What is the fourth trimester?

It’s not uncommon to hear about a fourth trimester. It relates to the baby’s care after they’re born - from birth until they’re three months of age. It's important not to confuse this with another three months of pregnancy!

It’s not only the baby who needs to be considered in this three-month window of time but the new mother as well. In the fourth trimester nurturing a mother is just as important as for the new baby, though in the whirl of adjusting to parenthood mothers often miss out.

What is the fourth trimester?

The fourth trimester is the first 12 weeks of a newborn’s life. The term ‘fourth trimester’ was named by an American paediatrician, Dr. Harvey Karp. In his experience, there are benefits in replicating the same kind of environment for newborns that they are accustomed to in the uterus. This helps them to transition to life outside the womb and be calmer and generally more settled.

The fourth trimester doesn’t stop the day a baby turns three months of age. For all sorts of reasons, some babies need a little more ‘newborn’ nurturing beyond this age. Prematurity, sickness, failing to thrive and feeding problems can all mean delays in development.

Ways to support your baby's adjustment

According to followers of the ‘fourth trimester’ it’s important for parents and caregivers to look for the baby’s cues around what they want. Being sensitive and tuned in helps babies to feel secure and safe.

Soothing strategies in the 4th trimester and beyond

Every baby will have their own preferences for what they like when they’re unsettled. However, there are a few things most babies respond to when they’re crying:

• Young babies often calm when they’re sucking and breastfeeding – this is one of the first principles of calming in the 4th trimester.

• Holding and rocking - because for the duration of a mother’s pregnancy, babies become used to feeling warm and secure.

• Babies also tend to soothe when they are spoken to in a gentle and nurturing way. Common language used by parents are “shsh” or “shsh now”. White noise is another option, but remember to keep the volume low.

• Newborns also like to be swaddled in a cotton or muslin wrap.

Expect times when your baby won’t settle and just needs to be held.

When a newborn won't settle, it can help to:

• Hand the baby over to another responsible adult and have a break.

• Give the baby a deep warm bath and tummy massage. Once they’re calm, offer another feed.

• Put your baby in a pouch/sling and take them for a walk outside. Another tip is to push them in their pram or take them for a drive in the car. Movement often helps babies to calm.

• Offer a pacifier (dummy), but make sure breastfeeding is well established before introducing one.

• Wrap/swaddle your baby so they feel secure. Enclose their arms and legs but allow for their knees to bend in a natural way.

What about mummy?

The fourth trimester can also be a reminder for new mothers to care well for themselves and focus on their health.

You can do this by:

• Eating well – healthy nutritious food and limiting processed food have a direct effect on energy levels. You’ll need to eat food which fuels your energy, especially if you’re breastfeeding. Low GI (glycaemic index) foods like wholegrains, cereals, nuts, meat and eggs, vegetables and dairy foods are ideal.

• Resting and sleeping whenever you can – this can be easier said than done, but you need to prioritise your sleep as much as possible.

• Saying yes to all reasonable offers of support.

• Avoiding extra stress and saying no to what can wait. This isn’t the time to plan a renovation, move house, start a new job or take on a project. Aim for a simple life for the first few months after your baby is born.

The fourth trimester and beyond

Supporting your baby through the fourth trimester does not mean you’ll need to quarantine yourself to your home. It’s important you maintain your social connections and do things which bring you joy.

As much as you may have thought one small person couldn't change your life too much, the reality is that becoming a parent is a huge life event. Adjusting to becoming a parent can often take up to a year.

Be kind to yourself and your baby. Try to view the first three months after having a baby as a time for adjustment. You and your baby will both benefit.

Written for Huggies by Jane Barry, Midwife and Child Health Nurse, 14/04/2022.