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>7lb13 = macrosomia = NICU?!?

1856 Views 15 Replies 14 Participants Last post by  boycrazy
My doula warned me that the new head of the NICU at the hospital where I'm delivering has a rule for diabetic mothers that if baby is over 7 lb 13 oz, then they are considered to have macrosomia and must go to the NICU. How ridiculous is that? I am scared and angry. One more battle I have to fight to have a safe, natural birth. Have any of you dealt with this before? I'm going to be schedling a consult with the doctor at my 1st NST next week. Can I insist on keeping baby with me? Homebirthing sounds better every day.
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I don't know much about diabetes in pregnancy, but that sounds crazy to me!

I wonder what his 'requirements' are for mamas without it?

There are so many healthy babies born over 8 lbs it's rediculous, I just don't know about that guy....I agree, homebirth would probably be much easier for you


Sorry I couldn't help any, but I wanted to comment and bump you up a bit
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Seven pounds thirteen ounces? I had heard that 8lb13oz was the cutoff for fetal macrosomia. DD was 9lb8.5 oz and I was c-sectioned because of a late term u/s and a crappy medwife and doctors. However, she stayed in our room the whole time, I was able to bf her an hour after she was out of my body, and she of course was as healthy as a horse!
Oh, by the way they suspected I had GD that they missed, but DD's blood sugar levels were just fine, they did check them often.
My daughter was 10 lb. 3 oz. and was with me the whole time. She never went into NICU.
Have him get you a form to sign that says that while you understand the possible risks you choose to not have your baby tested or removed to the NICU for suspected macrocosmia. And then have him put it on your chart that your baby will not be removed for any reason.

Or have a homebirth. Homebirth is good!
I always thought it was over 9 1/2 lbs. I did a google and all the article I could come up with were refering to 4500 to 5000 grams ( 9.92 -11 lbs). I would also speak up before you delivered at his rate all 3 of my babies would have been in the nicu and I only had mildly elevated blood surgars.

I found this if its helpful http://www.guideline.gov/summary/sum...=3972&nbr=3110
Colleen,

I'm on the page as you and the others who replied to your thread. Thats so horrible of the new head doctor to do that to you, your baby, family.

Thank you.
i've heard of 4000g as the cut-off, which would be about 8lb13oz as the PP said. but maybe there are risks for smaller babies if the mother is diabetic. but wouldn't there be some other way to ascertain a problem in the baby other than weighing them and then whisking them away?? i don't understand why they would have to separate mom& baby
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Good lord, seriously?


Can someone please explain what a "diagnosis" of macrosomia actually means? From what I can tell it's a description, not a diagnosis. And an arbitrary one at that. Big baby, so what? If there were any sugar problems wouldn't the best advice be for mom to breastfeed immediately?

Anyway that sounds totally ridiculous. I'm really sorry you have to deal with this crap... giving birth is not the time that you should have to run around arguing with your doctors
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If they are ignorant enough to consider a baby in need of intensive care simply for weighing 8 lbs., how can you trust them to get anything right?
Quote:

Originally Posted by fourlittlebirds
If they are ignorant enough to consider a baby in need of intensive care simply for weighing 8 lbs., how can you trust them to get anything right?
I totally agree. my son was 9lbs 10oz and although they tested his blood sugar often (I allowed this because i had no clue my ex's family has a history of 9-10lbs babies) he was allowed to stay with me.
I thought 7 lbs 13 oz was a little on the low side, to be honest. One of my 37 week twins weighed 7 lbs 13 oz--guess that quack would've tried to stick him in the NICU. I didn't even have GD.
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I believe the concern with diabetic moms is how well the baby can control his/her own blood sugar. Since that's a prime concern of a macrosomic baby *after birth*, maybe that's the reason for "considered to be"? In other words, we will treat this baby AS IF it is macrosomic, and monitor it's blood sugar for 24 hours. "Considered to be" is different than "is", after all.

My OB has something of this concern at my daughter's birth. I've got condition related to diabetes (insulin resistance) that I manage with diabetic medications. My OB is not very familiar with this condition, because it's not usually diagnosed until diabetes is fully developed. Fortunately, she's very good about listening to what I've learned about it, and researching what she doesn't know, so we get along well.

Anyway, at DD's birth, she wanted to follow the usual diabetic-mom protocol, which I believe is the same whether or not a baby is actually macrosomatic (DD was definitely not). The protocol involves blood sugar monitoring for 24 hours - it involves 11 heels sticks in that 24 hours. I didn't want to do it, because I knew my condition didn't put DD at risk for sugar issues at all. However, I agreed to her plan, simply to demonstrate to her what I already knew. Nothing like educating your doctor!
In the end, DD never had a single glucose reading out of line.

I do wonder about one aspect of this new policy, however. Why must the monitoring be done in the NICU? DD roomed in with me, and the nurses just came in to do the heel sticks according to their schedule. Maybe your doctor will write an order to that effect? I'm having a hard time imagining how/why the NICU director's policy would have more force than your doctor's orders.

Hey, here's a thought. Maybe you can get your insurance to say they won't pay for the NICU stay!
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Thank you thank you. I really appreciate your replies. I'm planning to see the NICU guy this week and will find out exactly what his protocol is. Boycrazy, that was a great article!! I'm printing it out in multiples. Fourlittlebirds, yes, that's exactly what is worrying me.
you are very welcome! I had GD this time and Millie was 6 days past date and 8#6.7 oz. I put her to the breast immediatly and kept her there as much as I ould for the first day. Her sugars never dipped at all. Lactation at our hospital believes that even drops of colostrum are enough to keep sugars up for baby.!So cool.
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