Small baby & fetal growth restriction — Wokingham, Berkshire

On this page

1. Overview
2. Causes and risk factors
3. Diagnosis and monitoring
4. Fetal growth restriction in Chinese medicine
5. Acupuncture for fetal growth restriction
6. Chinese herbal medicine for fetal growth restriction
7. Diet and lifestyle advice
8. Treatment at my clinic
9. Frequently asked questions
10. My Pregnancy Guide
11. References

1. Overview

Fetal growth restriction (FGR) — sometimes called intrauterine growth restriction (IUGR) — is a condition in which a baby does not grow as well as expected during pregnancy. It is defined as an estimated fetal weight or abdominal circumference below the tenth percentile for gestational age on ultrasound. A related term, small for gestational age (SGA), describes babies who are smaller than expected at birth, though not all small babies have pathological growth restriction; some are simply constitutionally small. FGR affects around 3 to 9 per cent of pregnancies in high-income countries and is a significant cause of stillbirth, premature birth, and neonatal complications.

Conventional medicine has no proven treatment to reverse established FGR; management centres on monitoring and timing delivery to balance the risks of prematurity against those of ongoing growth restriction. Acupuncture and Chinese herbal medicine offer a complementary approach, working to improve uterine and placental blood flow, nourish maternal Blood and Kidney Essence, and create the most favourable internal environment for fetal growth. Treatment is always undertaken in close collaboration with the obstetric team.

2. Causes and risk factors

FGR results from a failure of the fetus to achieve its genetically determined growth potential, most commonly because of inadequate delivery of oxygen and nutrients through the placenta. The underlying causes are typically grouped into three categories:

1. Placental causes — the most common; impaired placentation, spiral artery remodelling defects, placental insufficiency and abnormal umbilical cord blood flow. The placenta fails to develop adequate vasculature, leading to chronically reduced oxygen and nutrient transfer to the fetus
2. Maternal causes — including chronic hypertension, pre-eclampsia, diabetes, autoimmune conditions, anaemia, smoking, substance use, severe malnutrition, and antiphospholipid syndrome. Maternal conditions that impair uterine blood flow or systemic circulation are particularly important risk factors
3. Fetal causes — chromosomal abnormalities (such as trisomy 13, 18 or 21), structural congenital anomalies, and intrauterine infections (toxoplasmosis, rubella, cytomegalovirus and herpes simplex — the TORCH infections). These account for a smaller proportion of FGR than placental and maternal causes

Important risk factors include a previous pregnancy affected by FGR, a pre-pregnancy body mass index below 18.5, chronic hypertension, endometriosis or other uterine conditions, smoking, and carrying multiples. Women who have had FGR in a previous pregnancy carry a significantly elevated risk of recurrence.

3. Diagnosis and monitoring

FGR is detected and monitored through serial ultrasound measurements of fetal biometry — particularly abdominal circumference and estimated fetal weight — and Doppler velocimetry of the umbilical artery, which reflects placental vascular resistance. Normal umbilical artery Doppler shows forward blood flow throughout the cardiac cycle; absent or reversed end-diastolic flow signals severe placental insufficiency and is associated with a high risk of adverse fetal outcomes. Middle cerebral artery Doppler is also used to detect brain-sparing redistribution of fetal blood flow, a sign of compensatory response to fetal hypoxia.

Early-onset FGR (before 32 weeks) is generally more severe and more closely associated with abnormal Doppler findings and placental pathology. Late-onset FGR (32 weeks or later) is more common but typically carries a better prognosis, though it still warrants careful monitoring. All women diagnosed with FGR should remain under the care of their obstetric team and follow recommended surveillance intervals. Acupuncture and herbal medicine are used as complementary support alongside this monitoring, not as a replacement for it.

4. Fetal growth restriction in Chinese medicine

In traditional Chinese medicine (TCM), the fetus is nourished by maternal Blood, which circulates to the uterus and placenta via the Chong channel (Sea of Blood) and the Ren channel (Conception Vessel). The Kidney system governs reproduction and stores Jing (constitutional Essence) — both parents’ Jing contributes to the baby’s foundational development. Poor fetal growth in TCM is understood as insufficient nourishment reaching the fetus, arising from one or more of the following patterns:

1. Blood deficiency — the most common pattern underlying poor fetal growth; insufficient maternal Blood means the placenta and fetus do not receive adequate nourishment. Signs include a pale complexion, fatigue, dizziness, palpitations, scanty sleep, a pale tongue and a thin, fine pulse. Blood deficiency may arise from constitutional weakness, poor nutrition, excessive worry or overwork during pregnancy, or previous blood loss. Treatment nourishes Blood and the Liver (which stores Blood), using herbs such as Shu Di Huang, Bai Shao, Dang Gui and He Shou Wu within blood-nourishing formulae, and acupoints SP10 (Xuehai), BL17 (Geshu) and ST36 (Zusanli)
2. Kidney deficiency — when Kidney Jing and Qi are insufficient, the foundation for fetal growth is weakened; the fetus lacks the constitutional support needed for healthy development. Signs include lower back weakness or aching during pregnancy, fatigue, cold lower limbs, frequent urination, a pale tongue and a deep, weak pulse, particularly in the chi (rear) position. Treatment tonifies Kidney Essence and Yang to support placental function and fetal nourishment, using Tu Si Zi, Sang Ji Sheng, Xu Duan and Shu Di Huang, and acupoints KI3 (Taixi), BL23 (Shenshu), CV4 (Guanyuan) and GV4 (Mingmen)
3. Spleen and Stomach Qi deficiency — the Spleen transforms food into Blood and Qi; when Spleen function is weakened — typically by poor diet, cold foods, excessive fatigue or constitutional weakness — the mother cannot produce sufficient Blood to nourish the fetus adequately. Signs include poor appetite, loose stools, fatigue, abdominal distension, a pale tongue with a thin coating and a soggy or weak pulse. Treatment strengthens the Spleen and Stomach to improve the production of Blood and Qi, supporting fetal nutrition via Dang Shen, Bai Zhu and Huang Qi, and acupoints ST36 (Zusanli), SP6 (Sanyinjiao) and CV12 (Zhongwan)
4. Qi and Blood stagnation — when the circulation of Qi and Blood to the uterus is impaired — by stress, cold, or constitutional tendency — the placenta receives reduced perfusion. This pattern often overlaps with Blood deficiency and Kidney deficiency. Signs include a dusky or purple tongue, a choppy pulse, cold hands and feet, and a history of poor pelvic circulation. Treatment moves Qi and Blood gently to improve uterine perfusion, using acupoints SP10 (Xuehai), LR3 (Taichong) and ST29 (Guilai)

In practice, these patterns often co-exist, and treatment addresses the primary and secondary patterns simultaneously. The classical TCM text Jing Yue Quan Shu (Complete Works of Jing Yue, 17th century) explicitly describes the treatment of poor fetal growth by nourishing Blood and Kidney Essence, a principle that informs practice to this day.

5. Acupuncture for fetal growth restriction

The primary mechanism by which acupuncture supports fetal growth is through improving uterine and placental blood flow. The placenta is entirely dependent on maternal blood supply for the delivery of oxygen and nutrients to the fetus; improving that supply is the central therapeutic goal. Acupuncture achieves this through several well-researched pathways:

1. Reducing uterine artery blood flow impedance — high resistance in the uterine arteries (reflected in an elevated pulsatility index, or PI) reduces placental perfusion. Electro-acupuncture has been shown in multiple studies to significantly reduce uterine artery PI. Stener-Victorin et al. (1996), published in Human Reproduction, demonstrated that electro-acupuncture significantly reduced the PI in both uterine arteries in infertile women with high impedance; this reduced resistance means more blood, oxygen and nutrients reaching the uterus and placenta. Ho et al. (2009), in a randomised trial published in the Taiwan Journal of Obstetrics and Gynaecology, confirmed that electro-acupuncture significantly reduced PI in both uterine arteries compared with controls
2. Modulating the autonomic nervous system — acupuncture reduces sympathetic nervous system tone in the pelvic vasculature via beta-endorphin and serotonin pathways, producing vasodilation and increased uterine blood flow. This is the same mechanism through which acupuncture reduces high uterine artery impedance in women with fertility difficulties
3. Improving maternal nutrition and digestion — acupuncture at ST36 (Zusanli), SP6 (Sanyinjiao) and CV12 (Zhongwan) strengthens Spleen and Stomach function, improving the digestion and absorption of nutrients and thereby enhancing the quality of maternal Blood that nourishes the fetus
4. Reducing anxiety and stress — cortisol and catecholamines released under stress cause uterine artery vasoconstriction and reduce placental blood flow. Acupuncture modulates the hypothalamic–pituitary–adrenal (HPA) axis, reduces cortisol levels and promotes a calmer autonomic state, directly supporting placental perfusion
5. Supporting placental angiogenesis — research on kidney-tonifying and blood-nourishing formulae has demonstrated upregulation of vascular endothelial growth factor (VEGF) and improved trophoblast function. The acupuncture points BL23 (Shenshu), KI3 (Taixi) and CV4 (Guanyuan) tonify Kidney Qi and support the Chong channel’s nourishing function at the level of the placenta

Research evidence

The landmark study by Stener-Victorin et al. (1996) established that electro-acupuncture can significantly reduce uterine artery blood flow impedance (measured as pulsatility index) in women with high uterine artery resistance, improving uterine perfusion. This mechanism is directly relevant to placental insufficiency as a cause of FGR. Subsequent work by Ho et al. (2009) replicated this finding in a randomised controlled trial. A 2024 randomised controlled trial by Lai et al. published in the Chinese Journal of Integrative Medicine found that electroacupuncture in women with recurrent implantation failure promptly improved endometrial blood flow type and vascular distribution, confirming that acupuncture has measurable and clinically meaningful effects on uterine perfusion. A case report published in PMC (2025) described a woman with severe anaemia and thalassemia receiving TCM treatment with a therapeutic focus on nourishing Qi and Blood, tonifying the Kidneys and supporting gestational maintenance; the pregnancy proceeded to full term and resulted in the birth of a healthy infant, despite persistent anaemia throughout gestation — demonstrating the clinical potential of TCM in supporting compromised pregnancies.

6. Chinese herbal medicine for fetal growth restriction

Chinese herbal medicine provides daily support for fetal growth, nourishing maternal Blood and Kidney Essence continuously between acupuncture sessions. Prescriptions are individually tailored to the patient’s TCM pattern. Commonly used formulae and herbs include:

1. Shou Tai Wan (Fetus Longevity Pill) — the classical formula for Kidney deficiency in pregnancy; contains Tu Si Zi (Cuscuta), Sang Ji Sheng (Taxillus), Xu Duan (Dipsacus) and Sang Ji Sheng; tonifies Kidney Essence, strengthens Liver and Kidneys, stabilises the Chong and Ren channels and supports fetal nourishment. Modern research has shown this formula can improve uterine artery blood flow and support placental function. Note: this formula traditionally contains E Jiao (Donkey hide gelatin), which cannot be prescribed in the UK; a modified version substituting other blood-nourishing herbs is used
2. Ba Zhen Tang (Eight Treasure Decoction) modifications — the classical combined Qi and Blood tonic, used for Blood and Qi deficiency patterns; contains Dang Gui, Bai Shao, Shu Di Huang, Chuan Xiong, Dang Shen, Bai Zhu, Fu Ling and Zhi Gan Cao. Replenishes both Qi and Blood, strengthens the Spleen, nourishes the Liver and supports placental perfusion through improved maternal Blood production
3. Tu Si Zi (Cuscuta seed) — one of the most important individual herbs for Kidney deficiency in pregnancy; tonifies Kidney Yang and Yin, stabilises the pregnancy and supports fetal development; used as a primary herb in Shou Tai Wan and as an addition to many pregnancy formulae
4. Sang Ji Sheng (Loranthus / Taxillus) — strengthens Liver and Kidneys, nourishes the Blood and calms the fetus; one of the key herbs for both threatened miscarriage and poor fetal growth due to Kidney and Liver deficiency; supports the Chong and Ren channels
5. Shu Di Huang (prepared Rehmannia) — the principal blood-nourishing herb in TCM; enriches Kidney Yin and Essence, nourishes Liver Blood and supports placental function; fundamental in Blood deficiency patterns
6. Huang Qi (Astragalus) — the primary Qi tonic in TCM; strengthens the Spleen and Stomach to improve Blood production, supports immune function and has been shown in research to promote angiogenesis and improve microcirculation. Research on the Chinese herbal formula JLFC01 (which includes astragalus-type Qi-tonifying components) published in Placenta (2015) found it improved gestation by inhibiting decidual inflammation, enhancing angiogenesis at the fetal–maternal interface, increasing IGF-I and IGF-IR expression in the placenta, and promoting fetal growth in a mouse model of spontaneous abortion and IUGR
7. Dang Gui (Chinese Angelica) — the principal blood-nourishing and blood-moving herb; nourishes and invigorates Blood simultaneously, improving uterine circulation while replenishing Blood deficiency; an essential component of Ba Zhen Tang and many pregnancy blood-nourishing formulae. Used in carefully judged doses in pregnancy — blood-invigorating herbs are selected with particular caution

All herbs prescribed at this clinic are pharmaceutical-grade granule extracts supplied by Sun Ten (Taiwan), ensuring consistent potency and safety. Herbal prescriptions in pregnancy are selected with particular care, using only herbs with an established safety record in pregnancy and reviewing prescriptions at each stage of gestation. An online Chinese herbal medicine consultation is available for those unable to attend in person.

7. Diet and lifestyle advice

Maternal nutrition and lifestyle have a direct influence on placental development and fetal growth. The following advice is given alongside acupuncture and herbal treatment:

1. Prioritise blood-nourishing foods — in TCM terms, Blood is the primary substance of fetal nourishment. Dark leafy greens (spinach, kale), red meat (particularly beef and lamb in moderate amounts), liver, legumes, eggs, beetroot, dark cherries and mulberries all tonify Blood. Bone broth supports Kidney Essence. Walnuts, black sesame seeds and black beans tonify the Kidneys
2. Eat adequate protein — protein is the primary building block of fetal tissue; insufficient dietary protein is associated with poor fetal growth. Aim for at least 70 to 100 g of protein daily from varied sources including meat, fish, eggs, dairy, legumes and nuts
3. Take recommended pregnancy supplements — folic acid (or methylfolate if MTHFR variants are present), vitamin D, omega-3 fatty acids (DHA supports brain and placental development), iron and zinc are all important for optimal fetal growth. Low iron causes maternal anaemia, which directly reduces oxygen delivery to the fetus
4. Avoid smoking and alcohol — smoking is one of the strongest modifiable risk factors for FGR, causing vasoconstriction of uterine arteries and reducing placental blood flow significantly. Alcohol is also directly toxic to placental and fetal development
5. Manage stress and rest adequately — chronic stress elevates cortisol, which constricts uterine vasculature and reduces placental perfusion. Adequate rest, gentle exercise such as walking or pregnancy yoga, and stress-reduction strategies including mindfulness support optimal uterine blood flow
6. Avoid cold and raw foods — in TCM, cold foods and drinks impair Spleen function and Qi transformation, reducing Blood production. Warming, cooked foods are preferable during pregnancy, particularly in the second and third trimesters when Blood demands on the mother are greatest
7. Sleep on the left side — lying on the left side in the third trimester improves inferior vena cava blood return and uterine blood flow, and is recommended by obstetric guidelines for pregnancies complicated by FGR

8. Treatment at my clinic

I treat women with small baby and fetal growth restriction at my clinic in Wokingham, Berkshire. Treatment combines acupuncture with individually prescribed Chinese herbal medicine, taken daily between sessions to provide continuous support for maternal Blood, Kidney Essence and uterine circulation.

Treatment frequency depends on gestation and the severity of growth restriction. For women with a confirmed FGR diagnosis, weekly or twice-weekly sessions are recommended, always in parallel with obstetric monitoring. For women identified as higher risk for poor fetal growth — including those with a history of FGR, a previous small baby, chronic hypertension, uterine insufficiency or antiphospholipid syndrome — treatment can begin in the second trimester as a preventive measure. Treatment is always conducted in close collaboration with the obstetric team and does not replace conventional monitoring or management.

Related pages that may be of interest include healthy pregnancy support, morning sickness and prebirth acupuncture. Visit the prices page for treatment costs.

9. Frequently asked questions

Can acupuncture improve fetal growth?

Acupuncture cannot directly stimulate fetal growth, but it can improve the uterine and placental blood flow that delivers oxygen and nutrients to the fetus. Research has demonstrated that electro-acupuncture significantly reduces uterine artery blood flow impedance — effectively increasing blood supply to the placenta — which is the primary mechanism through which it supports fetal growth. It also reduces maternal stress hormones, which constrict uterine vasculature, and strengthens maternal nutrition by improving Spleen and digestive function.

Is acupuncture safe in a pregnancy with fetal growth restriction?

Yes. Acupuncture is safe during pregnancy when performed by a qualified practitioner experienced in treating pregnant women. A carefully selected set of acupoints is used, avoiding points that are contraindicated in pregnancy. In a pregnancy monitored for FGR, treatment is undertaken with particular care and in close coordination with the obstetric team. Acupuncture should always complement, not replace, the conventional monitoring recommended by your midwife or obstetrician.

When should I start acupuncture if my baby is measuring small?

If your baby has been identified as measuring small at a growth scan, starting treatment as soon as possible gives the best opportunity to support uterine blood flow and fetal nourishment during the remainder of the pregnancy. For women with a history of FGR or other risk factors, starting in the second trimester before problems arise is preferable. Early referral allows treatment to be established while there is still significant time to support placental function and fetal development.

Can Chinese herbs be taken in pregnancy for small baby?

Yes, with appropriate prescribing. Classical formulae for nourishing Blood and Kidney Essence — including modifications of Shou Tai Wan and Ba Zhen Tang — have a long history of use in pregnancy and are specifically indicated for poor fetal nourishment. All herbal prescriptions in pregnancy are individually tailored, selected only from herbs with an established safety record in pregnancy, and reviewed at each stage of gestation. Chinese herbal medicine provides daily support between acupuncture sessions, nourishing maternal Blood and Kidney Essence continuously.

Will I need to stay under obstetric care as well?

Yes, absolutely. FGR is a serious pregnancy complication that requires regular obstetric monitoring, including serial growth ultrasounds and Doppler assessment of umbilical artery blood flow. Acupuncture and Chinese herbal medicine are used as complementary support alongside this monitoring — not as a replacement for it. I work collaboratively with obstetric teams and am happy to communicate with your midwife, obstetrician or maternal–fetal medicine consultant about your care.

10. My Pregnancy Guide

11. References

Stener-Victorin E, Waldenström U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod. 1996 Jun;11(6):1314–7. PMID: 8671446.

Ho M, Huang LC, Chang YY, Chen HY, Chang WC, Yang TC, Tsai HD. Electroacupuncture reduces uterine artery blood flow impedance in infertile women. Taiwan J Obstet Gynecol. 2009 Jun;48(2):148–51. PMID: 19574177.

Lai YY, Liu LY, Wu YN, Huang L, Zheng XY, Gan D, Yu SY, Zhong Y, Liang FR, Zhou Y, Yang J. Immediate effect of electro-acupuncture on endometrial blood flow in patients with recurrent implantation failure: a randomised controlled trial. Chin J Integr Med. 2024 Apr;30(4):291–298. PMID: 38433155.

Kwak-Kim J, Yang KM, Gilman-Sachs A. Chinese herbal medicine for miscarriage affects decidual micro-environment and fetal growth. Placenta. 2015 May;36(5):559–67. PMC4395550.

Zhong Y et al. A case of severe anaemia in pregnancy treated with traditional Chinese medicine. Clin Case Rep. 2025. PMC12317101.

Chew LC, Osuchukwu OO, Reed DJ, Verma RP. Fetal Growth Restriction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. Updated August 11, 2024.

Unterscheider J et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound Obstet Gynecol. 2020;56:298–312.

Stover PJ. Blood support for fertility, pregnancy, and postpartum using acupuncture from ancient medical texts’ theory. Medical Acupuncture. 2019. PMC6918526.