The Fourth Trimester

The Fourth Trimester is the first 3 months of your baby’s life. It is particularly important as it is a time when your baby is adjusting to their new environment and you, as parents, are learning to understand how to meet your baby’s needs. As with all relationships, this doesn’t usually happen straight away; parent and baby have to learn to communicate with each other and build up their understanding.

These first 3 months can be challenging. For parents, you are learning to adapt to having a new baby in the family and battling with exhaustion. If you’re a mum, you are physically healing and managing hormones which can be all over the place. If you are breastfeeding you can feel sore and worried that your baby isn’t getting enough milk and you are also learning to step in to a new role which, for some parents, can be a real struggle in terms of self-identity. Responsibility for this new human being can sometimes be overwhelming, but understanding what is normal and how to meet your baby’s needs can really help.

Whilst your baby is in the womb, they feel warm, secure, fed and reassured. All their needs are automatically met. They do not need to wait for you to respond because you are there all the time. At birth, they are suddenly taken away from this environment to one which is bright, noisy, cold and for the first time they can feel hunger. This is completely different to what they have become used to. No wonder it takes a while for them to adjust to the new environment they now find themselves in. For you, as a parent, the birth can also be a traumatic time in some instances.

At birth, your baby will recognise their mum’s scent and also recognise your voices. Just being near to you at the birth can be really reassuring for your baby. Even if your baby has had to have some medical intervention, once they are stable, and you can be with them, it isn’t too late: they will still recognise your voice and you can ask the midwife/doctor if you can do some kangaroo care, which is carefully controlled skin-to-skin contact. Kangaroo Care has been shown to make a real, positive difference to a baby’s emotional and physical development and wellbeing and as a parent can help you to feel involved and to start early bonding and attachment.

You may find at 5-6 weeks, your baby is crying for long periods of time. This is totally normal and will pass, usually around the 3-week mark. You are not doing anything wrong and it’s not because your baby doesn’t love you or like being with you – it is just their way of starting to communicate to make their needs known.

During the 4th Trimester, you will need to go with the flow. Feed when baby ‘asks’, let them sleep when they need to, have some interaction time when they are alert and engaged and have lovely snuggles when they need to rest and quieten. There is no need to have a fixed routine for these first 3 months and no, you can’t get into any bad habits. Sway, walk around the room if they need soothing or demand feeding. Use slingwear and have lots of skin-to-skin contact. If you feed your baby to encourage them to sleep, or they naturally fall asleep during eating, this is all positive. You can change these associations if need be as your baby gets older, but at the moment just do what you need to do.

Parents are often told to let baby cry rather than respond straight away, that the baby, if left, will soothe themselves to sleep. The problem with this is that during these early months (and continuing for even longer than this) your baby is reliant on you. When they cry there is a reason and they need to have reassurance to manage those feelings. By responding promptly, but calmly, your baby will start to learn that you are there, that they don’t need to panic and that you will help to soothe them and to be present. Over time, your baby will come to understand that they can depend on you and you will see them feeling secure and safe. You should try and avoid coming across as anxious and upset as your baby will pick up on this, but it takes time and as a parent you need to grow in confidence too.

During this period, the neural pathways and nervous system is developing rapidly. When you respond to your baby, synapses start to become ‘alive/alert’. When we do something over and over again, these synapses make connections. When you give a cuddle, feed when your baby is hungry or help them to sleep, just keep repeating this. In time, your baby can relax knowing you are there for them and they can rely on you.

If your baby is showing signs that they need close contact with you, Sling Wearing can be a great way of meeting this need and freeing up your hands as well. It mimics the time when they were in the womb, so brings a sense of familiarity and love. For more information, and for some guidelines about Sling Wearing (known as TICKS), take a look at my 2022 blog post.

Babies can really struggle with their sleep, again because they have lost restricted movement and warmth from inside the womb. Swaddling can really help with this and can also prevent the startle reflex, or ‘sleep starts’, which can occur as baby drifts off to sleep. They are completely normal, but it can jolt baby awake. Fortunately, the startle reflex usually settles around the 6 month mark.

If you are swaddling:

• Make sure you follow ‘Healthy Hip Guidance’ to prevent hip dislocation and dysplasia.
• Your baby’s head and face should be uncovered.
• Use a thin cotton sheet or muslin and make sure knees can move freely with the hips being able to bend upwards and outwards.
• Avoid wrapping too tight across the chest.
• You must always stop swaddling as your baby starts to show signs they are going to roll and, as with all sleep positions, babies must always be put to sleep on their backs. For Safe Sleeping Guidance, including Safe Co-Sleeping, please visit ‘The Lullaby Trust’.

During the 4th trimester, babies should be given regular Tummy Time, which must always be supervised. You should repeat this several times a day for a few minutes, building the time up as your baby becomes more familiar with the position. Nappy Change times can be a good time to do this. Tummy Time helps build the strength necessary for being able to hold their head up and control their movement for sitting and crawling. As they start to roll onto their front, they are able to lift their face up from the mattress or floor which allows them to be able to turn their heads to one side.

Finally, accept help from others, even if it is just for a short period. It can allow you to rest, get something to eat, have a shower and get a few moments to yourself. Try not to worry about housework, for example. If you have a family member or friend who can do this for you for a short time, grab the offer with open arms! Self Care is so important.

Try and get some fresh air every day and eat regularly, making healthy choices where you can (chocolate of course doesn’t count! 🙂 There are also organisations who can help if you are feeling low, depressed or anxious. Reach out and let others know how you are feeling. Take it a day at a time and remind yourself how well you are doing: pat yourself on the back if no one else is around to do this for you. Treat yourself with some nice smellies for a bath/shower or anything that brings a smile.

If you would like further support and advice on this period please contact Julie to see how she can help.