Baby B Smaller, Less Active

I am 28w with Dizygotic BG Twins. My baby B (boy) has always been a bit smaller. Early on he was about 3 days behind. By about 24w he had caught up with baby A (girl) but at Friday's US he was measuring behind again and the nurse mentioned the size discordance and wanted me to come back again as soon as my regular OB returns to the office. My initial thought was that maybe he will have a growth spurt a bit later than baby A and catch back up like before. Of course over the weekend I have had time to stew over it and now I'm worried. He is definitely less active than she is and the size difference is about 15% I believe. Anyone BTDT? I'm feeling down and a bit worried.

 

We had a steady difference. Sounds like it might be u/s tech error. Either he was mismeasured when they thought he was big or a mis measurement . U/s as always can be up to 1lb off and as the pregnancy goes further its harder to get good measurements. I would follow up with your normal ob and see if they will rescan. Size discordance would make the u/s medical needed

 

I agree with the above. I have nothing else really to add.

 

My twins were always way off on sizes. Ultrasounds are only guess-timates. At some ultrasounds mine were 2 pounds difference and no one was ever concerned. My baby B was less active too because she was wrapped in a little ball position up by my throat! LOL. Good luck, it will all be fine.

 

A 15% difference is well within the range of potential ultrasound tech error. And a lot of times, it's not even error, it's just what happens. If a tech measures a femur at the very edge for one baby versus just inside the edge for the other baby, it can look like a major size difference. It's only because we can compare our two babies that a minor thing like the edge versus the very edge of a bone matters. So don't panic yet.

I was monitored weekly for size difference starting at 22 weeks. The size difference was always 15% - 25%. My girls were born with a 20% size difference and we learned it was due to Piper's cord implanting on the edge of the placenta, not the middle. She got fewer nutrients in utero. It didn't cause any lasting problems, so even if your boy IS smaller than his sister, there may be nothing to worry about.

When you talk to your OB, ask for a referral to a high resolution ultrasound place, or a perinatologist who has specially trained ultrasound techs who deal with stuff like size difference all the time. Then you'll be sure you can trust the ultrasound results.

Hang in there!

 

At my 24-wk ultrasound, my twin B was measuring, I think, almost 20% smaller than twin A (and she's always been less active too). So the OB scheduled me for another US two weeks later just to check and at that one, the gap was smaller. I know it's hard not to worry - I worried too in that two-week timespan. But I think some babies just grow at different times. Now I feel twin B more than I used to (though A still a little more).

I have another US this afternoon - I'm almost 30 wks - so I'm hoping that their weights will be similar.

Also, my OB told me after the 24-wk US when the difference was the largest not to worry just based on one US. Again, it's hard not to, but a 15% difference doesn't strike me as extreme, especially since I seem to routinely read of di-di twins being born and measuring well over a pound difference in weight.

Good luck - I hope your next US is reassuring.

 

I think the other thing to ask is how they are measuring for gestational age. For example, my baby b (boy) is measuring in the 85th percentile for gestational age while baby a (girl) is measuring 50th percentile. Because they are both measuring just fine for their gestation dates, the doctors are not concerned that they are different in size even though B is so much bigger. Does that make sense?

Also, the tech at my 28 week ultrasound told me the measurements could be off by +/-10% so a 15% difference is still within the margin for tech error, in my opinion (since +/- 10% is the average amount the measurements can be off by).

My baby boy was also less active until recently and now he's kicking up a storm while I barely feel baby girl anymore (whereas previously I always felt her move and rarely him--sometimes positioning can make it difficult to tell how well a baby is moving).

I hope your next ultrasound will put you at ease.

 

I don't remember the percentage differences. But my girls were always different in size on u/s. At 9 weeks, there was a 5 day difference. That difference just grew throughout the pregnancy. The last month, Sabrina (baby b) stopped growing. But I went full term with them and was induced at 37w5d. The day before they were born the u/s said my girls were 7#7oz and 5#5oz. Turns out when they were born they were 7#9oz and 5#3oz, so there was an even bigger difference. And Sabrina did struggle. It was a battle to put weight on her after she was born, too. She's a healthy, active 6 year old now, but she's still tiny. She's 33 lbs and her 2 1/2 year old brother weighs more than she does. She's never been on the size charts. Her twin sister (who's at about 40th %ile for height and 60th for weight) is 18 lbs, 4 inches and 4 shoe sizes bigger than she is. I do still worry about making sure she's eating enough and growing, but she just grows slower than most kids. I don't know if it has to do with in utero (her umbilical cord was only 7-8 inches long), but at least she's healthy and doing fine in most other ways (Sabrina is legally blind, but it's genetic and unrelated to her size or being a twin... believe me we've had her checked for everything).

This post maybe sounds more negative than I'm intending. The first months were kind of rough, but she's a smart, funny, bright, happy, healthy child.

 

My twins had a size discrepancy at every ultrasound, they were estimating Max to be at least 1 pound heavier and it turns out they were both the same weight at birth - and it was in the middle of what the estimations were, so yeah, that's a proof that erros happen, and it's hard to measure twins, since they are so twisted and cramped in there. I think the baby that seems less active may have his back towards your belly, so you don't feel him moving his legs/arms so much - that's what happened to me with Vanessa, I used to always worry with her, at times I wasn't sure she was moving, but she was always fine at ultrasounds and she's fine now - she was also the one estimated to be smaller at each ultrasound.

I am sure your twins are fine, but I know it's hard not to worry. Try to relax and enjoy the last stage of your pregnancy. I hope you can make it as long as possible.

 

I just posted about my US today in the appointment thread. My babies are back to having a sizable (to me, anyway) difference - A is 3 lbs, 7 oz and B is 2 lbs, 11 oz. So I was concerned, but my OB said afterward that both weights are in the normal range. I wish they were more similar, but there's really nothing I can do and the OB isn't worried. I'm having another US in a little over two weeks, so we'll see what those weights are.

Monica77, it is experiences like yours (measuring different on the US but with very similar birth weights) that make me feel better!

 

At my last ultrasound at 36 weeks they had both of my boys measuring around 5lbs after having baby B always measuring about a lb behind. Baby A was 6lbs oz and Baby B was 5lbs 2oz

 

Thanks so much ladies! I wasn't worried at first, but then I think it's hard when someone communicates concern about anything related to your babies. I guess I let the "what-ifs" get to me. I love these babies so very much and I don't want anything to happen to them.

I wondered if maybe baby B had his back towards my belly and that could be why I feel less movement. I was 27+4 at my US last week and he was measuring somewhere in the 25w range (25+?????).

He is moving as I type this and I am so very thankful. I mostly feel sweeping type movements with him whereas with baby A I feel hiccups and strong kicks. I'm praying he has a growth spurt this week and all is well next week. I have added protein just in case. :unknw:

I sincerely appreciate each of your responses. I was so thrilled to sign back on and see such support. Thank you so very much!!

 

I agree about the size discrepancy thing. Ultrasound estimations on weight are just that, guesses. If they could somehow weigh them, then it might matter more. My di-di twins were always different sizes from the beginning to the end. They were born at a 13 oz difference. My OB was never concerned about size discordance and they were up to 25% different at one time. My larger twin was my less active one. He stayed head down, closest to my cervix throughout the entire pregnancy. Baby B, my smaller twin, flipped back and forth weekly and over all was much more active. To this day he is the mover and the shaker compared to his brother I think it is their personality differences.

 

I was also told that when different technicians do the measurements, there always going to be discrepancies as each have their own of way of measuring.

 

Thanks. The same US nurse has been doing each of the measurements so at least there has been consistency in who is measuring. . .

 

The same person was measuring our twins all the time also, and at the appointment before birth she said Max was 7lbs and Vanessa was 6lbs and each of them weighed 6 lbs 5oz at birth. Vanessa was worrying me all the time, and I used to be reassured when I felt her have the hiccups also . She was twin A and she had an anterior placenta - her placenta was attached towards my abdomen and she was also turned with her back towards it, so I couldn't feel her as much as I felt Max. Also, she was always breech, I think she didn't have room to move and Max was always flipping, so he was very active and I could barely feel her, but now they are both just as active and climbing on everything and pulling everything they can .

Try not to worry too much, I know it's easier said than done. Good luck to everyone expecting!

 

Thanks again! Hearing stories from all of you twin mamas has really ease my concerns. I am eagerly awaiting my follow up appointment to see what my OB says.

 

Just a followup. Had our monthly growth scan today and B was estimated at a pound less than A. My OB immediately sent me to the MFM. They re-measured and are monitoring me with biophysical profiles weekly to keep an eye on things. The good news is that Bs blood flow is good and fluid is good, and A flipped to vertex. Praying B keeps growing...

 

Bpps are the best. It puts you at ease plus keeps better check on the babies. I was on twice weekly for the last 10 wks of my pregnancy

 

Thanks. I am having ups and downs. I went from feel really stressed about it yesterday to feeling OK and now I am feeling really stressed about it again. I just keep hearing my OB say that there is a heightened risk of baby B having some sort of accident in the womb. I know worrying will not do me any good, but it is so hard not to worry. The "what ifs" are getting louder and louder in my mind.

 

They told me to be prepared to loose jessy in utero. They were giving her very nominal chances for survival. They said things like we need to measure them very closely so that if we loose baby b in utero we can deliver as quickly as possible. It's very hard facing that but was glad my doctirs was straight with me. It made me very aware to follow all instructions. Jessy is very much a fighter

 

My boys consistently measured a lb apart from my 20 week scan on. When they were born my baby A was 6lbs 9oz and baby B was 5lbs 2 oz. I honestly don't think a lb difference is big, especially if baby is following his/her growth curve. He'll be fine.

 

Twinxes- how scary! Was that only due to size difference?

It is so hard to hear someone tell you that there is something wrong or might be something wrong with your child.

Our baby B is in the 3rd percentile, so I think that is what they are looking at in addition to the size difference. Thankfully my pregnancy with DD was so very easy after a bit of a rough start. This time I had a really rough start and just realized yesterday that I have had about 6 weeks of calm this entire pregnancy. I think I would feel better if I could feel him move as much as I feel baby A.

 

Both girls had improper implantation in the placenta and Jess had a 2 vessel cord instead of the normal 3 vessel so she was getting less flow for numerous reasons

 

Wow, how stressful that must have been for you.

 

Good luck with the BPPs, ThankfulMama. I'm crossing my fingers that your Baby B keeps growing! Keep us updated how things are going.

 

Thanks so much. Today is a really hard day. I guess I should take my early pregnancy advice and stay away from google. I have spent a good part of the morning crying. I feel like I'm failing my baby B and I don't know what to do to remedy it. Major mommy guilt.

 

I don't have any advice, thankfulmama, but I just wanted to let you know you're in my thoughts and prayers, and I'm really sorry you're having a tough day today. Hang in there.

 

I'm thinking of you too. Hugs! I'm sorry you're feeling so badly and that Baby B is not growing like he should be.

Do your best to rest and eat healthy--the advice here always seems to focus on lots and lots of protein and rest so I'll pass that along. I have no idea how much it will help, but at a minimum, it's something you can do for now. :hug: Please try not to feel guilty. :hug:

 

I am sitting here with my baby B in a wrap while baby A snoozes nearby. The gap between my two arrived near the end of the pregnancy and led to induction so he could get more space and support. He is now a voracious eater and working on catching up to his brother. In related news, we ran in to a couple from our twin class this weekend and her baby B stopped growing early and also led to induction. She is now a happy 2 month old. Have hope. Take care of yourself. Good luck with the mommy guilt (it's brutal...).

 

Thanks so much for the support. It really helps.

My BPP is tomorrow morning so I am praying that will go well and give me a much needed boost. I am trying to add in as much protein as I can, but eating is tough because of the reflux.

 

Have you tried ensure? I know reflux is hard especially when they are taking up most of the space. It really doesn't taste that bad.

Keep your chin up. The little ones are fighters.

 

I haven't tried ensure. I bought whey protein several months ago from Trader Joe's and have been adding that to things again. I have to be careful or it makes my stomach hurt. Plus, I am expecting these babies to have food intolerances as did DD1, so my ped recommended cutting dairy and soy before delivery. I haven't done that yet because I need the nutrients.

I had the BPP today and my MFM said he would decide early next week at my growth scan whether I could stay pregnant. I will now also be monitored 3 times per week starting next week (not sure why not this week??).

I guess we need to finish getting ready for babies and stay ready from here on.

 

Yeah I'd check with you mfm about cutting the soy and milk. It's easy to get rid of one or the other but not both. It is possible that they won't have food intolerance.

Hopefully they grow by leaps and bounds by next week. Still 33 weeks isn't too bad

 

Thanks! I'm hoping for a big growth spurt this week too. I haven't cut anything from my diet (and don't plan to quite yet) because I need the protein and calcium now. MFM hasn't said anything about diet, however. There is a very small chance that they won't have intolerances, but most likely they will--DD had severe intolerances and I was off the top 8 plus a number of other things for a very long time.