Mar 282 min read

Big Baby, Small for Gestational Age or just healthy, IUGR is not just weight - with senior Midwife KL Goode !!

Updated: Apr 2

The terms Small for Gestational Age (SGA) and Intrauterine Growth Restriction (IUGR) and Big Baby often evoke concern and prompt medical intervention. However, delving deeper into these concepts reveals a complex landscape rife with misconceptions and unnecessary labels. Let's unpack these issues with insights from seasoned traditional midwife KL Goode, my teacher who brings over five decades of experience and a wealth of knowledge to the discussion.

Understanding SGA and IUGR: SGA refers to babies who are smaller than expected for their gestational age, while IUGR specifically denotes babies whose growth rate is slower than normal during pregnancy. While the terms are often used interchangeably, it's crucial to recognize the nuanced differences between them.
Dispelling the Myth of SGA as a Concern: KL Goode challenges the notion that SGA is inherently problematic. She suggests that labeling a baby as SGA may be unnecessary and can lead to undue anxiety among expectant parents. It's important to differentiate between constitutionally small babies, who may be perfectly healthy, and those experiencing true growth restriction.
Evaluating the Significance of IUGR: Unlike the casual use of the term SGA, IUGR warrants serious attention. It indicates a potential impediment to fetal growth, which can have long-term implications for the baby's health. However, discerning true IUGR from other factors influencing fetal size requires careful assessment and consideration and overall long term care of the pregnant woman.
Limitations of Ultrasound in Detection: While ultrasound technology plays a crucial role in prenatal care, it's not infallible in detecting SGA or IUGR. Ultrasounds are actually heavy supersonic ways that have side effects. KL Goode emphasizes the importance of holistic assessment, including maternal health factors and clinical judgment, and the use of technology only when really required.
Insights from Research Papers: Drawing from evidence-based research, the approach to SGA and IUGR should be multifaceted. Studies highlight the need for individualized care, taking into account maternal and fetal factors, rather than relying solely on arbitrary diagnostic labels such as symmetry and just baby weight as a number againsta a standard, if we are really willing to solve anything!