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care-o-line
New Member
76 Posts |
 Posted - 04/09/2003 : 6:21:58 PM
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Hey guys - I've heard with pre-e most babies are intrauterine growth retarted (IUGR) AKA too small for their gestational age, but that with our condition it is usually head sparing so that their heads still grow at the normal rate. Well, I don't ever remember my baby's head being big for her body and she was small for her gestational age. And... when I go to the doc's office they always say that her head has grown so fast - faster than her height or weight and that just makes me wonder just how little was her head at birth if it's growing so fast now?! She has been doing OK developmentally so far (fingers crossed), but I can't help but feel a little panicy when I think of her head size 'cause I know that can really effect them. Anybody have any thoughts on this??
Caroline - 26
dh - 24
dd Sylvia 8/21/02- 32weeks- 3lbs,5oz- pre-e |
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Marlita
Starting Member
Canada
18 Posts |
Posted - 04/09/2003 : 7:33:39 PM
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Care-o-line,
With asymetric (or head sparing) IUGR/SGA, the head is growing at the correct rate for the baby's gestational age while the body is not... according to one of my books, this is kind of a survival mechanism to protect the brain by allowing it to grow normally by taking more than its 'share' of nourishment from what is available... and that their heads are larger in relation to their bodies than those of a full-sized newborns... so I'm guessing that we might not really notice that it's 'extra large', but a dr would.
I didn't notice that Janessa's head was large in comparison to her body, but when I had an u/s at 30 weeks, her head was measuring 30 weeks while her body was only measuring about 26-27 weeks... and she was born 1 week later. The dr told me that they are more worried when there is IUGR involving the head as well because that means the brain isn't growing at the rate it should, but as long as the head size is correct then chances are there is less risk for developmental problems. Also with Janessa, her ped for awhile was concerned because she said her head circ was crossing percentiles... not exactly sure what she meant but I think she was thinking it wasn't growing fast enough, but because Janessa was doing SO well developmentally she wasn't concerned... I think it's pretty much on track now.
The other thing to maybe consider regarding her head size is genetics... if you and/or your dh have a larger head, than it could be normal for hers to grow faster.
Hope I understood what you were asking and that it helped a little [:)]
Marla
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Edited by - Marlita on 04/09/2003 7:36:53 PM |
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care-o-line
New Member
76 Posts |
Posted - 04/10/2003 : 07:25:11 AM
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Well, I guess I didn't tell the whole story. At her first regular/out of the hospital pediatrician appointment they said that her head size was in the 40th percentile for her adjusted age and her height and weight had grown so much that she was now in the 50 - 60th percentiles. And... when I freaked out 'cause her head was only in the 40th percentile at the first appointment the doctor said not to worry 'cause her head had grown sooooo much already! Later at home I was thinking - well, what the heck? I know 40th percentile is not THAT little, but how little was her head before if it's grown so much??? At her second pediatrician appointment (1 or 2 months later - don't remember) her head was at the 50th percentile for her adjusted age while her body length and weight were in the 80th percentiles. At the last pediatrician appointment the doc said not to worry 'cause she is doing fine developmentally. I even had early intervention come, not because I saw any delays - but just 'cause I was freaked out about the whole head thing and they said that she is doing fine developmentally.
I keep telling myself maybe she is just destined to have a little head compared to her body. For example, mabye I'm exagurating it, but it seems that with sets of clothes when there was a hat with it, the clothes would fit but not the hat. I guess that makes sense considering the difference in the percentiles! Well, maybe I shouldn't freak out so much - people have different hat sizes right??
Also, I guess part of the problem is that I don't really trust my doctor. She seems VERY new to this preemie stuff. Does anyone have a suggestion on how to find a doc that is experienced with preemies??
Caroline - 26
dh - 24
dd Sylvia 8/21/02- 32weeks- 3lbs,5oz- pre-e |
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myfreckleface
Starting Member
Canada
43 Posts |
Posted - 04/10/2003 : 7:40:46 PM
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| Caroline, our NICU had a list of pediatricians they referred their patients to. Our ped used to work in the NICU, and he specializes in preemies so you can only see him through referral. Maybe you can call and find out? Also, are you seeing a GP or FP rather than a pediatrician? Our NICU wouldn't discharge us until we had a pediatrician because they said until she's older, they wanted someone who would be familiar with preemie issues such as RSV, Synagis, corrected age, etc. HTH. |
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care-o-line
New Member
76 Posts |
Posted - 04/11/2003 : 08:22:19 AM
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Sylvia is seeing a pediatrician, but she just doesn't seem like she is experienced with preemies. For example, before I leave the regular check ups she gives me a piece of paper with what baby should be doing according to ACTUAL age! Thank God I know to go by adjusted age otherwise I would probably have freaked out. The pediatrician isn't all that bad - I mean she gets synagis shots etc... but I just don't feel compeletely comfortable. I WILL call the NICU and get a some referals because now that I think about they would have set me up with one of their doctors if I didn't already have one picked out. Thanks.
Caroline - 26
dh - 24
dd Sylvia 8/21/02- 32weeks- 3lbs,5oz- pre-e |
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eandslane
Starting Member
28 Posts |
Posted - 04/26/2003 : 2:18:16 PM
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Some other thoughts on preemie heads! First, some background: our little Matthew was born 25-26 wks, 1# 13 oz... Since we finally brought him home, he has been followed closely by our pediatrician and a developmental pediatrician. Matthew, at 12 1/2 mo, 9 mo. adjusted, weighs in the 25th percentile, height in the 50th percentile, and head circumference in the 75th percentile!, on the preemie boy charts. (He's barely made it to the 5th percentile on the regualar term baby charts...he's come a long way!) He's a long, skinny baby with a great big head! Cute as a button, though! [:)]
Anyway, his developmental pediatrician told us that the big head is a sign of a well nourished ex-preemie, on their way to growing out of the preemie thing. Sooner or later, their bodies catch up. So, your baby might just have caught up with her head and she's done with the preemie body shape! She also said that head size is only one indicator, developmental progress is a more major indicator of the baby's well-being. After all, different people have smaller and larger heads, and so do their babies. I think Matthew is going to be a big-head baby: his body shape, and the rest of him for that matter, looks just like big sister, who wasn't at all a preemie (10# girl) and who also has a long, skinny body and a big head! (Also, cute as a button! [:D])
Our NICU, CHOP in Philadelphia, has a neonatal follow-up program where they monitor their very high-maintenance patients, like the micropreemies, after discharge for quite awhile. They have a whole team, including a developmental pediatrician, who follow these babies to manage health issues the babies went home with and to watch for any developmental issues that could come up as the baby grows. If your hospital/NICU has a program like this, I would definately recommend taking Sylvia for a visit, if for nothing else, to hear that she's totally fine from people who specialize in just this kind of patient. If they don't, maybe your pediatrician could refer you to a developmental pediatrician. Another possibility, the March of Dimes has programs in some areas where they follow "at risk" babies, including preemies, for all kinds of health and development issues. My best friend had a preemie in Chicago and I know they ran the program she took her baby to. She said they were excellent.
Anyway, sorry to run on so long... Hope this helps!
Ellen
Ellen (37)
DH Sam (37)
Joseph 3/26/98 37 wks PE/HELLP
Emma 5/2/00 38 wks HELLP?
Matthew 3/30/02 25-26 wks PE/eclampsia (doing great now!) |
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care-o-line
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