Birth is the end of your pregnancy journey, but the beginning of a beautiful and overwhelmingly new reality with your baby. The fourth trimester is the transitional period between birth and approximately 12 weeks postpartum, during which your new baby is adjusting to the world; and you’re adjusting to your new baby. It is a whirlwind, but you and your baby can and will navigate it together.
Postnatal advisor and maternity nurse Katie Thomas has compiled her most essential tips and suggestions below, to carry you through the fourth trimester as smoothly as possible.
1. Be as prepared as possible
Write a list! Often when we are trying to accomplish everything, we end up doing nothing. It can all feel like too much, and this can completely overwhelm us. Getting your to-do-list down on paper immediately frees up the mind and can encourage a sense of calm and order. Perhaps prioritise your list, and enjoy slowly ticking things off as you do them in your own time. Also, make a list of things you need – this way when people ask if you need anything when visiting or checking in, you can very easily check your list and ask for something on it. People genuinely want to support a new mum, so please don’t be polite, be honest.
2. Expect a hormone rollercoaster
Pregnancy, birth and early motherhood cause dramatic hormone shifts for a woman. The ‘baby blues’ that usually start a few days after birth, peak around day 6 and taper off by the end of week 2, effects 70-80% of all mothers – with symptoms of feeling low, anxious, unable to cope, unable to sleep, crying spells, irritable and feeling overwhelmed. It is important to remember that this is completely normal, as are having feelings of pure and total elation alongside. Recovering from birth physically and emotionally while meeting the needs of a highly dependent and irregular sleeping newborn, can result in some huge overwhelm and fragility. If after the first 2-3 weeks your baby blues have continued and deepened, if it’s preventing you from meeting your own or your baby’s needs, it’s important you seek support and get some extra help. Postnatal depression effects 10-20% of all mothers – medication and therapy are available, early detection and intervention is crucial.
3. Accept help
Whether you have help pre-booked or on call, it is really important to have family, friends or professionals that you trust to call on for support and guidance when you need it. Delegate house work and meal preparation, prioritise sleeping when you can and self care; as simple as a daily shower and putting on your favourite show while feeding. Your loved ones will want to help, please let them. As they say – it takes a village to care for a new mum and baby, you’re never alone, bring in your tribe when you need them.
4. Dealing with conflicting advice
Everyone has an opinion when it comes to babies, and knowing how to filter the overwhelming noise can be one of the biggest challenges of parenthood. Books, google, social media, hospital staff, family and friends may overwhelm you with their conflicting advice and opinions. Well-meaning but misdirected or irrelevant advice can make new parents feel inadequate, try to trust your gut and follow your instincts. If you can, find one or two trusted people you can turn to for guidance and filter out the rest.
5. Good food, hydration and rest
Healing your postpartum body and mind requires regular nutritious meals, continuous hydration and ample rest. You’re experiencing a huge amount of change in a short time, so it’s important to slow down. Sunshine, fresh air and a gentle walk can turn everything around, as can turning the lights down, getting cosy and having some skin to skin in bed – listen to your own needs. It’s helpful to master the prioritisation of your time; newborns sleep a lot, but it can feel like you have no time to yourself as after feeding and settling your baby there are a million things that need to done. Be kind and gentle with your mind and your postpartum body, everything and everyone else can wait.
6. Focus on establishing feeding
Feeding your baby is one of the most important skills to master over the fourth trimester period. New babies grow at an exceedingly fast rate, so getting the hang of feeding effectively is essential. If breastfeeding, remember it is a learning curve for both of you and can be fraught with pain, damaged nipples, latch or low milk supply issues, breast pumps, creams, shields and often a lot of anecdotal advice from well-meaning friends and family. You must get the support you need, from the right sources, and at the end of the day please remember – fed is always best.
7. Differentiate day and night
Like everyone, babies have a circadian rhythm, this is a biological process or body clock that cycles about once every 24-hours. When they are born however, their internal clock isn’t synchronised with the external 24-hour cycle of the sun; meaning day and night means nothing to them. It takes time and guidance from us to gently teach the day and night differences of our social world. Lots of natural daylight, eye contact and engaging during the day vs darkness (or low/amber light) during the night will help with this process.
8. Feed and wake schedule
A predictable routine is generally not achievable for the first few weeks or even months, and is a personal decision to implement or not. Being conscious of age appropriate awake times and ensuring your baby is feeding enough during the day, can be really beneficial to having a calm and content fourth trimester and beyond. It will help to ensure your baby isn’t getting overtired or snacking and catnapping day and night, as well as creating a predictable rhythm to assist in keeping baby settled. If and when you feel ready to implement a routine, seeking personalised guidance from a postnatal advisor is invaluable.
This is one of a baby’s main forms of communication, knowing that crying is normal and expected is an important point to understand as new parents. A baby’s cry can feel absolutely gut wrenching, especially to a vulnerable and exhausted mother riding the wave of hormones. There is an indescribable urge to comfort that little baby, and not knowing why they’re crying or how to settle them can feel extremely overwhelming. It takes time and a lot of practice to expertly decipher a cry. Using a process of elimination to figure out what your baby is needing, is a good place to start. Some examples of why they could be crying are: hungry, tired, overtired, over-stimulated, under-stimulated, cold, hot, wind, pain, dirty nappy, need a cuddle!
10. 5 S’s
A great tool to help with newborn settling, initially coined by Dr Harvey Karp, an American paediatrician whose settling technique mimics the womb environment; providing comfort, safety and reassurance for your newborn. The 5 S’s are Swaddle, Side, Swing, Suck, Shhh – these techniques can be used all together or on their own, to help settle your overwhelmed or over-stimulated newborn. Moving away from social situations and into a darker room can help during these periods too, by reducing stimulation and sensory overload. Skin to skin sessions, and swaddling for all sleeps have also seen considerable shifts in the contentedness of babies.
11. Go to the appointments
As challenging as it can be leaving the house, it’s really important for your physical and mental health and healing to have your postpartum checks. See your midwife or obstetrician when appropriate, visit your GP to ensure your levels (iron especially) are all stable, go to a pelvic health physio before commencing any exercise or if you have any concerns, reach out to a lactation specialist if you’re struggling with breastfeeding, contact a postnatal advisor for guidance and support – discuss openly what you need with the right professionals. There is always help available.
Remember, this too shall pass – try to keep the fourth trimester as simple and calm as possible. Stay mindful and try to focus on the small, wonderful moments. It is such a precious time that you can never get back, and as difficult and demanding as it may feel when you’re in it, you will miss it.
Katie’s comprehensive Guide to Healthy Sleep is full of detailed and practical sleep support and tips and tricks. Katie offers an invaluable postnatal advisory service, providing guidance and support for a calm and content fourth trimester and beyond. Contact Katie for more info.