Small for date infant

Small-for-Gestational-Age (SGA) Infant - Pediatrics

By

Arcangela Lattari Balest

, MD, University of Pittsburgh, School of Medicine

Medically Reviewed Oct 2022

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Infants whose weight is &lt the 10th percentile for gestational age are classified as small for gestational age. Complications include perinatal asphyxia, meconium aspiration, polycythemia, and hypoglycemia.

Gestational age Gestational Age Gestational age and growth parameters help identify the risk of neonatal pathology. Gestational age is the primary determinant of organ maturity. Gestational age is usually defined as the number.. . read more is loosely defined as the number of weeks between the first day of the mother's last normal menstrual period and the day of delivery. More accurately, the gestational age is the difference between 14 days before the date of conception and the date of delivery. Gestational age is not the actual embryologic age of the fetus, but it is the universal standard among obstetricians and neonatologists for discussing fetal maturation.

The Fenton growth charts provide a more precise assessment of growth vs gestational age; there are separate charts for boys Fenton growth chart for preterm boys and girls Fenton growth chart for preterm girls .

Fenton growth chart for preterm boys

Fenton growth chart for preterm girls

Causes may be divided into those in which the growth restriction is

• Symmetric: Height, weight, and head circumference are about equally affected.

• Asymmetric: Weight is most affected, with a relative sparing of growth of the brain, cranium, and long bones.

Symmetric growth restriction usually results from a fetal problem that begins early in gestation, often during the first trimester. When the cause begins relatively early in gestation, the entire body is affected, resulting in fewer cells of all types. Common causes include

• Genetic disorders

• First-trimester congenital infections (eg, with cytomegalovirus Congenital and Perinatal Cytomegalovirus Infection (CMV) Cytomegalovirus infection may be acquired prenatally or perinatally and is the most common congenital viral infection. Signs at birth, if present, are intrauterine growth restriction, prematurity... read more , rubella virus Congenital Rubella Congenital rubella is a viral infection acquired from the mother during pregnancy. Signs are multiple congenital anomalies that can result in fetal death. Diagnosis is by serology and viral... read more , or Toxoplasma gondii Congenital Toxoplasmosis Congenital toxoplasmosis is caused by transplacental acquisition of Toxoplasma gondii. Manifestations, if present, are prematurity, intrauterine growth restriction, jaundice, hepatosplenomegaly... read more )

Asymmetric growth restriction usually results from placental or maternal problems that typically manifest in the late second or the third trimester. When the cause begins relatively late in gestation, organs and tissues are not equally affected, resulting in asymmetric growth restriction. Common causes include

• Placental insufficiency resulting from maternal disease involving the small blood vessels (eg, preeclampsia Preeclampsia and Eclampsia Preeclampsia is new-onset or worsening of existing hypertension with proteinuria after 20 weeks gestation. Eclampsia is unexplained generalized seizures in patients with preeclampsia. Diagnosis... read more , hypertension Hypertension in Pregnancy Recommendations regarding classification, diagnosis, and management of hypertensive disorders (including preeclampsia) are available from the American College of Obstetricians and Gynecologists... read more , renal disease Renal Insufficiency in Pregnancy Pregnancy often does not worsen renal disorders; it seems to exacerbate noninfectious renal disorders only when uncontrolled hypertension coexists. However, significant renal insufficiency ... read more , antiphospholipid antibody syndrome Antiphospholipid Antibody Syndrome (APS) Antiphospholipid antibody syndrome is an autoimmune disorder in which patients have autoantibodies to phospholipid-bound proteins. Venous or arterial thrombi may occur. The pathophysiology is... read more , long-standing diabetes Diabetes Mellitus in Pregnancy Pregnancy aggravates preexisting type 1 (insulin-dependent) and type 2 (non–insulin-dependent) diabetes but does not appear to exacerbate diabetic retinopathy, nephropathy, or neuropathy ( 1). .. read more )

• Relative placental insufficiency caused by multiple gestation Multifetal Pregnancy Multifetal pregnancy is presence of > 1 fetus in the uterus. Multifetal (multiple) pregnancy occurs in up to 1 of 30 deliveries. Risk factors for multiple pregnancy include Ovarian stimulation... read more

• Placental involution accompanying postmaturity

• Chronic maternal hypoxemia caused by pulmonary or cardiac disease Heart Disorders in Pregnancy Heart disorders account for about 10% of maternal obstetric deaths. In the US, because incidence of rheumatic heart disease has markedly declined, most heart problems during pregnancy result... read more

• Maternal malnutrition

• Conception using assisted reproductive technology Assisted Reproductive Techniques Assisted reproductive techniques (ARTs) involve manipulation of sperm and ova or embryos in vitro with the goal of producing a pregnancy. For assisted reproductive techniques, oocytes and sperm... read more

An infant may also have asymmetric growth restriction and be small for gestational age (SGA) if the mother is a heavy user of opioids, cocaine, alcohol, and/or tobacco during pregnancy (see Social and Illicit Drugs During Pregnancy Social and Illicit Drugs During Pregnancy Drugs are used in over half of all pregnancies, and prevalence of use is increasing. The most commonly used drugs include antiemetics, antacids, antihistamines, analgesics, antimicrobials, diuretics... read more ).

Many SGA infants are healthy but just constitutionally small, and not all infants whose growth was restricted in utero are SGA (ie, weight is < the 10th percentile for gestational age).

Despite their size, SGA infants have physical characteristics (eg, skin appearance, ear cartilage, sole creases) and behavior (eg, alertness, spontaneous activity, zest for feeding) similar to those of normal-sized infants of like gestational age. However, they may appear thin with decreased muscle mass and subcutaneous fat tissue. Facial features may appear sunken, resembling those of an elderly person ("wizened facies"). The umbilical cord can appear thin and small.

Full-term SGA infants do not have the complications related to organ system immaturity that preterm infants of similar size have. They are, however, at risk of

• Perinatal asphyxia

• Meconium aspiration

• Hypoglycemia Neonatal Hypoglycemia Hypoglycemia is difficult to define in neonates but is generally considered a serum glucose concentration < 40 mg/dL (< 2.2 mmol/L) in symptomatic term neonates, < 45 mg/dL (< 2... read more

• Polycythemia Perinatal Polycythemia and Hyperviscosity Syndrome Polycythemia is an abnormal increase in red blood cell mass, defined in neonates as a venous hematocrit ≥ 65%; this increase can lead to hyperviscosity with sludging of blood within vessels. .. read more

• Hypothermia Hypothermia in Neonates Hypothermia is defined by the World Health Organization as a core temperature < 36.5° C (97.7° F). In preterm infants, hypothermia increases morbidity and mortality. Hypothermia may be purely... read more

Perinatal asphyxia during labor is the most serious potential complication. It is a risk if intrauterine growth restriction is caused by placental insufficiency (with marginally adequate placental perfusion) because each uterine contraction slows or stops maternal placental perfusion by compressing the spiral arteries. Therefore, when placental insufficiency is suspected, the fetus should be assessed before labor and the fetal heart rate should be monitored during labor. If fetal compromise is detected, rapid delivery, often by cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery by incision into the uterus. Up to 30% of deliveries in the US are cesarean. The rate of cesarean delivery fluctuates. It has recently increased, partly... read more , is indicated.

Meconium aspiration may occur during perinatal asphyxia. SGA infants, especially those who are postterm, may pass meconium into the amniotic sac and begin deep gasping movements. The consequent aspiration is likely to result in meconium aspiration syndrome Meconium Aspiration Syndrome Intrapartum meconium aspiration can cause inflammatory pneumonitis and mechanical bronchial obstruction, causing a syndrome of respiratory distress. Findings include tachypnea, rales and rhonchi... read more . Meconium aspiration syndrome is often most severe in growth-restricted or postterm infants, because the meconium is contained in a smaller volume of amniotic fluid and thus more concentrated.

Hypoglycemia often occurs in the early hours and days of life because of a lack of adequate glycogen synthesis and thus decreased glycogen stores and must be treated quickly with IV glucose.

Polycythemia may occur when SGA fetuses experience chronic mild hypoxia caused by placental insufficiency. Erythropoietin release is increased, leading to an increased rate of erythrocyte production. The neonate with polycythemia at birth appears ruddy and may be tachypneic or lethargic.

Hypothermia may occur because of impaired thermoregulation, which involves multiple factors including increased heat loss due to the decrease in subcutaneous fat, decreased heat production due to intrauterine stress and depletion of nutrient stores, and increased surface to volume ratio due to small size. SGA infants should be in a thermoneutral environment to minimize oxygen consumption.

If asphyxia can be avoided, neurologic prognosis for term SGA infants is quite good. However, later in life there is probably increased risk of ischemic heart disease, hypertension, and stroke, which are thought to be caused by abnormal vascular development.

Infants who are SGA because of genetic factors, congenital infection, or maternal drug use often have a worse prognosis, depending on the specific diagnosis. If intrauterine growth restriction is caused by chronic placental insufficiency, adequate nutrition may allow SGA infants to demonstrate remarkable “catch-up” growth after delivery.

• Supportive care

Underlying conditions and complications are treated. There is no specific intervention for the SGA state, but prevention is aided by prenatal advice on the importance of avoiding alcohol, tobacco, and illicit drugs.

• Infants whose weight is &lt the 10th percentile for gestational age are small for gestational age (SGA).

• Disorders early in gestation cause symmetric growth restriction, in which height, weight, and head circumference are about equally affected.

• Disorders late in gestation cause asymmetric growth restriction, in which weight is most affected, with relatively normal growth of the brain, cranium, and long bones.

• Although small, SGA infants do not have the complications related to organ system immaturity that preterm infants of similar size have.

• Complications are mainly those of the underlying cause but generally also include perinatal asphyxia, meconium aspiration, hypoglycemia, polycythemia, and hypothermia.

Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

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Small-for-Gestational-Age (SGA) Newborns - Children's Health Issues

By

Arcangela Lattari Balest

, MD, University of Pittsburgh, School of Medicine

Medically Reviewed Oct 2022

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A newborn who weighs less than 90% of newborns of the same gestational age at birth (below the 10th percentile) is considered small for gestational age.

• Newborns may be small because their parents are small, the placenta did not function normally, or the mother has a medical disorder or has used drugs, smoked, or consumed alcohol during the pregnancy.

• Unless they are born with an infection or have a genetic disorder, most small-for-gestational-age newborns have no symptoms and do well.

• Some small newborns remain small as adults.

Gestational age Gestational age Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 9% of newborns need special care after birth due to prematurity, problems... read more refers to how far along the fetus is. The gestational age is the number of weeks between the first day of the mother's last menstrual period and the day of delivery. This time frame is often adjusted according to other information doctors receive, including the results of early ultrasound scans, which give additional information regarding the gestational age. A baby is estimated to be due (the due date) at 40 weeks of gestation.

At a gestational age of 40 weeks, boys who weigh less than about 6 pounds 9 ounces (3 kilograms) are small for gestational age. Girls who weigh less than about 6 pounds 3 ounces (2.8 kilograms) are small for gestational age. Doctors use published growth charts or computer apps to evaluate babies at other gestational ages.

(See also Overview of General Problems in Newborns Overview of General Problems in Newborns Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 9% of newborns need special care after birth due to prematurity, problems... read more .)

Most newborns who are moderately small for gestational age are healthy babies who just happen to be on the smaller side. However, some are small because their growth in the womb was restricted by various factors. Growth restriction is when a baby in the womb (a fetus) does not grow as expected.

Growth restriction can be classified as

• Symmetric: The newborn is proportionately small, that is, its weight, length, and head size are similarly low or small.

• Asymmetric: Weight, length, or head size are not equally affected (for example, head size may continue to grow as expected, but weight or length may be lower than expected).

In symmetric growth restriction, the cause probably occurred early in the pregnancy when it would affect all of the cells in the newborn's body. Asymmetric growth restriction probably results from problems that occur later in pregnancy because some tissues develop sooner than others and not all would be affected equally.

Not all infants whose growth was restricted in the womb are small for gestational age.

Risk factors for growth restriction include those involving the mother's underlying health, and those involving the pregnancy and/or the fetus.

The risk of having a small-for-gestational-age (SGA) baby is increased for mothers who are very young or very old or who have had other SGA babies.

Medical disorders in the mother that increase the risk of having an SGA baby include

• High blood pressure High Blood Pressure During Pregnancy High blood pressure (hypertension) during pregnancy is classified as one of the following: Chronic hypertension: Blood pressure was high before the pregnancy. Gestational hypertension: Blood... read more (hypertension)

• Long-standing diabetes Diabetes During Pregnancy For women who have diabetes before they become pregnant, the risks of complications during pregnancy depend on how long diabetes has been present and whether complications of diabetes, such... read more

• Chronic kidney disease Kidney Disorders During Pregnancy Often, pregnancy does not cause a kidney disorder to worsen. Usually, kidney disorders worsen only in pregnant women who have high blood pressure that is not well-controlled. If pregnant women... read more

• Heart disease Heart Disorders During Pregnancy Most women who have heart disorders—including certain heart valve disorders (such as mitral valve prolapse) and some birth defects of the heart—can safely give birth to healthy children, without. .. read more or lung disease

• Lupus Systemic Lupus Erythematosus (Lupus) Autoimmune disorders, including Graves disease, are more common among women, particularly pregnant women. The abnormal antibodies produced in autoimmune disorders can cross the placenta and... read more

• Severe anemia Anemia During Pregnancy Anemia occurs in up to one third of women during the 3rd trimester. The most common causes of anemia are Iron deficiency Folate deficiency (See also Anemia.) If women have a hereditary anemia... read more

• Sickle cell disease Sickle Cell Disease Sickle cell disease is an inherited genetic abnormality of hemoglobin (the oxygen-carrying protein found in red blood cells) characterized by sickle (crescent)-shaped red blood cells and chronic... read more

• Abnormalities of the uterus, for example, a uterus that has two parts (bicornuate uterus)

• Having more than one fetus Multiple Births The term multiple births refers to the presence of more than one fetus in the uterus. The number of twin, triplet, and other multiple births has been increasing during the last two decades.... read more , for example, twins or triplets (Twins grow at the same rate as single fetuses until about 32 weeks. After that, twins grow more slowly and may be SGA at birth. For triplets, slower growth begins at about 28 weeks.)

• Use of assisted reproduction Assisted Reproductive Technologies Assisted reproductive technologies involve working with sperm and eggs or embryos in a laboratory (in vitro) with the goal of producing a pregnancy. (See also Overview of Infertility.) If treatment... read more to conceive the pregnancy

• Preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more

• Early separation of the placenta (placental abruption Placental Abruption Placental abruption is the premature detachment of the placenta from the wall of the uterus, usually after 20 weeks of pregnancy. Women may have abdominal pain and tenderness and vaginal bleeding... read more )

• Use of alcohol Alcohol during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more or cigarettes Cigarette (tobacco) smoking during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more

• Use of certain drugs such as amphetamines Amphetamines during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more , antiseizure medications Seizure Disorders During Pregnancy Most women who have a seizure disorder that is well-controlled by antiseizure drugs are able to safely give birth to a healthy baby. If these women get enough sleep and take antiseizure drugs... read more , certain cancer medications, cocaine, or opioids Opioids during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more

• Severe malnutrition

• Birth defects Overview of Birth Defects Birth defects, also called congenital anomalies, are physical abnormalities that occur before a baby is born. They are usually obvious within the first year of life. The cause of many birth... read more that involve the brain Overview of Brain and Spinal Cord Birth Defects Birth defects of the brain and spinal cord can occur in early or late fetal development. Typical symptoms include intellectual disability, paralysis, incontinence, or loss of sensation in some... read more , heart Overview of Heart Defects About one in 100 babies is born with a heart defect. Some are severe, but many are not. Defects may involve abnormal formation of the heart's walls or valves or of the blood vessels that enter... read more , or kidneys Kidney Defects There are several different birth defects that affect the kidneys (the two organs that filter waste from the blood to make urine). These defects are not usually apparent at the doctor's examination... read more

• Certain infections in the fetus, including Zika virus Zika Virus Infection Zika virus infection is a mosquito-borne viral infection that typically causes no symptoms but can cause fever, rash, joint pain, or infection of the membrane that covers the white of the eye... read more , cytomegalovirus Cytomegalovirus (CMV) Infection Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms: from no symptoms to fever and fatigue (resembling infectious mononucleosis) to severe symptoms involving... read more (CMV), or rubella Rubella Rubella is a contagious viral infection that typically causes mild symptoms, such as joint pain and a rash, but can cause severe birth defects if the mother becomes infected with rubella during. .. read more (German measles)

• Genetic abnormalities Gene abnormalities Chromosomes are structures within cells that contain a person's genes. A gene is a segment of deoxyribonucleic acid ( DNA) and contains the code for a specific protein that functions in one... read more , such as trisomy 18 Trisomy 18 Trisomy 18 is a chromosomal disorder caused by an extra chromosome 18 that results in intellectual disability and physical abnormalities. Trisomy 18 caused by an extra chromosome 18. Infants... read more

Despite their size, small-for-gestational-age (SGA) newborns usually look and act similar to normal-sized newborns of similar gestational age. Some SGA newborns appear thin and have less muscle mass and fat, and some have sunken facial features (called wizened facies). The umbilical cord can appear thin and small.

During pregnancy, growth-restricted fetuses are at increased risk of miscarriage Miscarriage A miscarriage is the loss of a fetus before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect) or in the woman (such... read more or stillbirth Stillbirth Stillbirth is death of a fetus after 20 weeks of pregnancy. Stillbirth may result from a problem in the woman, placenta, or fetus. Doctors do blood tests to try to identify the cause of a stillbirth... read more . At birth, SGA newborns who are born full term do not have the complications related to organ system immaturity that preterm newborns of similar size have. They are, however, at increased risk of the following problems:

• Perinatal asphyxia Perinatal asphyxia Birth injury is damage that occurs as a result of physical pressure during the birthing process, usually during transit through the birth canal. Many newborns have minor injuries during birth... read more : This complication is a decrease in blood flow to the baby's tissues or a decrease in oxygen in the baby's blood before, during, or just after delivery. It may result from a problem with the placenta before or during delivery.

• Meconium aspiration Meconium Aspiration Syndrome Meconium aspiration syndrome is trouble breathing (respiratory distress) in a newborn who has breathed (aspirated) a dark green, sterile fecal material called meconium into the lungs before... read more : Growth-restricted fetuses may pass meconium (dark green fecal material that is produced in the fetus's intestine before birth) in the amniotic fluid and take forceful gasps and breathe (aspirate) the meconium-containing amniotic fluid into their lungs.

• Low blood sugar (glucose) levels (hypoglycemia Hypoglycemia Hypoglycemia is abnormally low levels of sugar (glucose) in the blood. Hypoglycemia is most often caused by medications taken to control diabetes. Much less common causes of hypoglycemia include... read more ): This complication often occurs in the early hours and days of life because the small newborn does not have enough stored carbohydrates to use for energy and is unable to adequately process the carbohydrates it does have.

• Excess red blood cells (polycythemia Polycythemia in the Newborn Polycythemia is an abnormally high concentration of red blood cells. This disorder may result from postmaturity, diabetes in the mother, twin-to-twin transfusions, in which blood flows from... read more ): SGA babies may have a higher blood count than usual, and too many red blood cells cause the blood to become too thick, which may slow blood flow. Newborns with polycythemia have a reddish complexion and are sluggish. Polycythemia also can contribute to hypoglycemia, respiratory distress, and hyperbilirubinemia Jaundice in the Newborn Jaundice is a yellow color to the skin and/or eyes caused by an increase in bilirubin in the bloodstream. Bilirubin is a yellow substance formed when hemoglobin (the part of red blood cells... read more (causing jaundice, in which the skin turns yellow).

• Difficulty regulating body temperature Difficulty regulating body temperature A preterm newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, preterm newborns have underdeveloped organs, which may not be ready to function outside of... read more : This complication occurs because SGA newborns have less fat and body weight to keep them warm and they do not have enough carbohydrates to use for energy.

• Increased risk of infection: SGA newborns may have an impaired immune system, which increases their risk of developing infections in the hospital.

Recent studies suggest that intrauterine growth restriction increases the likelihood of problems during adulthood, including heart disease, high blood pressure, and stroke.

• Before birth, measurement of the uterus and ultrasonography

• After birth, assessment of gestational age and size and weight of the baby

During pregnancy, doctors measure the distance on the woman's abdomen from the top of the pubic bone to the top of the uterus (fundus). This measurement, called a fundal height measurement, corresponds roughly with the number of weeks of pregnancy. For example, the normal fundal height for a woman who is 32 weeks pregnant is about 30 to 34 centimeters. If the measurement is low for the number of weeks, the fetus may be smaller than expected.

Ultrasonography Ultrasonography Prenatal diagnostic testing involves testing the fetus before birth (prenatally) to determine whether the fetus has certain abnormalities, including certain hereditary or spontaneous genetic... read more can be done to assess the size of the fetus and estimate the weight of the fetus to confirm the diagnosis of small for gestational age. Ultrasonography may also be helpful in establishing the cause of the growth restriction and how it has affected the fetus. Depending on the findings, doctors may do genetic testing or magnetic resonance imaging (MRI) to determine the underlying cause.

After birth, small for gestational age is diagnosed by assessing the gestational age and the weight of the baby. Doctors measure the baby's length Length and Height Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more and head circumference Head Circumference Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more to categorize the growth restriction as symmetric or asymmetric. Diagnostic tests, including ultrasonography, x-rays, MRI, tests for infection, blood tests, and genetic tests, may be needed to find the cause of the growth restriction.

Prognosis varies greatly depending on what caused the infant to be small for gestational age and whether complications developed.

Infants who have a moderately low birthweight usually do well unless they have an infection, genetic disorder, or perinatal asphyxia. Most catch up their growth during the first year of life and have a normal adult height.

Infants who are particularly small because of illness in the mother are at risk of complications but usually do well. Some small babies remain small as adults and others are within the normal range.

Infants whose growth was restricted because their mother used alcohol while pregnant are likely to have long-term developmental and behavioral problems.

The outcome for SGA infants exposed to illicit drugs during pregnancy is complicated. It is difficult to predict the prognosis because pregnant women who use illicit drugs often have other social and economic problems that affect their child's development.

There is no specific treatment for small-for-gestational-age newborns, but underlying conditions and complications are treated as needed. Growth hormone injections are sometimes given to certain SGA infants who remain quite small at 2 to 4 years of age. This treatment must be given for several years and must be considered on a case-by-case basis.

Newborns with polycythemia Polycythemia in the Newborn Polycythemia is an abnormally high concentration of red blood cells. This disorder may result from postmaturity, diabetes in the mother, twin-to-twin transfusions, in which blood flows from... read more are given intravenous (IV) fluids, and newborns with hypoglycemia are treated with early (within 1 hour after birth) and frequent feedings or IV glucose.

All pregnant women should receive good prenatal care and should avoid alcohol, tobacco, and illicit drugs (such as cocaine and heroin) while pregnant.

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Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

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Date ideas for couples with young children

10/16/2017 | WOWexperience | 2 comments

The appearance of a baby in a family is often a long-awaited (at least almost 10 months!) event and brings as much joy and excitement as significant changes in the way of life of the family. The regime is changing, the feeling of being in a new role, because a newly-made family member insistently demands attention, and just a banal desire to sleep intrusively reminds of itself.

But, if the first stage of adaptation is over, and now you have the strength and desire to be alone with your loved one (the one who is your husband), below are a few ideas. I will make a reservation right away, I am a supporter of the fact that one of the best investments in the health and upbringing of a child is happy parents who have a very good relationship and it is worth the effort and cost. So, option one.

If you are a happy owner of sufficient financial resources to pay for a babysitter on a regular basis, or if your family has an amazing grandmother-aunt-cousin of your baby, who do not have a soul in him and are ready to stay often, and let you go on all 4 sides, then do not waste time on this article! The kid is in their hands and, having looked through the posters, forward to any pleasant pastime for you :)!

Variations on the theme: ask one of your friends to stay with your baby or arrange with friends to “exchange” babies: stay with them in turn, but do not forget that both options do not hurt the child only if they know them well.

Arina Rodionovna hasn’t met yet on your way, grandmothers-aunts are far away or don’t want/can’t look after the child during your date, so you go on a date together.

Date Option #1

My husband and I practiced and still practice nap dates. Technically, it looks like this: on your general day off, you get into the car (our option, because we live outside the city) or just put the child in the stroller and drive towards the place of your date, we love cozy cafes like Lvivska Chocolate Shop , "Galician Plyatski", etc. On the way, the child falls asleep and you have a couple of hours to communicate with each other in a pleasant atmosphere. You can think over the topic of communication in advance, light and simple (if you do this regularly, once a week, for example, you can start with the “Ups & Downs” game - talk about what upset and supported each of you this week). Or just take a moment to sit silently with a cup of tea and look into your beloved eyes.

If cafes aren't your thing, feel free to think about your passions and head to the tennis court, the ping-pong court, or your other passions.

Date Option No. 2

A great option to invite 1 more couple with you on a date, especially if they will also be with a child / children, ideally a little older than your baby, or just a childless couple who loves children (!). While the kids are entertaining each other, you can have a great picnic (don't forget the treat for the kids!), play board games, or arrange a fun or romantic quiz at home: tell each other how you met, how your wedding went, what you appreciate in a spouse .

If the weather is not conducive to a picnic in any way, go to anti-cafes and co-working spaces that are now popular, choose options with rooms for children.

Date variant No. 3

If you are avid moviegoers and most of all miss the cinema during your family maternity leave, arrange an alternative for yourself! Modern autodromes are a great romantic option, for which you need a car. Feel like teenagers in love from beautiful American films :) However, I advise you to muffle the sound a little.

If you don't have a car, you can try attending a session for young parents in the Zhovten complex, however, I have only heard about them personally and haven't been there myself.

Another difficult, but very interesting option: arrange a session with a projector (with friends in the country or in a private house on a summer evening, it can be amazingly magical!), well, or a long-forgotten version of filmstrips to plunge into childhood :) !

Date option No. 4

Nature in general has a calming effect on everyone and fills them with strength. Baby - in a stroller or sling, and invite your partner for a romantic walk in the park, forest, lake or river. If you do all this at sunset or to the chirping of crickets under the starry sky, a romantic mood is guaranteed. It will not be superfluous to take thermal mugs with your favorite tea with you and tune in to the best.

Date variant No. 5

Remember what exactly unites you, what you like to do together and introduce your baby to this. If you love festivals - many of them are quite suitable for kids, if you are a music lover, try to find concert options for kids, if you are avid travelers, do not deny yourself this: some inconvenience will more than pay off with your happy eyes and shared memories! Up to six months, you can safely take a baby with you in a sling or stroller almost everywhere: to exhibitions, museums, hiking, restaurants, and even training.

And a few more recommendations : get yourself such a “disturbing suitcase” - a bag or a backpack with the baby’s things so that you can pack up with him somewhere much faster (depending on age, put diapers and napkins there, change clothes, favorite toy and food for your favorite child), do not forget to update as needed. Remember that dates with your baby won't be the same again, but that doesn't mean they're any worse! Tune in to the fact that you need to be flexible: the baby may not fall asleep, the concert or film will not be interesting, but this is also part of the date! Include humor, flexibility, wisdom and simplicity, they are so important in a romantic relationship :)!

Love and romance to you! Author: Alexandra Kanevskaya

How to go on a date with a small child.

1. Forum
2. Archive
3. Psychology of love

The situation is this, I am divorced, my child is a year old, psychologically I have already gone through a breakup and I am ready for a new relationship. But I live alone with a child, there are no relatives in the city. More than once it was possible to go on a date, but everything rests on the fact that I have no one to leave the child with. Do not invite me a man immediately to his home. I thought about finding a nanny, but it will work out once or twice a week (and even not every day) for a day / evening, do they agree to such conditions ... Has anyone been in such a situation?

Look for a "nanny" among elderly non-working neighbors

Is there a nanny in your city? Well, keep in mind that such a nanny needs to be paid more than a regular one.

I used to go on dates with children )) I said straight to the forehead - I have no one to leave them with, we can talk in the park or walk around the shopping center. Most dropped out right away, only one remained ))

You warned them in advance that you had children, or even when you arrived ))

You can go with your child every year. My friend got married like that, sat on the site, then went into a cafe, and off we went. And another one too, by the way.
Either find someone in your house, or a mother like you, and "swap" in the evenings.

I went with a child)
But I got married right away) My husband immediately decided to get married when he saw me on a date with a stroller)

and you warned him that you have a child and will come on a date with him?)

Gee. ..I remember that a young man who approached me on the street to meet me said that I was going to the kindergarten for a child and offered to keep me company. So, for fun, look at the reaction. Compiled. Then he proposed to meet and all that.
And if in a good way, then the situation should be explained to potential gentlemen right away. Not a fool will understand, will take action depending on the motivation. And you don't need a fool

You should warn about a child right away. Your option is to look for a girlfriend in the same situation and let each other go. An excellent option from all sides - and a girlfriend and help.

And I went like this)) I remember a funny incident)))) He was silent on a dating site for a long, long time trying to persuade me to go on a date. He did not suit me at all, although it was pleasant to communicate with him - smart, lively, good conversationalist, but young at all, without children, without experience in family life .... I tried to dissuade him that he did not need such an aunt like me, yes with 2 more children. He persuaded me only by the fact that I had to take a walk with my daughter (she was then six months old), and he wanted to keep us company in the park. I arrived, got out of the car, looked at the stroller and ... froze in horror ... At first I decided that I just didn’t like it live (well, it happens). But no, he looks at the stroller with widened eyes and doesn’t leave the place . .. The child was frightened to such an extent))) And there that child was not visible - it was winter, one nose sticks out of the envelope sleeping)))) ))
In short, I stood like that for a couple of minutes, I stuck it in the car and sent it home))))))))

overestimated my strength)) and then they still walked like this?)

let me guess: I moved to you .... Then I laughed until colic )))))))
I went. But I never hid the presence of children, so this was not a surprise to anyone. But I'm generally extreme in terms of dating. I went shopping for groceries on the first date, and I came in pajamas without makeup (honestly, I’m not lying) ...

you must be so lucky with your child that you have the strength to go on dates
but it's interesting - with whom do you leave your child when you go to work?

is she up to work?!

I think it is necessary to talk about the child right away. ))
I put the child to bed and go on a date, although my mother lives in the next room with us.
And my friend hired a nanny. Her son was still 2.5 years old, at first a young girl came from a neighboring entrance, then she left to study. Now they have a pensioner.)))

So you went out so late in the evenings?
It somehow confuses me a little that I will try to improve my personal life, go on dates periodically, and at this time someone will sit with the child ...) it’s that I’m not on business, namely on a date - like you sit, and I went to have fun)) I am driven by all sorts of unnecessary things ... (

No, I bought a three-room apartment next to the one that I rented with a child) But this is after the wedding) I am from St. Petersburg. Now in Moscow )

No, I came with a stroller and that's it. We went to the park, then to a cafe, since then I have loved Sokolniki. And my husband also remembers that first cool meeting)

The same people get married.
People often go out with children, oddly enough.

Author, sex is your topic? You already decide whether to strive for orgasm with your husband or build new relationships in a divorce.

Just a child is and is, what's the difference, it's all the same to live and walk with him, not on the first date, so on the third. Who does not suit, immediately from the beach. The rest of the child will not interfere with any date, just to be next to a woman. On the contrary, it seems to me that some men react very well to a child and decide more quickly about relationships.

I am also in the company of those who went on a date with a child.
My age was five or six.
And, in principle, she could attach - to her parents. But after all, you’ll hesitate every time to think of where I’m going, or to tell the truth (then mom immediately marries or vice versa)

Exactly! Moreover, wealthy, self-confident men marry women with a child)

My, I just analyze my problems when I was married

Let's just say, those women with a child who perceive a child as a bonus and men are selected according to the appropriate principle: The interests of the child are a priority.

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