Growing and Moving

Most of us remember being visited by distant relatives when we were children and having to endure all those exclamations about `Haven't they all grown!' One of the most obvious things about children is that they do grow; and at the most tremendous rate - in height, in weight and in different proportions. For instance, your newborn baby's head accounts for a third of his whole body weight, but of course the head of an adult is proportionately much smaller than this compared to the rest of his body.

All parents are concerned about their child's growth because it is an important sign of health and progress. However, other signs are just as important, such as intellectual development (Stages of Development), behaviour and general health. If you have a very large child you may worry that he is overweight for his age. Of course obesity, or excess fat, can be a health problem (Fat children), but if your child is simply big then this need not affect his health and progress. In general, exceptional smallness, particularly at birth, is more likely to be a cause for concern. However, even if your child looks very small and frail, if he has plenty of energy and can do the things that other children his age are able to, he is probably very well.

How Your Baby Grows

The way we grow is governed by our inbuilt genetic and hormonal programming and also by environmental factors - events that happen to us. These outside influences, such as nutrition, love and education, interact with and affect our genetic programme, and the effects of these can never be completely separated. For example, a child who does not get enough to eat will not grow and develop normally no matter how genetically large he is programmed to be. And, not surprisingly, a child who is consistently deprived of love can also fail to grow. Lack of growth can be a symptom of illness, but, given a reasonably healthy, safe, loving home background, the process of human growth and development will unfold of its own accord.

How Your Baby Grows in the Womb

When your baby is first conceived he results from the fusion of two gametes (the sperm from the male and the female ovum). Everything the child needs to develop is contained in the genes that each parent has contributed. The chemical substances that contain genes are called `chromosomes'. The 23 chromosomes in each gamete (or 46 chromosomes in the resulting cell) contain directions for the development of all the bones, organs, nerves, muscles and other tissues and for the physical and some intellectual characteristics that will make your child who he is.

Your baby will spend about 40 weeks growing in the womb (for more about this Click here), but anything from 37 to 42 weeks is quite normal. Your baby's growth there will be measured in a number of ways - by your own weight gain, by the increasing height of your uterus, and by ultrasound scans. If your baby does not seem to be growing well, special measures can be taken to help to promote his growth, or, if the pregnanry is nearing its end, he may grow better outside the womb and the birth can be induced early.

Your baby grows very fast in the womb - reaching a peak rate of growth at around 20 weeks. At this stage he is growing at a rate of 10 cm (4 in) a month, but after birth the rate of his growth is only 20 cm (8 in) a year, and this steadily decreases. Obviously your baby could not continue growing at this fast rate or he would become a giant! As well as growing in length and weight he is also developing the various limbs and organs. It is during this very early stage that your baby- is most at risk from external damage. For more about this click here, but basically you have to be very careful not to take any unprescribed medicines or be exposed to X-rays, and always tell your doctor you are pregnant if he is prescribing for you.

Babies of mothers who smoke are, on average, smaller than babies of mothers who do not. Being small-for-dates can be dangerous for the baby. In addition, heavy drinking in pregnancy can cause damage and some doctors suggest that to be on the safe side pregnant women should drink no alcohol at all, especially from the time you stop contraception until the end of the first three months of the pregnancy. It is important for women to eat a sensible, balanced diet during pregnanry, but in general babies take what available nutrition there is even if the mother is undernourished - it is the mother who can end up being depleted and unwell. There is no evidence that morning sickness, however severe, will affect your baby's well-being.

Fitting into the Womb

One of the most remarkable ways in which nature ensures that your baby will have a safe delivery is that the growth of a baby adjusts itself according to how much or how little room there is in the mother's womb during the last weeks of pregnanry. The size a person will grow to is ultimately determined by the genetic characteristics he inherits from both his parents - each contribute half of the genetic material. So if you are a small mother with a large husband, the baby, who has an equal contribution from both of you, might be too big to be delivered safely through your small pelvis and birth canal. Fortunately, during pregnanry the father's contribution is `suppressed' and the baby grows just enough to fit comfortably into his mother's shape. After the birth, however, the baby will grow more rapidly to accommodate the father's `largeness' genes and by the time he is two years old will represent this equal contribution more exactly.

In the same way, a larger woman with a generous-sized pelvis will give birth to a larger than average baby even if her husband is small. However, the baby will grow more slowly during his first two years until, again, his parents' contribution is equally represented. His ultimate size will probably be somewhere between the two parents. Growth after birth also depends on external factors, in particular nutrition. Even if both of you are large but your baby is undernourished(perhaps because of illness) he will not grow to his full genetic capability. Other environmental factors can also affect physical growth, as explained above.

Birthweight

While he was in the womb it was difficult to assess exactly how your baby was growing. After the birth it is very important that he should be checked expertly as the starting point for the monitoring of his development, and also to see whether there are any immediate problems which need extra medical or nursing help. That is why some time will be spent in the delivery room weighing, measuring and checking your baby One of the most important indicators of your baby's well-being is his weight. Most healthy full-term babies weigh between 2.7kg (5 Ib 13 oz) and 4.3 kg (9 Ib 6 oz) if they are boys, and between 2.6 kg (5 Ib 10 oz) and 4.1 kg (9lb 16oz) if they are girls. There will always be some healthy babies who come on either side of this range, but this is taken by doctors as a general guideline to what is considered normal birthweight. If your baby is one of the few individual exceptions outside this range he will be given special checks just in case there might be anything that needs extra care. When your baby is born and you hear the doctor or midwife saying that he should be checked for smallness or largeness for dates, remember they are checking not diagnosing. These checks are important and in many cases all is well. Furthermore, if anything is potentially wrong it can usually be put right

Pre-Term Babies

A baby born before 37 weeks of pregnancy is known as pre-term and he may need special nursing care because his life-support systems may not be working properly - his lungs, digestive system and nervous system may not be able to cope on their own. Such a baby will usually be below 2.7 kg (5 Ib 13 oz) but this in itself is not automatically a cause for concern. So long as he is the correct weight for the pregnancy (gestational) age, doctors will not be primarily concerned about his size. They will be more concerned about his immature bodily functions and check to see if he needs help with breathing, digestion, temperature control and so on.

Small-for-Dates Babies

A small-for-dates baby is one who weighs less than he should do for his pregnancy age. Sometimes failure to grow properly in the womb can be picked up during pregnancy and the birth may have to be induced so that the baby can be fed and nurtured better outside the womb. Sometimes the placema tends to wear out and stops working effciently before the baby has completed his growth in the womb. A small-for-dates baby is not just small, he is undergrown, and this is why women should take seriously warnings about the dangers of smoking, which causes the risk of producing light babies. There is nothing wrong with being small if that is the way you are intended to be, but it is dangerous to be smaller and less well developed than you should be.

Large-for-Dates Babies

Babies over the 4.3 kg (9 Ib 6 oz) normal limit should be checked in case their mothers have had undiagnosed diabetes during pregnancy (Pregnancy Diabetes). Many very large babies are not large because of diabetes in the mother, they are simply genetically large, perhaps because their mothers are large in build. These babies will not have any problems and, contrary to what many people believe, they will not be unusually difficult to breastfeed. The only other possible danger with a large baby is that he can be difficult to deliver; if pre-natal tests show the baby is very large and the mother is rather small-boned by comparison, the birth may be induced a week or two early or a Caesarean delivery performed. However, it is quite difficult to make such a judgement antenatally and many doctors are happy to let large, fast-growing babies be delivered normally in their own time. It is quite possible for large babies to be safely delivered without even an episiotomy being needed.