Texas Mom Gives Birth to 16 Pound Baby Boy
Janet Johnson and Michael Brown shocked the world last week when their 16 pound baby boy named JaMichael was born. According to TODAY Parenting, he came close to breaking the world record of the largest baby ever and he may very well have tipped the scale to be the largest baby on record in Texas.
Janet suffered from gestational diabetes during her pregnancy, which may have contributed to JaMichael’s massive size —the hospital didn’t even have any diapers big enough to fit him! When he was born via Cesarean section last Friday, he weighed 16 pounds, 1 ounce, measuring a full 2 feet long with a head measurement of 15 inches and a chest measuring 17 inches.
“It’s a beautiful baby, but for health reasons, we’d rather not see a baby this large,” a hospital nurse who was in the delivery room for JaMichael’s birth, told reporters. “They can have a little harder time maintaining their blood sugar.” JaMichael is reportedly progressing well and expected to be released from the hospital soon.
In the wake of this story, we asked Parents.com medical expert Michele Hakakha, M.D., to shed some light on JaMichael’s situation, and to answer a few important questions related to gestational diabetes:
How did this happen and what are the health issues he is facing?
This likely occurred from either undiagnosed pre-existing diabetes (meaning the woman started her pregnancy with diabetes and didn’t know it) or very poorly controlled gestational diabetes with chronically elevated blood sugars.
What is gestational diabetes?
Gestational diabetes means that the sugar (glucose) levels in the blood are high during pregnancy. It is a type of diabetes that only occurs during pregnancy and is caused by a hormone made by the placenta (human placental lactogen or hPl). hPl makes it harder for the body to use insulin. This causes the pancreas to work harder in order to make more insulin. In some women, the pancreas can’t keep up with the body’s demand for insulin causing a temporary diabetes during pregnancy.
How common is it?
About 4% of all pregnant women get it, but it is more common in women over the age of 35.
What are the symptoms of gestational diabetes?
This is the tricky part. Typically, there are no symptoms and this is why it is so important for ALL pregnant women to be screened. Occasionally if the diabetes is severe, you may be excessively thirsty and urinate frequently. Additionally, your practitioner can pick it up during your routine office visit by seeing a lot of sugar in your urinalysis (the urine test you have every time you go in to see your practitioner).
How is it diagnosed and treated?
Gestational diabetes is something that all pregnant women are screened for between 24 and 28 weeks. A woman is asked to drink a sugary drink (containing 50 grams of glucose) and then her blood is drawn one hour later. If this screening test is elevated (the cut-off can vary, but usually ranges from 130 to 140), a patient is asked to come back to have a 3 hour glucose tolerance test performed. This test is a little more involved and is comprised of getting 4 blood tests: the first blood draw is done in the fasting state and the 3 that follow are done at 1 hour intervals after drinking another sugary drink provided by the lab or your practitioner (only this time there are 100 grams of glucose in the drink, which unfortunately doesn’t make it taste any better). If two or more of the four values are elevated, a diagnosis of gestational diabetes is made.
Can women prevent getting gestational diabetes? If so, how?
It is very difficult to prevent getting gestational diabetes because many risk factors are out of one’s control (age, family history, ethnicity). However, we do know that obesity and increased pregnancy weight gain are risk factors. So, starting your pregnancy at a healthy weight and being mindful of weight gain during a pregnancy (25 to 35 lbs for women of normal pre-pregnancy weight, 11 to 20 lbs for women who are overweight prior to pregnancy), in addition to getting regular exercise, can all help prevent diabetes.
How can women who do get gd wisely manage it and stay healthy?
The key point is excellent sugar control, as babies born to women with gestational diabetes that have well-controlled sugars, have minimal to no additional risks. It is important to meet with your practitioner or a diabetic educator/nutritionist to go over your diet. Daily blood sugar levels need to be checked and recorded. Moderate exercise (30 minutes a day) improves glucose control, as well. And, occasionally, if glucose levels continue to be elevated despite altering diet, an oral hypoglycemic (sugar-lowering) medication, or rarely insulin injections, may need to be used. The bottom line is that it is very important to be in close contact with your practitioner regarding your blood sugar levels so that the risks to the developing baby are minimized.
How can gestational diabetes affect an unborn baby?
If a woman’s sugar/glucose levels are well-controlled, there are very few risks to the fetus. The big risks come when a woman does not control her daily blood sugars. If a mother has chronically elevated blood glucose levels, the glucose crosses the placenta and leads to elevated glucose levels in the baby as well. This can lead to a number of problems for the fetus and newborn baby including:
1) macrosomia (large birth weight)
2) birth trauma (shoulder dystocia-a large baby has a hard time fitting through the birth canal and can get stuck)
3) increased risk of Cesarean delivery
4) increased risk of stillborn
5) increased risk of low blood sugar after birth, jaundice, newborn seizures, and respiratory problems.
There are also risks to the newborn later in life such as an increased risk of developing obesity, type II diabetes, developmental delays and heart disease. This is why it is so critical that a woman diagnosed with gestational diabetes be followed closely with a strict diet and occasionally, oral medication or even insulin.
What happens after pregnancy?
After pregnancy, the culprit (the placenta) has been removed and in almost all cases, a woman’s blood sugar goes back down to normal. Every woman that had gestational diabetes, however, should have another screening test done at 6 to 10 weeks post delivery called a 2 hour glucose tolerance test. This test is done to ensure that a woman’s metabolism of sugar has returned to normal.
Two key points to remember however, are 1) that there is a 33 to 50% chance of developing gestational diabetes in a subsequent pregnancy, and 2) there is an increased lifetime risk of developing type 2 diabetes later in life. It is very important to live a healthy lifestyle including eating a well-rounded diet, getting regular exercise and continuing with annual health care exams.
Read more about gestational diabetes at Parents.com: