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Warning-sign checks

Small for gestational age: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services if a newborn or infant:

    • Is struggling to breathe or has blue, grey, or very pale skin
    • Has a seizure
    • Is floppy, unresponsive, or very difficult to wake
    • Stops breathing

    Slow weight gain without urgent symptoms usually needs a routine appointment rather than emergency care.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    During pregnancy, contact your maternity unit promptly if your baby is moving less than usual or there is a clear change in their normal movement pattern.

    Do not wait until the next routine appointment.

    Urgent assessment is also needed for vaginal bleeding, leaking fluid, regular painful contractions before term, severe headache, vision changes, sudden swelling, or severe pain beneath the ribs.

    These symptoms do not necessarily mean the fetus is small, but they can occur with pregnancy complications that affect fetal wellbeing.

    Seek same-day medical advice if the baby is feeding much less than usual, repeatedly vomiting, unusually sleepy, cold or feverish, increasingly jaundiced, or producing fewer wet diapers.

    Follow any discharge instructions about blood sugar, feeding, and temperature.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a review if the child is not following their expected growth pattern, has persistent feeding problems, or is not meeting developmental milestones.

Every sign above is quoted from the sofidex article on Small for gestational age. If you are not sure, err upward — it is always reasonable to be checked.