Fourth Trimester in a Nutshell

Fourth trimester? Is that a thing? Well, you are not alone, I didn’t have a clue it was a thing until my first baby came along and I wished I had read more about it beforehand (which I did for my second -yeii). Knowing and understanding what the fourth trimester is, was such a blessing, that is why I’m writing this blog: sharing is caring :) The fourth trimester is basically the first 12 weeks of your newborn baby. This term was popularized by Dr. Harvey Karp who suggests that babies are born too soon. You might be thinking “are you kidding me? TOO SOON?” I know, for many moms the last month of pregnancy is a nightmare (for saying it lightly)… heartburn, hip and back pain, puffy ankles, stretch marks, and peeing every 2 hours don’t make it easy. But, if given the choice, babies would definitely stay inside the womb for a few extra months. Your baby’s head is so big that you have to give birth after 9 months, even though she/he is still tiny, immature, and helpless. As a result, she/he isn’t quite ready for the big, wild outside world. Think of the fourth trimester as a transition period for you, your baby, and your family. During this period, you should think of your baby as a fetus outside the womb (Dr. Karp suggests). 

What can you expect?

It’s not like in the movies! After having 2 kids, I realized everyone idealizes those first months. Yes, they are beautiful, you finally get to hold your little bundle of joy and they are tiny, cute, and squishy and you love them deeply…. But it is stressful, frustrating, and exhausting at the same time. During these first weeks, you can expect a fussy, crying, and clingy baby. Newborns cry A LOT, they are learning to adjust to the cold world and cannot even understand what they need. You are not doing anything wrong and you are not alone. Naps might be short, as short as 20 min; and feedings might be long, as long as 1 hour; your breasts will more likely be sorrow  (breastfeeding is a whole different blog, wait for it); and you may want to cry here and there. 

You might be asking, so what can I do to have a less fussy, crying baby? Well, let me tell you that no matter what you do, your baby will have her/his moments, and IT IS FINE! However, there are things you can do to give your baby a helping hand…  I’m a nerd and have read a ton about it. From all of what I’ve read, there have been 2 approaches I found really interesting, and I want to share them with you. In the end, I will let you know what I did and what I would do differently. The first one is Dr. Karp’s 5 S’s, and the second one is known as the points of reference (widely used in the Montessori community).

Dr Karp’s 5 S’s 

1. Swaddling refers to bundling a baby in a burrito type of wrap, mimicking the snugness they experience in the womb and reducing the startle reflex. Keep in mind that swaddling is temporary and should be stopped once your baby rolls over. 

2. Shushing is about the whooshing sound of blood rushing in utero, which takes your baby into a state of relaxation. You can mimic this sound with white noise, which is especially useful during naps and bedtime. 

3. Swaying motion… let’s get real, you were your baby’s on-the-go swing for 9 months. During 9 months your baby was constantly and gently rocked at a perfect pace. A glider or a swing could mimic this motion and give a helping hand.  BEWARE! some babies are not fooled by it and rather be worn by mom, whose rhythm is just perfect. 

4. Side/stomach position refers to holding your baby by holding them on their side or placing them over your shoulder as if they were on their stomach. This should be done only to soothe a fussy newborn while the caregiver is supervising. Remember that babies should always be placed on their backs for sleep.

5. Sucking is a reflex, and pacifiers can help a newborn self-sooth. However, if you are breastfeeding, you might want to wait until week 8 when breastfeeding is well established to avoid nipple confusion. During that time, you might be a human pacifier (I know, sounds terrifying!). 

Points of Reference

On the other hand, the point of reference are the memories that a newborn has from the womb. These points of reference include familiar sounds, smells and movements. Allowing your baby to keep and access them after birth will comfort your little one and support her/him to have a smooth transition to the world while they develop new points of reference. The following are some points of reference: baby’s hands, mom’s voice, free movement, mom’s smell, and mom’s heartbeat. How can you support those?

1. Their hands – it means no (or little) swaddling or mittens – contradictory to the 5s’s right? Swaddling is great for the startle reflex, but newborns are constantly looking for their hands and bring them to their face as they did in utero (point of reference). 
2. Freedom of movement – again, no or little swaddling, no baby swings/bouncers and as little time in containers as possible, given that these restrict movement and don’t support any other point of reference. As few clothes as possible but making sure your baby is warm. This will allow your baby to start having sensory experiences and getting familiar with the new world – side note: it also includes no socks as their feet are a great gateway for sensory exploration (more about this on future blogs). 
3. Mom’s voice – your baby heard you talking all the time while you were pregnant, and your voice is soothing. Talking to your baby using real rich language as you were doing it before she was born is a great way to support them. Talk to your baby about what is going on around them, talk to them before you pick them up, change them or wash them, let them know what will happen next. 
4. Mom’s smell – your smell was their first smell… avoid using perfumes and hold your baby skin to skin. A great tip here is that you can sleep with your baby’s blankets, swaddles, sheets before they use them, that will 100% calm your baby (I know it sounds weird)
5. Mom’s heartbeat – hold your baby skin to skin and wear them. Spend as much time snuggled up against you as possible… time flies!

Now, let me tell you what I did with my two kids… to be honest, I didn’t follow either approach 100% I kind of personalized them to what made sense to me and was functional for my family. I didn’t swaddle but did wrap their chest a bit tight to help them feel snuggle, leaving hands free for them to touch their face. Yes, they had a scratch here and there, but they did so in utero as well! (This is my youngest kid, she sleeps with her hand covering her face lol).

I wore them as much as I could, and skin to skin as much as I could, keep in mind you are not going to spoil them during this rough phase, which is always a concern. White noise? With the first one I didn’t do it at the beginning, but then I started and what a blessing for sleeping!!! Pacifier after 8 weeks; I had a rough breastfeeding journey, otherwise I would have introduced it before. Mom’s voice; I usually talk non-stop so I continue doing so to them, and they seem to like it… first smiles came while I was narrating a bath with one and a diaper change to the other 😊 Side story (that I love): both of them stopped crying when they were born as soon as I sang to them (and my voice isn’t pretty). In addition, to help my babies develop new points of reference and smoothly adjust to the wild world outside the womb; I created simple routines around daily activities such as napping, sleeping, playing and nursing.   

So, to wrap up: the trick is to mimic the womb… soft red light or dark to sleep, keeping them warm, tight and full of rhythmic sensations: the sound of our blood pulsing and rushing through our body, the bouncy motion, and the constant cuddle of the amniotic fluid. There is no way a newborn baby will enjoy bright, quiet, and/or staying still. I know you might have worked so hard on having the perfect nursery, and you have mobiles, toys, bouncers, swings, etc… but truly, during this time, they only need YOU, they will get to use all of that after. During the fourth trimester give yourself a break, you won’t spoil your baby even if you hold her 24/7, if she cries it’s not your fault, if she doesn’t sleep it is normal, if you feel exhausted you are not alone…  just think 12 weeks is nothing compared to a lifetime of happiness (until the “terrible two’s come along lol)

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Disclaimer: This is not professional or medical advice of any kind. Please see your health care provider for any guidance. This is me sharing my personal experience.