor makes much greater difference on how quickly labor progresses.

~BV

[MsElle07]

What was your labor like? I agree that the mother's position makes as much of a difference as the baby's position. I can see how it would be very difficult to deliver an OP baby while confined to a bed with an epidural -- the mom needs to be able to move into positions that facilitate the descent and rotation of the baby.

[ckhagen]

Ok, this is just anecdotal, but..
My first was 10lbs 8oz. I was shocked when he was born. I'm tiny, 5'2" and about 115lbs pre-pregnancy. I never saw that coming.

When I got pregnant the second time I wasn't exactly "concerned" about making another big baby because I figured it was probably just how my body made them.

But, I did try and do a couple things different. The first time around I had spent 5 very unnecessary weeks on bedrest (really dumb OB) and I ate whatever I wanted to. I had far too many chocolate chip cookies :
I don't think that exactly made him huge, but I'm sure it didn't help.

So, the second time around, all I did was be a little more careful about the quantity of what I put in my mouth. I didn't go crazy on myself not allowing any sugars or starving myself, I just paid a little more attention to it and sort of asked "do I really need this?".
I was also a lot more active. Chasing a toddler can do that to you. No bedrest either.

The second little guy came out at only 9lbs even! His head circ was 12.75in rather than 14.5. And his chest looked like it came from another, much smaller, planet :. They were both born at 40w3d btw, the first ended in c-section, the second was a VBAC.

[sunshine's mama]

i am of the belief that a baby will be whatever size it is bc that's what size it was meant to be.

i gained a total of 12lbs when i was pregnant with dd#1 3 years ago.....i was pretty sick the first trimester and a bit into the second trimester but then i was able to eat anything and everything i wanted and i did but still gained slow...

dd arrived at 8 pounds 15 ounces despite the low gain i had....

she is the biggest baby on either side of the family back at least 4 generations (dh's niece is a geneology buff and has the family traced back further than that) by almost 2 pounds....

guess she was just meant to be a big baby...she's average size now but labor was difficult....

i am hoping though that this one is a tad smaller.....but i spose i'll find out on birth day...

[Defenestrator]

Originally Posted by bryonyvaughn

Instinctively I think a high carb diet is more likely to make a fat momma than a fat baby and certainly not capable of producing a large boned baby.

I can see how you would think this, but if a woman takes in more sugars than her body can process, the excess will cause more skeletal growth for the baby as well as more fat.

Some women could eat nothing but m&ms during their pregnancy and have a small baby -- their bodies are pumping out enough insulin and that insulin is working well enough that they are converting all of their sugars to energy and fat for their own bodies. That is why study after study has not shown a strong correlation between weight gain and macrosomia. Others, though, including many women who have low weight gain during pregnancy, will send those extra sugars to the baby because their bodies are not capable of processing them and then the baby will take on those calories and grow faster/bigger.

Nutritionists who studied twins and low birth weight found that women who ate more in the first and second trimesters had bigger babies than those who just tried to eat more in the third trimester. The babies were putting on skeletal growth in the early part of pregnancy from those extra calories long before they put on any significant amount of fat.

I do believe that diet in pregnancy matters. I don't believe in end-of-pregnancy ultrasounds for weight estimation or elective c-sections or inductions for macrosomia, but I do believe that women who eat well in pregnancy do better and that their babies are healthier. If I see signs that women are not handling their sugars well (most often I see it in polyhydramnios around weeks 28-32) then I do recommend that they eat better and learn what kinds of foods are a problem with them. Often small changes make a big difference and women will often feel better with smaller variations in blood sugar levels as well.

[MoonStarFalling]

I followed the blood type diet this time. Baby came out 2 full pounds smaller than my first and the same length. I also worked out every day. I think that is just as important as diet.

[ktbug]

I ate horribly and irresponsibly during my pregnancy - cookies, cookies, cookies, then breakfast, then more cookies - and my 40wk ds was 6lbs 14oz. I definitely took in more carbs than my body could handle (10mos later am still trying to take the weight off) but it didn't translate into a big baby in my case.

[MoonStarFalling]

Forgot to add that I made a point not to consume animal products with artificial growth hormones. Just as a precaution. I'm not sure if there's any real data linking growth hormone consumption during pregnancy to big babies.

[ckhagen]

I should add...
With my 10.5lb baby I gained only 23 lbs and lost 40 within 3 weeks. With my 9lbs baby I gained only 17lbs and lost 35 within weeks. Both of my GTTs were better than perfect. So, in my case, I had no sugar issues and no excessive weight gains. The only other difference between the pregnancies, besides the tiny bit of effort I put forth to consume less, was that the first 17 weeks of the first pregnancy (bigger baby) I threw up four+ times a day. The second pregnancy I had nausea but only threw up about 3 times total.
So, for me, the theory that I ate a lot in the first tri is out the window because I lost a ton of weight and barely ate a thing, what I did eat I puked up.

[wombatclay]

Subbing since this is a question I was wondering myself...

My c/s babe was large, but I firmly believe that fat squishes and larger babes are the norm in my family. The "problem" was her head circumfrence was 19 inches and she was posterior and asynclitic to boot! She managed to wedge pretty firmly into my pelvis and after 32 hours even my amazing natural birth support team was suggesting a c/s. I gained close to 70 lbs following the Brewer diet and carried dd1 to 42+ weeks.

My VBAC babe, born almost two weeks ago, was born at 40 weeks, I gained 37 lbs, and although her size/weight was almost the same as her older sister her head circumfrence was only 14 inches. Even so, her head got impacted on my pubic bone and this was followed by severe shoulder dystocia. And yes, we were trying lots of positions! My wonderful natural birth advocate care provider actually said that she'd suggest a c/s in the future if an u/s indicated a head circumfrence much over 14 inches...

So I'm very interested in nutritional guidelines that might improve my odds...I certainly wouldn't plan a pregnancy assuming a c/s, so I need every possible "trick".

[BetsyS]

Thanks for all your replies! I especially love hearing about second babies that are smaller than the first.

Thinking back on it, I do think I probably had some blood sugar issues. I did not pass the 28 week GTT test, but did pass the 3 hour challenge (all 4 numbers). At the time, I chalked it up to having been awake 24+ hours at hte time of the one hour, but now I'm wondering if my sugars weren't just a little off. Not enough for gestational diabetes, but enough to make a difference. While I gained an impressive amount of weight last time (48 lbs), much of it was water, and I lost 58 lbs in the first month postpartum.

Someone asked about my labor...it was slow going. I had prodromal type contractions for a couple of weeks, then 12 hours of early labor stuff, then 24 hours of active labor. I was stuck at an anterior lip for 10.5 hours. I just couldn't push past it. I labored for a good time in every position known to man, got an epidural, rested, had the epidural pulled out, labored in more odd positions, got another epidural, rested, and then finally delivered my son via c-section. Honestly, it was a really slow labor. I did feel like we tried everything at least once. The baby tolerated it well, so that gave us a lot of time. I, on the other hand, wasn't the most dignified laboring mama, but that's another story.

I'm going to try to add daily exercise (last time was hit or miss) and watch my sugar intake more closely this time.

Here's keeping my fingers crossed for a 10 pounder!!

[Glittergal]

We've had some moms with first babies like yours and besides the other tips people have given, I would recommend chiropractics or acupuncture (if you can afford it) to help get you better aligned and just try to prevent that darn OP position and also some serious work at getting labor to start at 39-40 wks. I'm all for letting babies cook and big babies are great, but big OP babies are so hard to get out! Maybe acupuncture to get stimulate labor, start with the EPO early, weekly membrane stripping (not trying to sound too medical here, just some ideas ). In my experience though, even if it another big baby, just trying to prevent that OP position can do wonders and hopefully you'll do great

Are you in a VBAC friendly area?

[Mamamazing]

My second was over a pound lighter than my first, you should eat a healthy diet and be careful about sugars, but don't, please, deprive yourself of food.

Oh, yes, both were much larger than normal, too.

[fruitful womb]

bryonyvaughn

My 17.5" head circumference kid's labor was 50 minutes start to finish.

wombatclay

her head circumfrence was 19 inches

I didn't know that was even possible. Thought 15" was big. Mine were 14.5.

When I was pregnant with my daughter we got into some trouble with investing in real estate so we were DIRT POOR for awhile. Because of that we opted for WIC. All I could get was fruit juices, cheese, and hormone happy milk. Nearly everything I ate had hormones in it. Either that or not eat at all. She weighed 10/5.

[doctorjen]

Actually, 19 inches is the 90% for a 1 year old. I'm wondering if something was written down wrong there. A newborn with a 19 inch head would looking mighty strange.

I have had many mamas actually have smaller second babes- often randomly. I do think you can do some things to help, though. Regular exercise would be my first suggestion. I like Defenstrator's suggestion for following your sugars at home so you know how you respond to different diet tips.

[crsta33]

My ds weighed 10 lbs 7 oz and I feel like I'm under the gun to try to produce a smaller baby this time. My first only weighed 8 lbs 3 oz. I gained about 50 lbs with each pg and I have a history of episodes of hypoglycemia.

The midwife is concerned about undetected GD last time and so is more concerned about it this time. I'm trying eliminate/limit sugar and white flour and I'm also avoiding taking flaxseed oil supplements which I took the entire pregnancy with ds to help with constipation. There has been some speculation that flaxseed oil may be linked to bigger babies.

Christa