Sunday, 11 l 09 l 2011 Source: The Sunday Times
By: Chai Hung Yin
 WHEN baby Josiah Shalom Mok arrived in July, his mother was surprised. Madam Allie Chen, 27, was expecting a 3.3kg baby but her son turned out to be 4.4kg instead. Because of his size, the freelance babysitter went through 13 hours of gruelling labour, and ended up on the operating table because the baby would not descend into the birthing canal. She told The New Paper on Sunday: “I wanted a natural birth. So I pushed and pushed, but the doctor said his heartbeat had dropped. His headand shoulders were also swollen.” For the safe arrival of her big bundle of joy, Madam Chen finally went for a Caesarean section with an epidural, which meant she was awake but numbed from chest down whenJosiah was born. “When I saw my baby, I was crying with joy, while everyone else was smiling,” exclaimed Madam Chen.
While the average weight of babies born here has not changed drastically – KK Women’s and Children’s Hospital (KKH), which gets the lion’s share of births here, says the figure hovers around 3.1kg – obstetricians and gynaecologists The New Paper on Sunday spoke to gave anecdotal examples ofmore cases like Madam Chen’s. Indeed, the biggest babies born at the Singapore General Hospital, KKH and Thomson Medical Centre weighed 5.1kg, 5.6kg and 5.8kg respectively. They were all born in the last decade. A medium sized bag of rice is 5kg. Most babies delivered here weigh between 2.8kg and 3.5kg. Any infant above 4kg at birth is considered large.
Doctors are not keen for mother and child to get too big, as delivery will be fraught with risks and the child has a higher likelihood of developing health issues. Dr Irene Chua of Irene Chua Clinic for Women at Gleneagles Medical Centre, remembers delivering a 5.2kg baby. There was a lot of “pushing, pulling and yanking” by a team of four doctors and three nurses, before the baby was finally delivered with the help of forceps, she recalls. The main culprit? Mostly, better –and in many cases, too much– nutrition.
SGH’s head and senior consultant in the Department of Obstetrics and Gynaecology, Associate Professor Tan Hak Koon, said: “Once mothers eat better, their babies get better nutrition. “In fact,many overeat,” he said. Madam Chen and other mums we interviewed did admit eating more during pregnancy. For instance,Madam Chen had a bottle of birds’ nest and two bottles of chicken essence every week during her second trimester . She said: “I did eat a lot. I drank a lot of milk in various flavours and ate a lot of vegetables.” She also ate plenty of sirloin steak during her last trimester “so that baby would be strong”.
Another big baby mother, Madam Liu Yue, 28, succumbed to her craving for durians. She said: “I had durians about twice or thrice a week since the start of my pregnancy. I stopped eating (so much) only when my doctor said I was overweight but I still sneaked in a few pieces here and there.” She thought the durians would give her baby the needed nutrients for him to grow strong and healthy. Madam Liu and Madam Chen gained 19kg and 20kg respectively during their pregnancies – way above the recommended 12kg to 14kg weight gain.
Obese mums can expect their babies to be born bigger, said Prof Tan. Gestational diabetes can also send sugar levels and the baby’s weight skyrocketing. While mummy’s eating habits do have an impact, genetics is also key. Which is why Asian newborns are often smaller than their Caucasian counterparts, he added. Also, if child No.1 was large, child No.2 might be that way too. Madam Leung Pui Wei, a 39 year old human resources officer, gave birth to her third child, Ong Kah Yen, nine days ago. Her daughter tipped the scales at just under 4kg . She said: “People said she’s very big, but I don’t think so. I’ve seen bigger ones, like my oldest daughter, Kah Yim.” Her first child,now six, was born at a whopping 4.4kg. Madam Leung remembers how she was clumsy when carrying her. She said: “I was walking like a tortoise. Sometimes I had to stop halfway to catch my breath.When people on the streets saw me, they asked if I was okay.”
Like her, Madam Liu recalled being large from the start. She said in Mandarin: “When I was three to four months’ pregnant, people were already giving up their seats for me on the buses and MRT. Most other women don’t start showing until they are further along.” Her first child, now 13 days old, was a hefty 4kg bundle, for whom she went through 24 hours of labour. She also ended up with an emergency Csection. Despite the harrowing experience, Madam Liu said she wants a second child. “But this time, if I’m overweight, I would opt directly for a Caesarean section,” she said.
Risks to big babies:
A key worry for large infants is shoulder dystocia. This is when the baby’s head has emerged but one of the shoulders becomes stuck behind the mother’s pelvic bone.
- The baby cannot start breathing because its chest remains compressed. The oxygen carrying umbilical cord is also squashed.
- In severe cases, the baby might suffer brain damage due to a lack of oxygen, or even death. *The nerves in the neck provide movement and feeling to the arm. When the baby’s shoulder becomes stuck, the nerves in the baby’s neck may be damaged.
- The child also has a higher risk of developing obesity and diabetes when he or she grows up.
Risks to mothers:
- Mother risks tears and injuries to her genital tract.
- Higher chance of instrumental delivery such as the use of forceps or a vacuum, or a Caesarean section.
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