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I’m in my third trimester and my baby is small for her gestational age. Should I be worried?

Not all babies are born the same size. Some are naturally bigger; others smaller. This could be determined by genetic factors. If your husband or you are petite, and your unborn baby is putting on weight consistently over the weeks, then that may be considered normal. In some cases though, it could mean there is intrauterine growth restriction in the baby.

This occurs when he is not getting enough oxygen or nutrients, hence slowing down the growth velocity. A common cause is placental insufficiency, when the placenta – which delivers oxygen and nutrients to the baby – is not working optimally. Other causes could be smoking or excessive alcohol intake, maternal infections, high blood pressure, prepregnancy diabetes or foetal anomalies.

Your doctor may want you to do a scan to determine if the umbilical cord is working well and if your baby is receiving adequate oxygen or nourishment. Sleeping on your left does increase blood flow to your baby, so you should do that if he is small.

How else can I help my unborn child put on weight quickly?

If your baby is small due to poor maternal weight gain, and not due to placental or umbilical cord problems, then increasing the amount of calories you consume will help your baby gain weight.

Your diet should include protein-rich foods like eggs and meat, and you can also try increasing your carbohydrate intake. Eating durian can help, as it is a high-calorie fruit. But check with your doctor first. Some high-calorie foods are not appropriate if you have gestational diabetes or other medical problems, such as kidney dysfunction.

ASK THE EXPERT

These questions were answered by Dr Goh Shen Li, a consultant obstetrician and gynaecologist in S L Goh Women’s Clinic at Mount Alvernia Medical Centre D. Got a question? E-mail us at magyoungparents@sph.com.sg.