SGA babies may need to be born early (prematurely). A baby showing an abnormal pattern on heart monitoring or reverse blood flow in the umbilical cord vessels on scanning may need 10 be bom by elective caesarean section. lf the baby’s reserves of sugar are adequate, an induction of labour may be undertaken- Labour is monitored closely because of the susceptibility to fetal distress. Using upright postures for birth reduces fetal distress.
Under 35 weeks the mother is given a dexamethasone (cortisone) injection to boost the maturation of the baby’s lungs before birth. After birth, close body contact with the mother and a warm room is essential because small babies lose heat rapidly. They have few fat reserves for insulation and heat production. The baby requires early feeding at birth because reduced sugar stores increase the risk of low blood sugar (hypoglycaemia) which may cause brain damage if let untreated for too long. Lf despite frequent breastfeeding there are signs of hypoglycaemia (irritability, floppiness, low blood sugar levels on a heel prick sample) top-ups with formula milk are essential. Occasionally the baby may even need a glucose drip” A careful paediatric examination of the baby is useful to exclude an underlying problem. Some babies with placental insufficiency and IUGR gain weight rapidly and the weight and height catches up within a few months. Many other SGA babies may remain small.