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Old 03-06-2013, 01:16 PM   #1
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Large for gestational age...

DD was born in September on her due date. I'm certain of the dates with her pregnancy. When they did her gestational age evaluation after her birth, they also said she rated at 40 weeks exactly. She weighed 8lb 12oz & was 21" long. They deemed her "large for gestational age". I rolled my eyes at the time. I was kind of out of it immediately following her birth and it took me awhile to realize what was going on. Along with the title of "large for gestational age" came a ton of extra heel sticks. They checked her blood sugar constantly for the first 36 hours. Apparently the extra blood testing was new hospital protocol. Some of the nurses weren't even quite sure of the procedure - they had to continuously check with their supervisor on when she was to be tested next. They kept telling me that they though it was ridiculous. Our very last nurse made a joke about declining the extra testing. I was caught off-guard and asked if I could do that. She said that I could have. It was too late at that point, she was doing the very last stick.

I think the extra testing was torture. It was beyond ridiculous. In the beginning they were testing every 2 hours. I had to call the nursing staff in before I could nurse her so that they could test her first. Her blood sugar was always in the normal range. 8lbs 12oz isn't even that big of a baby! I'm pregnant again, due next September. It's very likely that this LO will be just as big or bigger. I fully intend on declining the extra heel sticks if he or she is also deemed "large for gestational age". I'm afraid that it will be marked down as going against medical advice though. I can't risk my insurance declining the claim. That said, we've successfully declined the vitamin K, Hep B, & eye ointment with both of our previous births. They even made me sign something with DD that said that I was aware that I was going against the advised protocol. That didn't hurt my insurance claim, so declining the extra blood sugar testing probably won't either, right?

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Old 03-06-2013, 02:02 PM   #2
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Re: Large for gestational age...

If you know that you dont have gestational diabetes, then no matter what the size of your baby, its pretty unlikely they have it and yes, i would too decline them.

When I had DS, he was born at 38 weeks and was 8 lbs 9 oz and 21'' long. I had GD, but maintained my sugars perfectly. They didnt really give me much of a choice of doing the heel sticks or not on him since I had it, there was a chance he did too. Thankfully he did not. As long as you dont have it, I would decline.
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Old 03-06-2013, 02:07 PM   #3
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All hospitals check sugars in babies over 4000 grams. Ours did after right after birth then 2 hours after that.


Personally I wouldn't decline. Low sugars in large babies can make some pretty nasty side effects and nursing problems.

It is likely they will sign it AMA....I would ask for 2 sticks though, if they are both normal then it shouldn't be a concern as long as baby is on the breast ASAP.
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Old 03-06-2013, 02:10 PM   #4
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Re: Large for gestational age...

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If you know that you dont have gestational diabetes, then no matter what the size of your baby, its pretty unlikely they have it and yes, i would too decline them.
I didn't have GD.
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Old 03-06-2013, 02:40 PM   #5
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Re: Large for gestational age...

this is standard procedure here as well. I would not decline the first one... but, if the first one is fine, I'd decline the rest.

My friend just had her baby this past weekend and being 8.5 lbs, she had to have her checked before every nursing session. But, her baby had really low blood sugar levels (like a 6) and had to be on glucose for a little while.

she did not have gestational diabetes.

if your baby's heel prick comes back fine and the baby doesn't need glucose or whatever, I would decline the rest.
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Old 03-06-2013, 02:50 PM   #6
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Re: Large for gestational age...

My son was born at exactly 38 weeks (IVF baby) and went to the NICU. He was born at 8 lbs 1 oz. I had NO idea that they did this with babies and thought all the heal pricks were because they needed to figure out his blood gasses.

This baby is measuring big head and big belly last check (14 w 1 d, measuring at 14w 6d for both) honestly that is how DS was measuring in utero. Are you getting an ultrasound in your pregnancy? I would think that if the baby was large at 20 weeks, then large at birth, then that would make sense and not need to check the sugars all the time. Though that is just a guess on my part.
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Old 03-06-2013, 03:02 PM   #7
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Neither of my boys had this done. I know ODS had an initial heel prick since he was 9lb12oz, but I think that was it. Not sure about ds2 (8lb11oz). He didn't have multiples, but may have had an initial test while I was in surgery. Neither had blood sugar issues, and I did not have GD. Just big boys.
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Old 03-06-2013, 03:20 PM   #8
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Re: Large for gestational age...

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Are you getting an ultrasound in your pregnancy? I would think that if the baby was large at 20 weeks, then large at birth, then that would make sense and not need to check the sugars all the time. Though that is just a guess on my part.
I will have a 20 week u/s. My kids are just big. They both measured a bit big for their gestational ages on their ultrasounds before they were born. DS was 8lbs 8oz at 42 weeks. That's not huge, but he grew so fast. He's always been in the 90+ percentiles for both height & weight. He's even gone off the top of the chart a few times. He just had his 3rd birthday & he's in size 5T. DD is a tiny bit smaller compared to what he was at her age, but she's pretty much following his lead. DH & I were both bigger babies than either of ours have been so far. I'm not going to have a small baby. It's not in my DNA. I'm honestly surprised I haven't had even bigger babies given our family history.

I'm not opposed to one or two sugar tests. I think PKU testing is of the utmost importance. I just don't understand why it's necessary to keep repeating heal sticks for sugar testing when the first couple aren't remarkable in any way. Those heel sticks are torturous. She cried so hard every single time. They could never get enough blood. They had to keep milking her poor heels. She came home with so many marks on her heels. It was awful. I don't want to go through that again.
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Old 03-06-2013, 03:24 PM   #9
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Re: Large for gestational age...

I think this is new too. My son was 9.10 and they pricked him a lot. His blood sugar was fine, but did have a high blood sugar one time. We had to stay an extra day bc of it. He's fine now, but I'm glad they did it just in case there was something wrong. Also, I did not have gd either.
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Old 03-06-2013, 04:10 PM   #10
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Re: Large for gestational age...

I did not have GD but did have a large baby 3 weeks ago. Fionn weighed 9lb13oz and did require glucose testing because of weight.T hey require 3 normal range tests over a number of hours.Their minimum was 40 and he just made it for the first stick. The second was lower. His was not dangerously low like the pp mentioned but he was very sleepy. It makes it difficult to nurse. When they can't nurse their glucose will drop more. I would havve done darn near anything to keep him out of the NICU after having our last baby spend 6 days there. Yes, pricking their heel stinks. I hate causing them any pain when they are so tiny. Low blood sugar can be dangerous and I went ahead and had all of the suggested glucose testing which ended up being six. It is a personal choice for you but I wouldn't only one and done because their sugar can drop. Just my 2cents.
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