BIG BABIES CAN MEAN BIG DANGER

It seems like the baby from Indonesia who weighed 19.2 lbs at birth has become world famous.  The press needs some feel good items once in a while to lighten all the bad news.  For people who work in obstetrics, however, this is actually a rather tragic situation.  This is a baby who could very easily have died in utero from the effects of out of control blood sugars in a diabetic mother.  Then, the world would never have heard of him.  This happens every day around the world.  Even after being born alive, any pediatrician will tell you that these babies who look so big and strong are alarmingly vulnerable.  Most pediatricians would rather look after a tiny premature baby any day than a macrosomic (large) infant of a diabetic mother (IDM).

Newborn weighing 7 Kgs

Newborn weighing 7 Kgs

 

 

WHAT IS THE CONCERN?

 

 The growth and maturation of the fetus are closely associated with the delivery of maternal nutrients, particularly glucose. This is most crucial in the third trimester when the baby and the placenta are both making demands on the mother’s insulin-producing capabilities.

Pregnancy problems associated with maternal diabetes include a higher risk of pregnancy induced hypertension (PIH), urinary tract infections, cesarean section, and worsening diabetes.  Remember the role that Julia Roberts played in “Steel Magnolias”?  The character was a diabetic who had a precarious pregnancy.  She did carry to term but, in the movie, her diabetes took her life when her son was just a toddler.   Problems associated with diabetic pregnancies for the baby are:  macrosomia (large baby), neural tube defects, polyhydramnios, neonatal hypoglycemia (low blood sugar), hypocalcemia, hypomagnesemia, jaundice (hyperbilirubinemia), birth trauma, prematurity syndromes, and subsequent childhood and adolescent obesity.In addition to careful monitoring of insulin needs, diabetic women are given the following diet guidelines:What foods to avoid?
•             sugar (white or brown)
•             honey, molasses, syrup, jams, jellies, marmalade
•             chocolate, candy
•             puddings, Jell-O, fruit yogurts
•             desserts—cakes, pies, pastries, iced cookies, etc.
•             soft drinks, tonic water
•             sweetened condensed milk
•             sweet sauces—oyster sauce, teriyaki, plum, sweet & sour, ketchup

 
Caffeine has been shown to make the body more resistant to the effects of insulin so tea, coffee and all soda pop should be avoided.
 
Fruit sugar should only be consumed in small portions.  ½ a banana, 10 grapes, a small apple are the serving sizes. Milk products are also high in sugar and should be used in moderation according to the advice of a diabetic nutritionist. 
For more information on Infant of a Diabetic Mother, see
http://www.nlm.nih.gov/medlineplus/ency/article/001597.htm


   

 

14 thoughts on “BIG BABIES CAN MEAN BIG DANGER

  1. Hi Gloria,

    I posted this question for health care providers over yonder on my blog…

    If you saw two ten pound newborns next to one another and you knew that one was from a non-diabetic mother and one was from a mother with uncontrolled diabetes, could you tell which was which?

    As someone that’s seen thousands of newborns, could you easily tell the difference?

  2. That is a great question Jill. And, can a breastfeeding mother induce a diabetic baby through her breast milk by the foods she eats?

  3. I mean, is it possible? Has it happened? I’ve gotta 20 lb 4month old. She is long as well as solid. But very happy. I don’t eat the best, but I’m not obese either… I’m feeling a twinge of guilt here…

  4. Hi Ms. Lemay,
    I am a doula and hope one day to be a midwife once my kids are school-aged and I can go back to school myself. I wanted to take a minute to let you know how much I appreciate your blog. I read every new post and always find wonderful information about topics I am intersted in (and some that I’d never previously thouuht about). I used to be “to each their own” about circumcision, but after looking at your site for over a year now, I have become very vocally anti-circumcision. The advantage of being an American living in Europe, I suppose, is that most people here think my intact son is perfectly normal, and it gives me a way to bring up the subject with family and friends back home who are questioning the practice themselves.
    Anyway, I just wanted to say thank you for the wonderful insight you provide on the culture and science of birth. You, along with several other midwife blogs I read, have helped me define goals in my life, and even unknowingly supported me in the natural waterbirth of my second child, a moment in my life so wonderful that I can’t discuss it without tears welling up in my eyes. It is this online community of birth advocates that gave me the power to “think outside the hospital” and my baby girl and I thank you.

  5. Are your comments relevant for a mom who is designated as having gestational diabetes, as well? I think the medical model treats her as “having diabetes”, by inducing her under the “big baby” pretext, but I wonder about that……..

  6. I come from a family of big babies. my two children so far have been 9 and 10 pounds at birth. nobody is diabetic here, we’re just big. I have a big problem with health care people freaking out about the size of my children. they have both grown up to be normal sized toddlers. my son who was 10 lbs at birth grew (on breastmilk only) to 16 lbs at 6 weeks and 22 lbs by four months! I am not overweight and I have a very healthy diet, much lower in sugar than most people I know. my children are just big! stop discriminating!

    I am also interested to know the answer to Jill’s question! can you tell the difference between a normal 10 pounder and one that grew too big because of uncontrolled blood sugar?

    why do we need to make women even more paranoid that everything they are eating is somehow wrong? now fruit is too sugary? give me a break. I never drink pop or juice, and I limit desserts. when I make my own desserts I use much less sugar than the recipe calls for. I feel good about my moderate choices, and I dont feel the need to go over the top just because the statistics say my children are “fat”. it’s just another form of fat-hate in our society.

    diabetes is a dangerous condition and I understand that. but cant health workers distinguish betweend a diabetic condition and a person who is just normally larger than average?

    my 4005 gram daughter (at birth) was awakened every two hours the first night of her life to have blood drawn because she was 5 g over the weight limit!

  7. I was worried this might happen. Way too many questions for the one little post. I guess I’d better do another one on what an infant of a diabetic mother looks like. Did you all read the link at the bottom of the post?

    I’m overweight and I grew a 10 lb baby the last time but, let’s be honest, we are all eating way too many carbs and too much sugar. We stuff and starve ourselves and have never been shown how to eat properly. The N. American diet is so different now than it was 100 years ago and the evolution of babies isn’t that fast. Add to that, the fact that we sit at the computer or watching TV for a good part of our day.

    Managing diabetes in pregnancy is a very interesting topic and the more you learn, the more there is to learn. One area that I have found really interesting is using a diabetic regimen to help women who have had multiple unexplained miscarriages. With the lifestyle changes, they carry to full term.

    Yes, you can tell at birth the baby who is suffering the consequences of out of control gestational diabetes. The most obvious thing is a puffy, chubby appearance with no visible neck. Then, what I have seen, is a baby with very rapid breathing (like a dog panting). Lack of muscle tone, unusually blue extremities, tremors. . . these are not things you see in a baby who is just large.

    My sister had a 12 lb boy by cesarean. The doctor asked me to take the baby to the nursery and try to breastfeed him while they sutured her. They were concerned that he needed to feed with something right away and, even tho it was 26 years ago, they were open to his auntie nursing him. Funny thing is that my nephew never took my breast. He kept looking at it with a confused look on his face as if to say “You’re not my mom”. When my sister came to post op, I took him in to her and helped her position him and he chomped right on to HER breast. These kids really do know who they belong to.

  8. I never had the glucose test with the gross drink. I had to do a 2 hour fast or something. I ate a really healthy meal then didn’t drink or eat anything for 2 hours and had my blood taken exactly 2 hours after my last meal had started. My midwives said they don’t like their mothers drinking the sugary drink. Wonder if one is more accurate than the other.

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  10. I am a young mother of 2 kids. both me and my kids father were average weights at birth (he was 7pound7 and i was 7pound 6) and our first child (a boy) was born 9 pound 12.5 ounces. And our second child (girl) was born 8 pound 13ounces. Both were natural vaginal births.

    Both times i was tested for gestational diabetes and came back normal. My great grandmother was the last in my family to have a big baby and that baby was only 8 pound something.
    I have no idea why i have big babies but it apparently has nothing to do with diabetes, and I am average height and weight myself.
    I am now 15 wks pregnant with my 3rd child and am worried this will be another large baby. (my first child needed forceps to help him out as he got stuck) this is why im worried about this baby.

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