10 pound newborn baby girl

Is Birth Weight Rising? Why Some Women Deliver Enormous Babies

Health

Fetal macrosomia, or having a larger-than-average baby, is by some estimates on the rise. Here's what you need to know about extra big babies.

Updated: November 17, 2020

Originally Published: June 13, 2017

Birth weight has trended upward in the U.S. for decades, with the average weight for a newborn now hovering around a healthy 7.5 pounds. Beyond that gentle statistical climb, however, there are worrying outliers. About 1 percent of babies weigh more than 9 lbs. 15 oz. at birth, and that’s when doctors grow concerned. In the past few years, babies that would’ve been considered gargantuan — 13-pound-plus newborns — have become more commonplace, with record-breaking deliveries recorded in Pennsylvania, California, Germany, Spain, and elsewhere. In the U.K., one mom famously gave birth — vaginally, no less — to a whopping 15-lbs., 7-oz. son. And just last year, a Florida woman raised eyebrows when she gave birth to a 13-pound baby girl by C-section. “It looked like they pulled a toddler out of my belly,” the mother told ABC News. “When the doctor was pulling her out of me I just start hearing them all laughing and excited.”

As birth weight approaches 10 pounds, vaginal delivery can put the mother and baby at risk. Delivering giant babies vaginally can injure the mother’s birth canal, tearing vaginal tissue and potentially rupturing the uterus, which can lead to severe bleeding and, if left untreated, death. Meanwhile, even if the enormous kid somehow makes it out of his or her mother, studies suggest the child is more likely to develop diabetes, obesity, high blood pressure, and abnormal cholesterol levels, opening the door to a life of long-term cardiovascular problems.

Macrosomia, and the related condition LGA (Large for Gestational Age), typically refer to babies who weigh more than 8 lbs. 13 oz. at birth. That’s big, but also fairly routine — about 7 percent of infants born in the U.S. (and 9 percent worldwide) qualify. Studies suggest that mothers who are older than 35, obese, or diagnosed with diabetes (either before or during pregnancy) are more likely to give birth to large children. Male babies are more likely than female babies to be born enormous, and overdue babies are also at higher risk.

We’re seeing more large babies now than ever before, and that might be because some of the factors that cause macrosomia — maternal diabetes and obesity — are also on the rise. One 2004 study suggested that, as mothers gained more weight and smoked less frequently, babies were starting to grow to unhealthy sizes in utero.

Unfortunately, high birth weight is difficult to predict. There are a few warning signs — an abnormally long distance between the mother’s uterus and her pubic bone (known as fundal height), for instance, or excessive amniotic fluid. But even ultrasounds are notoriously unreliable when it comes to estimating birth weight. In fact, suspicions of macrosomia are among the most common reasons for doctors scheduling unnecessary C-sections and inductions — only to deliver babies with normal birth weights. One 2008 study found that interventions to protect women from high birthweight babies carry more risks than delivering a giant baby vaginally.

“Our ability to predict macrosomia is poor,” the authors of the 2008 study wrote. “Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome.”

Research has shown that a fear of macrosomia leads to medical interventions that are riskier for mothers and babies than delivering a larger-than-average infant. In other words, it isn’t easy delivering a giant baby. But potentially worse? Getting worked up about the relatively remote chance of having one.

This article was originally published on June 13, 2017

Having a large baby | Pregnancy Birth and Baby

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When you have a baby, one of the first things people like to know — besides the baby's name — is their birth weight. Even before the baby's born, parents can start to worry about its growth and development in the womb, particularly if they've been told they're having a big baby. But does size really matter?

Babies come in all shapes and sizes

More than 9 out of 10 babies born at term (37 to 40 weeks) weigh between 2.5kg and 4.5kg.

If your baby weighs 4.5kg or more at birth, they are considered larger than normal. This is also known as 'fetal macrosomia' and large for gestational age (LGA). (If they weigh less than 2.5kg, they may be considered smaller than normal.)

How is a baby's size measured?

During routine antenatal check-ups, your doctor or midwife may estimate the growth and size of your baby by measuring the 'fundal height'. That is the measurement from your pubic bone to the top of your uterus.

An ultrasound can also give health professionals an idea of how big your baby is likely to be, but it's not very accurate.

Your doctor may also check the level of amniotic fluid. Excessive amniotic fluid, which surrounds the baby in the womb, can indicate the baby is larger than average, since larger babies can produce more urine.

However, there's no way of reliably measuring your baby's weight until after they are born. In many cases, women who are told they're going to have a large baby actually give birth to a baby within the normal range.

Why is my baby big?

A baby may be large at birth due to genetic factors, the mother's health or, in rare cases, a medical condition that causes the fetus to grow too quickly.

Several factors can contribute to large birth weight. For example:

• the baby's parents' height and stature
• if the baby is a boy (baby boys tend to be larger than baby girls)
• having older siblings (the chance of fetal macrosomia increases with each pregnancy)
• a previous pregnancy in which the baby was large
• being overdue by more than 2 weeks
• if the mother has diabetes during pregnancy
• if the mother gains a lot of weight during pregnancy or is obese
• if the mother is aged 30 or older

In some cases, larger-than-normal birth weight doesn't have a clear cause and can't be explained.

Giving birth to a large baby

Most large babies who weigh more than 4.5kg do not have a difficult birth. But there are still some risks associated with having a big baby.

Labour may take longer and be more likely to involve complications. There's an increased risk of having a forceps or vacuum-assisted delivery or a caesarean, and of birth injury to the mother or baby.

There is a link between fetal macrosomia and shoulder dystocia. Shoulder dystocia occurs during a vaginal birth when the baby's head has been born, but one of the shoulders becomes stuck behind the mother's pelvic bone. The baby's shoulders need to be released quickly so the baby's body can also be born, and they can start breathing.

Shoulder dystocia can happen during any birth. At least half of all babies who experience shoulder dystocia at birth weigh less than 4kg.

Large babies can be born via a normal, vaginal delivery — but it's best to give birth where you can access specialist medical services, just in case things don't go according to plan. Every pregnancy and birth is unique, so talk to your doctor or midwife about the best place for you to give birth.

After the birth of a large baby

Since many large babies are born to mothers with diabetes, some babies will need help regulating their blood sugar after they're born. Later in life, the risk of childhood obesity or being overweight may increase and the baby may develop other problems with their metabolism.

A larger than average baby may need help breathing following the birth, so they may be admitted to the neonatal intensive care unit (NICU) or special care nursery (SCN).

There is also an increased risk of jaundice (yellowing of the skin) among large babies.

Regardless of their size at birth, a baby's weight is always monitored closely after they are born to make sure they are healthy and growing properly. But their weight isn't the only thing that's important. How well they are feeding and the number of wet nappies and poos they produce daily can also indicate that your baby is doing well.

Can you avoid having a large baby?

Often there's nothing you can do to avoid having a large or small baby. But looking after yourself during pregnancy is important for all women. You should consider:

• giving up smoking (if you currently smoke)
• eating a balanced, healthy diet
• maintaining your weight or, if overweight, losing weight before conception if possible
• if you have diabetes, trying to manage it properly
• avoiding alcohol and illegal drugs

Where to seek help

Always talk to your doctor, obstetrician or midwife first if you are concerned about your pregnancy, your own health or the health of your baby.

If you are worried about your baby's growth — or how fetal macrosomia might affect you as a mum — call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse.

Sources:

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: September 2020

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Related pages

• Labour complications
• Guide to a healthy pregnancy
• Pre-existing diabetes and pregnancy
• Gestational diabetes
• Weight gain in pregnancy
• Check-ups, tests and scans available during your pregnancy
• Routine antenatal tests
• Having a small baby

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.

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Kate Middleton gave birth to a daughter The weight of the newborn princess is 3.7 kg. The girl and her mother are doing well. Queen Elizabeth, the Duke of Edinburgh, the Prince of Wales and the Duchess of Cornwall, Prince Harry and members of both families have already been notified of the replenishment, the press service of Kensington Palace reports.

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