Life in the Fourth Trimester

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Enjoying newborn Eleanor snuggles

You may have heard of the fourth trimester. Basically, it’s the idea that the first 3 months of life are very much an extension of life in the womb for baby. Baby has spent 40 weeks (or there abouts!) having her every need attended to. She never knew hunger, was always rocked, and could always hear mama’s heartbeat. Given that, it seems pretty unrealistic to expect a newborn baby to adjust to life on the outside instantly. That’s why attempts at scheduling a newborn or unrealistic expectations about sleep frustrate parents more often than not.

I’m certainly not a child rearing expert. But what I’ve found to be true (and what many I know have found as well) is that your best bet in the fourth trimester is let go of your need to schedule and instead follow your baby’s cues. I am very much a type-A personality – a huge planner. But I made a conscious effort with Callum to let go of the need for certainty and control. I followed his cues about about when he needed to eat, when (and where!) he needed to sleep, when he needed to be held, and so on. As a result, I was a much more relaxed and happy mama and he was a more content and happy baby!

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On the go watching big brother play

Things are a bit different this time around – chasing a toddler around while caring for a newborn makes things a bit more interesting. While it’s true that I don’t have nearly as much time to simply stare at Eleanor and marvel at her presence, I have found that my fourth trimester “rules” are even more important to keep in mind as I juggle the needs of two children.

So what are the keys to life in the fourth trimester?

Give Lots of Snuggles:  Babies are born used to the daily rhythm of mama’s movements.   So it makes sense that they would protest at attempts to transition them suddenly to a stationary object like a crib or bassinet.  The popularity of baby swings and bouncers attests to the universal need babies have for motion.  Swings and bouncers certainly have their place but nothing substitutes for mama’s (or daddy’s) arms.  As much as new parents would love to just sit and hold their newborns, that’s certainly not realistic (especially if you happen to have one of those toddler creatures running around).  Enter the baby carrier.  Mama gets her hands and mobility back, baby gets snuggled and rocked – everyone is happy.  Few things calm a fussy baby as well as being worn; the upright tummy to tummy position provides much relief to babies suffering from reflux or gas (more so than the semi-seated position of bouncers, swings and car seats).  You certainly don’t have to wear your baby 24/7 to reap the benefits, but a good carrier (see our recommendations for newborns) is a must have for the fourth trimester and beyond.

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Staying close while Mama works

Feed on Demand: Regardless of how you feed your baby – breastfeeding, pumping, formula or some combination – feeding a newborn on demand is key not only to baby’s happiness but also to baby’s growth and well-being.  Just like adults, babies calorie needs change from day to day; during growth spurts, babies will need to eat more and more frequently.  Instead of counting ounces or watching the clock, learn to watch your baby for hunger cues.  And don’t be surprised if your newborn wants to eat an hour or less after her last feeding.  Newborns have tiny tummies!  If you are breastfeeding, this on demand feeding is crucial in the early weeks.  Breastfeeding is a supply and demand business; nursing often is key to building a good breastmilk supply.  Newborns are also notoriously slow and lazy nursers so it may feel like nursing is all you are doing in those first few weeks.  They will get faster though!  In the meantime, enjoy the extra opportunity to rest and snuggle.  One exception to the feed on demand rule – newborns need to nurse every 2-3 hours around the clock until they regain their birth weight.  This may mean you need to wake them to feed as brand new babies can be very sleepy (particularly if they are at all jaundiced).  Once they hit birth weight, you can let them go longer stretches although you may want to avoid letting them go too long during daytime hours in order to avoid extended night wakings.  Kellymom.com is a fantastic resource for breastfeeding mamas with lots of good info on the importance of on demand feeding.

Let Go of Sleep Expectations: Sleep is probably the number one concern of new parents.  It seems like the first thing anyone asks a new mama is “Is baby a good sleeper?”  My favorite reply is “She sleeps like a baby” – delivered with a smile of course.  And by that I mean she wakes several times throughout the night to eat or just to be reassured – and that’s completely normal.  Meredith Small’s Our Babies, Ourselves Life in the Fourth Trimester gives an interesting perspective on sleep expectations in Western cultures.  She contends that babies are biologically hardwired for night waking and echos the work of sleep researcher Dr. James McKenna and others who have shown that safe co-sleeping and bed sharing practices actually reduce the risk of SIDS (see Holly’s excellent post on bed sharing for more info on how to create safe shared sleeping spaces).

Small also discusses cultures that not only share sleep spaces but who also wear their children for much of the day.  Many parents express a concern over “getting baby to nap in the crib.”  Not that it’s bad for baby to nap in the crib, but it’s also not bad or wrong for baby to nap while being worn.  Even if you aren’t on board with rocking your year old to sleep or wearing your 10 month old for naps (and there’s nothing wrong if you are on board with those things; in fact, I’d argue they are quite normal!), wearing or holding your baby for sleep in the fourth trimester isn’t going to create “bad habits” that can’t be broken.  Babies need to sleep and babies sleep best snuggled up to loving caregivers.

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Callum and Eleanor having a chat

Of course, mama needs to sleep too – and that’s where much of the concern over “sleeping through the night” comes from.  Adjusting your expectations about sleep may also mean changing some of your sleep habits.  If baby has her longest stretch of sleep from 8pm to midnight – maybe you need to adjust your own bedtime temporarily to take advantage of that.  Sharing a sleep space can also help with mama’s sleep deprivation since it cuts down on the amount of time mama has to be awake and most likely will help baby sleep longer stretches too.  It also helps to remember that this stage won’t last for ever.  All babies will sleep longer stretches eventually.  If you let go of the expectation that your baby should sleep 8 hours or more straight by 2 or 3 months, it’s a little easier to handle those night wakings; it felt much better to me to consider my baby’s behavior as “normal” instead of trying to figure out what I was doing “wrong.”

Think About Routines Instead of Schedules: Just because you’ve decided to follow baby’s cues doesn’t mean your life will be devoid of order.  Babies are pretty good at falling into a routine and there are simple things we can do to encourage that development.  Many newborns are born with their days and nights confused (makes sense when you consider they spent their days in the womb lulled to sleep by your movement and nights more awake when you were sleeping and still).  You can nudge them towards sorting out their sleep habits by keeping things dark and quiet at night (during feedings, diaper changes, night wakings, etc.) and bright and “noisy” during the day.  I don’t blast the Beastie Boys while Eleanor is napping (ok, that might have happened this morning) but we don’t make a big effort to stay quiet during the day.  This has the added bonus of making her able to sleep almost anywhere and through anything (at least when she’s worn) – particularly handy when you need to be out and about with your toddler.  All babies will have different tolerances for noise levels of course, but in general you can be “louder” during day sleep.

Many babies respond well to a bed time routine.  While your newborn isn’t going to have a set in stone sleep schedule or bed time, you can incorporate the same nightly rituals into your evenings – maybe a bath or massage or favorite book or lullabies.  Remember too that many babies will have an evening “witching hour” – these calming rituals can help alleviate that.  Many newborns will also want to cluster feed in the evenings so take that into account when thinking about your own evening activities – a good book or catching up on your Netflix might be the way to go.  For more information infant sleep, we like Elizabeth Pantley’s The No-Cry Sleep Solution Life in the Fourth Trimester .  It’s worth reading when you have a newborn to better understand what is normal in infant sleep.

Some parents are big fans of routines that demand baby eat, play, sleep in a particular order (the concern being eating should never lead to sleeping).  I’m more in the “mother nature made nursing sleep inducing for a reason” camp – if Eleanor falls asleep nursing – fine.  If she doesn’t, that’s ok too.  Better to read baby’s cues and not try to force a particular order of events.  It is helpful to watch for baby’s tired signs and help her back to sleep before she becomes overtired (and therefore less likely to sleep).  For early fourth trimester babies, the entire “wake” period may be consumed by eating so trying to prevent them from falling asleep on the breast seems especially silly.

Don’t Worry About Creating “Bad” Habits: Yup, it’s true – you can not spoil a newborn!   No matter how much you rock, cuddle, wear, or hold your baby, she is going to turn into an independent little person.  Children are not spoiled by love and affection; they thrive on it.

The fourth trimester is a time for mama to heal and for a newly expanded family to get to know one another.   Some mamas refer to this time as a “babymoon.”  Much like a honeymoon for newlyweds, the fourth trimester shouldn’t be about schedules or expectations.  Instead it – and our babies – should be greeted with patience and wonder.

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17 comments to Life in the Fourth Trimester

  • Sara

    Thanks! I needed to read this. My 3 year old is very routine driven, so I really do need to make sure that his schedule and routine stay as consistent as possible, or else we end up with a monster on our hands. And I feel like my 2-month-old gets the short end of the stick because of it. He does sleep with us because he absolutely WILL NOT sleep in his crib. Only sleeps more than 45 minutes at a stretch if he’s being held or worn. But…that’s the way babies are. And i need to remind myself of that and enjoy the snuggles more :-) And not get too frustrated by my lack of sleeping. (Unfortunately the time that he sleeps best is from about 5-8 am. I need to get up between 6-6:30 to get my toddler, so I can’t take advantage of sleeping during the baby’s good sleep time…) This too shall pass. And until then, I relish every smile, coo, grin, and snuggle from the baby!

  • Susan

    Good article! It would have been good, though, to include warning signs of Post Partum Depression. PPD detection and intervention can help a new mother during this very important time.

    • Meredith

      Excellent point – definitely an important topic. As I don’t know much about it myself, I’ll need to do some research and a follow up post. Thanks for the suggestion!

  • @crunchymommy73 @MamatotoDoula said on twitter that they loved your article. I just had to have a look and I love it too. Full of sensible, practical suggestions to make the early neonatal experience a joy filled, peaceful one. I love the fact that you are a self confessed control freak, and yet still manage to follow your baby’s cues so thoughtfully, that is just a joy to see. Your baby wearing suggestions are ‘spot on’ and so supportive of optimal brain development. Thank you for a great post. I look forward to seeing your update on PND etc, your writing style is so easy to read.

  • stacy h

    Good post! I like the idea of thinking about it like a 4th trimester. It’s very true. The only thing I’ll add is if planning on going back to work within that first 6 months, to make sure and have a provider able to do the things you have been doing(babywearing, especially). It is really difficult for everyone(baby, provider and parents!) if they are unable to do those same things baby has become accustomed.

  • Great post! I still have a lot to learn about the “4 trimester” but you’ve summed up a lot about what I’ve read! :)

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  • This is a great article. I am training to be a postpartum doula and this website has great information for the fourth trimester. Its definitely something i can share with new parents.

  • Great common sense piece – I prefer to discuss “patterns” when it comes to normal newborn behaviour. Patterns or routines both suggest parent driving them and also some rigidity. The 4th trimester is about patterns that develop as we learn from and about our baby. It is about learning to read our baby instead of books, because our baby will show us IF we are prepared to be aware, pay attention and learn.

    As far as patterns go too – we as adults may have some patterns to our lives, but when it comes to the basics of eating – we are most likely grazers – sometimes we eat heaps, pick a little and hopefully randomly drink plenty of water. Babies are random in this respect – just as we are.

  • Katie

    Thank you for your piece! My little guy is 11 weeks old, and I really enjoyed it! ,made me feel like I’m actually doing things right and I shouldn’t stress so much..

  • Naomi

    Yep, very reassuring for a FTM with a one month old. Thank you ;)

  • Lisa valentine

    This is fantastic and a must for any first time mum. Thank you :) my instincts tell me to follow this advice so we should do what comes naturally more often rather than trying to control our little ones

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