Can A Newborn Baby Have Obesity?

By Dr. Okechukwu Amako, MBBS (Ibadan)
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Almost everyone is aware of obesity in adults and the resulting health implications if nothing is done; some people may have heard about obesity in children. But many people don't know that a baby in the womb can have a weight larger than normal for his or her pregnancy age; something that can be referred to as obesity but in newborn babies.

How do doctors know that the weight of a baby in the womb is larger than normal? They do so by checking the baby's weight at birth. There is a range for normal weight gain for each pregnancy week as the baby grows and develops in the mother's womb. The same applies at birth: the normal healthy range for the weight of a baby at birth is between 2.5kg and 4kg. Any baby weighing below 2.5kg at birth is said to have low birth weight which is caused by many conditions. When the birth weight of a baby is above 4kg, that baby is described by doctors as being large for his or her age and they call this condition macrosomia. You probably would have come across a picture of a big newborn baby. You can choose to see it as a newborn baby having obesity.

A baby with a larger than normal birth weight shows that some things were not in the right state in the mother before and/or during her pregnancy with the baby. Conditions that are likely to lead to the birth of an obese baby include:

1. The mother being diabetic before becoming pregnant or developing diabetes during pregnancy which was either untreated or not properly treated. These two conditions have been shown to contribute to a pregnancy producing a baby with a larger than normal weight at birth.

2. A baby is likely to have a larger than normal weight for his or her age in the womb and at birth if the mother was obese before pregnancy or gained excessive weight during pregnancy.

3. The normal due date of delivery for any pregnancy falls anywhere between the 37th and 40th week of pregnancy. Mothers whose pregnancy extends beyond 40 weeks are at a higher risk of giving birth to a baby with a larger than normal weight.

Also, women who get pregnant after the age of 35 are at a higher risk of having an obese baby than those who are below 35.

4. It has also been found that the more a woman becomes pregnant and gives birth (after her fifth pregnancy and childbirth), the more likely that her next pregnancy may produce a baby with a larger than normal weight at birth.

A bigger than normal sized baby growing in the womb is both risky to the health of the mother and the baby.

1. Pregnant women whose babies are bigger than normal may have difficulty in giving birth the natural way, necessitating delivery through a caesarean section. Caesarean delivery puts the woman at a risk of womb rupture in any subsequent pregnancy if she attempts giving birth the natural way, especially if the baby in the womb is bigger than normal. Hence, subsequent pregnancies will have to be delivered through a caesarean section.

Even when the pregnant woman can attempt giving birth through the natural way, she may sustain injuries in her birth canal, such as a vaginal wall laceration, due to the baby's size.

On the other hand, due to the bigger than normal size of the baby, the labour can become obstructed during which one or both of baby's shoulders may get locked within the mother's birth canal after the head has come out of the canal. This can lead to a fracture of the baby's collar bone in the process or a damage to a part of the nerves supplying the shoulder and the arm, possibly leading to paralysis in the forearm and wrist in the baby.

2. The womb may distend beyond its normal capacity to accommodate the very big size of the baby. This can result in the inability of the womb to contract after the baby is delivered, leading to a serious bleeding afterwards (called postpartum haemorrhage).

3. Obstructed labour during the delivery of a baby with a larger than normal weight can compromise the breathing of the baby if the labour lasts longer than normal. This can result in a stillbirth in the absence of an emergency intervention to relieve the obstruction and deliver the baby at once.

To avoid being pregnant with a bigger than normal sized baby, it is important that:

1. Couples seek preconception care. We have talked about the importance of preconception counselling and care in one of our previous health tips.

Preconception care (care given to a woman before she gets pregnant) involves a complete history, physical examination and some medical tests done by a medical doctor to help uncover conditions like diabetes, hypertension or obesity in the woman for appropriate treatment after which she can get pregnant in a healthy state.

2. Pregnant women should register for and start receiving antenatal care as early as the second missed period (around 8 weeks or second month of pregnancy). Proper antenatal care will help monitor them for and control things like blood sugar and blood pressure if they are above normal.

3. Pregnant women should engage in mild to moderate physical exercise after consulting their obstetricians and physiotherapists in order to maintain an optimum weight for pregnancy. Those who can afford it should also work with registered dieticians on the right meals so as to be within the normal weight range for a healthy pregnancy.

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Published Monday, May 22nd 2017

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