Birthing Complications -Big Baby (Macrosomia)

4 min read

Written by Pradeep


Big Baby

What is Big Baby?

Macrosomia literally means “big body”. Big Baby (Macrosomia) is the term used for newborns who have significantly larger weight as compared to the average baby weight. In India, the average weight of newborns usually lies somewhere between 2.5 to 3.5 kg, so a baby weighing 4kgs or more is generally said to be as macrosomic. Big babies can put both the mother and the baby at a risk for complications. Though many mothers give birth normally to big babies without complications, yet some big babies’ birth may require assistance and help. A macrosomic baby also has a higher risk of few other possible complications like abnormally high blood sugar level, increased blood pressure, excess body fat and high cholesterol levels. All these conditions together can increase the risk of heart disease, stroke and diabetes in the baby.

What Causes Babies To Be Large?

There are varieties of causes that can play an important part in making your baby large.

  1. Gestational diabetes: One responsible factor is maternal diabetes or gestational diabetes, a mother who has such condition is in double risk of having a large or big baby. Read more about gestational diabetes here
  2. Genetics: Genetics can also be a leading cause, if you were a macrosomic baby than you have more chances of delivering a large baby. Taller and heavier parents generally produce big babies. If you have gained extra weight during pregnancy than it can also contributes towards macrosomic baby
  3. You go past your due date: If in case you have crossed the due date by 10 to 12 days than your baby has more time to grow and it can result into large baby. Age of women also plays a big role, women above 35 years of age have more chances of having a big baby than younger women
  4. History: Your history of macrosomic past pregnancies will also increase your chances of having an oversize baby
  5. Weight gain or high BMI: If you have a high BMI or have gained a lot of weight during pregnancy, you can run a chance of having a large baby. Read about pregnancy and weight gain here

Please note that even if you have some risk factors stated above than also it doesn’t mean that you are going to give birth to a big baby. Quite often, big babies are born to mothers who reported none of the risk factors stated above.

Can A Macrosomic Baby Be Detected Earlier?

It is very difficult to diagnose a macrosomic baby before his birth but women with gestational diabetes can have higher chance of having big baby. However ultrasound taken during the second and third trimester can also provide some idea about baby weight but for accurate diagnosis one needs to wait till the baby is born. A 10% margin between the weight of the baby as predicted by an ultrasound and the actual weight at birth is considered admissible.

How Will A Large Baby Affect The Birth?

Delivering the macrosomic baby vaginally can be a little risky for both baby and mother. During the process of delivery, a mother may have to experience perineal tearing, and extensive blood loss whereas the baby can face a potential risk of injuries and broken bones. Most dangerous complication of macrosomic baby during vaginal delivery is shoulder dystocia, in which the baby’s shoulder gets stuck behind the mother’s pelvic bone. Such complications often result in collar bone fractures in the baby and the second dangerous and most feared complication is asphyxia. If your baby is stuck for a longer period of time then it can result in death of your baby due to lack of oxygen.
In order to prevent these complications your doctor can recommend a C-section especially if you have diabetes or your ultrasound suggests that the baby has higher chances of being overweight.

Recovery From Birthing A Macrosomic Baby

A complete recovery and healing from perineal tear or episiotomy during vaginal delivery of your big baby can take some time, mostly it depends upon how deeper the perineal tear is, the more deeper the tear, the longer it will take to repair.
In order to recover completely, along with following your doctors instructions you can also follow some simple tips provided below:

  • Try not to sit for long periods of time till your stiches are not fully healed
  • Keep the area infection free
  • Change your sanitary pad frequently
  • Depending upon your condition you can also try to take warm soaks in the tub
  • If in case you cannot sit then take hot bath and pour warm water on your perineum
  • If in case your pain doesn’t cease with time go and see your doctor


Please keep in mind that your baby might be at risk of obesity and higher sugar levels, so he should be monitored for these conditions during future checks. And for yourself you can also take a preventive test to check your sugar levels within every few months after delivery.


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