# What is the 4th trimester?
You may not have heard of it but every parent and their infant will go through it.
The 4th trimester, is a phrase coined by Dr.Harvey Karp (an American paediatrician) describing the time immediately following birth and lasting up to 3-4 months post-partum when human babies are born less mature than other mammals and may need nurturing as though they were still in utero and when a mother is recovering from birth and transitioning into motherhood.
After the comfort and the warmth of being in the womb, life in the outside world is a shock to a newborn. During the 4th trimester, parents are encouraged to create a similar womb like environment for their baby just as they had experienced during pregnancy.
From an evolutionary perspective, it is believed that human babies are born with immature brains because if human babies stayed another 3 months in utero their brains would get bigger and their heads would not be able to pass through the birth canal.
Unlike other mammal babies who can stand and walk at birth, human babies are born with an immature brain and nervous system. The 4th trimester marks a time of significant physical, mental and emotional development for your baby.
#What can I expect from my baby during the 4th trimester?
Your newborn baby has gone from the warm, dark comfort of being inside the womb to a world of bright lights and extreme stimulation. They have gone from having close contact with their mother at all times to spending time alone and separated. Your baby has gone from having a continuous food supply to feeling hunger pains for the first time.
You can expect your newborn baby to be easily stimulated with lots of period of fussiness and crying during these first few weeks and months together as your baby adjusts to their life outside the womb. This crying and fussiness is a normal stage of infant development and you shouldn't worry if you are experiencing this. Your baby hasn't developed an internal clock yet and day and night can get mixed up with lots of feeding and awake time when you would like to sleep.
#How can I help my newborn baby adjust to life outside the womb?
During the 4th trimester babies need lots of attention to help them transition through this time. YOU CAN'T SPOIL A BABY. Contrary to popular myth, its impossible for parents to hold or respond to their baby too much. You may have been warned by well intended family members not to give in too often or respond too quickly to your baby to prevent you from spoiling them but this is simply not the case. Brain science and developmental research has shown us that young babies cannot consciously connect cause and effect. A young baby is not able to think to themselves 'I'm going to cry until I get what I want!'. We also know that young babies are not able to regulate their own emotions and feelings and are born entirely dependent upon their caregiver to help them to calm and soothe when experiencing big emotions like hunger, frustration, pain from colic or tiredness. When parents respond calmly and consistently to their young baby, particularly in the 4th trimester, they are helping to set up pathways in their baby's brain that controls how a baby will regulate their emotions throughout their entire life. Research has shown us that parents who respond promptly and consistently to their crying baby from birth have infant's who cry for shorter durations and periods at 4 months old.
#The 5 S's.......
I advise 4th trimester parents to think of the 5 S's when helping their newborn babies adjust to the outside world:
Skin to skin contact is the holy grail of activities to try for any new parent and their baby.
Skin to skin contact essentially involves placing a baby undressed (with or without a nappy) onto a parent's bare chest and then both covered with a warm blanket. Skin-to-skin helps a baby feel connected to a parent and will:
help a baby stay warm (temperature regulation)
regulate a baby's heart rate and breathing rate
help keep a baby's blood sugars stable
solve breastfeeding problems
calm and relax distressed or overwhelmed babies.
it is recommended that skin to skin contact takes place between a mother and her baby immediately following delivery for at least an hour (but don't worry if this can't happen). A parent, (mothers and fathers) can try skin-to-skin for as often and for as long as it feels right throughout the early days, weeks and months.
Swaddling is a traditional practice of wrapping a baby up gently in light breathable blanket to help them feel calm. Safe swaddling a newborn baby can help them to feel secure and contained especially during times when they are overstimulated. However, its important that parents follow the safe swaddling guidelines so as not to overheat their infant or restrict a baby's hips and knees from moving. Please see the NCT Safe Swaddling guidelines. before giving safe swaddling a go.
In utero, babies suck their fingers and this is made possible as the womb's soft walls deflect the baby's hands towards their mouth. Sucking is one of the baby's first reflexes and a baby will practice sucking in utero long before birth. If you gently stroke the edge of your newborn baby's mouth you will trigger this reflex and they will begin sucking. Unfortunately, after birth newborns can't suck their own fingers anymore because of poor muscle control and co-ordination. They might try but are more likely to hit their face with their hand rather than their mouth. Sucking for both nutrition (nutritive sucking) and for comfort (non-nutritive sucking) is magical for calming and soothing a young baby. When a baby sucks it has deep effects within the nervous system. Sucking triggers the release of calming chemicals from the brain. Research has shown us that when a new baby sucks their heart rate decreases, their blood pressure decreases and the baby calm's and settles. Sucking is also used following vaccines and other invasive procedures as a natural pain relief.
Breastfeeding babies should always be fed on demand and in the early days, some of their suckling at the breast will be non-nutritive as breastfeeding is established.
There is a wide debate over the use of dummies with babies. In my experience, using dummies with babies really depends on the baby. Some newborns are highly sensitive and require lots more non-nutritive sucking than others. Dummies can also give breastfeeding mothers a break and allow fathers to take over some of the nurturing. I would always recommend that dummies aren't used with breastfed babies until breastfeeding has been fully established (usually by week 6). I would also suggest that parents view dummies as being a tool to try for short periods and only when babies are particularly stressed. The other S's should be tried first and when a baby settles the dummy should be removed. It's best not to settle new babies to sleep with a dummy as this can set up problems later down the road but having said that sometimes as a parent you have to do the best you can and think about the consequences later down the track. For more information on the effects of dummies on SIDS please readhttps://www.lullabytrust.org.uk/safer-sleep-advice/dummies-and-sids/#:~:text=Dummies%20and%20SIDS%20Some%20rese
Your newborn has spent the last 9 months constantly moving in a gentle and rhythmic way and from birth is suddenly still for long periods of time. Re-creating this swaying and swinging motion with your newborn in the 4th trimester can help to calm and soothe them. Simply make sure that your baby's head and bottom is well supported and try placing them over your shoulder, cradle them or even place them on your chest as you sit and gently move from side to side in a rhythmic motion.
Sling wearing or baby wearing is simply the action of carrying a baby close against one's body in a sling or similar carrier. When you use this technique you are getting the benefits of skin-to-skin, safe swaddling and swaying all for the price of one! Research has shown us that baby wearing can reduce non-specific crying in young babies. The sling you choose has to be fitted well to avoid injury or even suffocation to the baby. Please read ttps://www.nct.org.uk/baby-toddler/slings-and-swaddling/everything-you-need-know-about-slings-and-carriers for more information on how to use a sling safely.
Nurture your newborn and nurture yourself!
The 4th trimester is a time of enormous physical, emotional, psychological and relational change for any parent. Making sure that you look after yourself is so important. Your baby relies entirely upon you and you can't give the best of yourself if you are exhausted and depleted. Every new parent needs to be nurtured just as much as a new baby does.
#Nurturing ideas for 4th trimester parents:
Give household chores to friends & family
Keep visitors to a minimum
When your baby rests you rest.
Drink plenty of water.
Nourish your body with wholefoods.
Spend some time outside every day (even for a little walk)
Spend some time each day concentrating on your breathing.
Practice daily 4th trimester affirmations.
Ask for help if you are struggling.
And remember, this too shall pass! By 3-4 months most babies have developed more regular patterns of sleeping and feeding, are less easily stimulated and things will begin to feel a bit more like 'normal'.
If anything in this article has struck a chord please get in touch via the forum on this website. I'm happy to answer any 4th trimester questions or point you in the right direction if its something that I can't help with. If you are a 4th trimester parents struggling please speak to your GP, midwife or health visitor.
I offer 1:1 perinatal support in person to families living in Sussex and Surrey and I can offer ZOOM consultations worldwide. You can email me email@example.com to arrange a FREE 20 minute consultation to discuss your needs.