As all expectant mothers know, pregnancy consists of three ‘trimesters’ or periods, each lasting about three months. The ‘fourth trimester’ describes the period from birth until your baby is three months old. It was first defined by British obstetrician Sheila Kitzinger in the mid-1970s:
there is afourth trimester of pregnancy that many mothers neglect. The fourth trimester is a period of transition, about three months after the birth, when many women are emotionally very vulnerable, experience hopelessness, anxiety and reactive depression, especially after the first baby.â 1
Recently, the term has been popularized by American pediatrician Dr. Harvey Karp and articles have been published pointing out that the fourth trimester is challenging for babies and mothers:
if they could choose, babies would prefer to stay in the womb for a few more months. So, for the first three months after birth, in the fourth trimester, you should think of the babies as fetuses outside the wombâ¦â
In the fourth trimester, it is possible that your baby will cry out in discomfort and you will be very tired. Newborn babies are learning to adapt to life outside the womb, which is warm and cozy! Combine the baby’s constant crying and short naps with your tiredness and it is natural to feel exhausted during this period.
although sometimes exhausting, the first weeks of parenthood are an exciting and loving process of getting to know your newborn baby and experiencing this time with your family and friends. You will experience the tremendous rewards of seeing your baby’s rapid development and begin to understand its personality. Being mentally and practically prepared for the fourth trimester will help you and your partner meet the challenges, adapt to your new role as parents and enjoy this special time
Sensory and social development of the newborn
Your baby was born completely helpless. Unlike other single-born mammals that can lean on or hold on to their mothers for the first hours of their lives, the newborn cannot even support its own head. It relies completely on you to provide for all its needs.
Your newborn baby’s brain grows at an incredible rate of 1% every day for the first three months of its life. 2 By the end of the fourth trimester, he or she will not only be able to lift his or her head, but will also be smiling and making his or her first contact with you. At the beginning of motor skills, the baby will be able to grasp things and kick their legs and follow and reach their eyes with their hands(the beginning of hand-eye coordination)
Vision in Newborn Babies
Your baby’s vision improves significantly in the first weeks. Scientists disagree on how well newborns can see (e.g. color and focus range), but two things are certain: small babies like to look at faces more than anything else, and they focus best on objects 20 to 35 cm away. This is related to the distance of your face when your baby is feeding. 3 Â 4 At one month old, you may notice that your baby likes to look at strong black and white patterns and sharp contrasting colors. At two or three months, you will see that he follows objects with his eyes and begins to recognize his favorite people and objects at a greater distance.
Hearing in Newborn Infants:
Your newborn baby recognizes and prefers your voice, which it heard very often in the womb. 5 If you find yourself speaking to your baby in a higher-pitched, slower, sing-song voice, it is because you know intuitively that newborns prefer a‘parent‘ or‘baby-focused speaking‘ style. 6
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During the first three months, you and your partner can support your baby’s sensory and social development by interacting with him or her as much as possible. Talk to him, sing songs, ask him questions, make eye contact with your baby and exaggerate your facial expressions. Choose high-contrast toys, books to attract his/her attention. Do not distract your baby with your phone, computer or TV screen when they want to interact with you.
Soothing your baby
Expectant parents usually create a beautiful nursery and buy a cozy crib for their baby to sleep in. However, the most common situation for new parents is that the baby does not want to be left in the room or sleep alone in the crib.
Look at it from your baby’s point of view. He spent nine months in the dark comfort of your womb, constantly surrounded by warmth and amniotic fluid. Thanks to the tight interplay of your placenta and umbilical cord, her belly never felt empty. It rocked and swayed as you went about your daily life, and your digestive system and blood flow provided a constant empty movie soundtrack.A Many experts, including Harvey Karp, say that the best way to help a baby adjust to the outside world is to make conditions as womb-like as possible. You will probably instinctively shush and rock your baby to calm him or her, and when he or she is occupied, you can use apps with rocking chairs, rocking cribs and sounds similar to the sounds he or she heard in the womb to create the same effects. A Using an over-the-shoulder sling when taking your baby outside or doing household chores reconnects them to the familiar movements they felt in the womb. A bassinet also keeps her warm and safe, bringing her closer to the comforting scent of your body and your voice.
Some (but not all) babies like to be swaddled in the first few weeks because it helps to recreate the feeling of being held in the womb. Be sure to follow safe swaddling methods before practicing. Some babies like to be in a warm bath. You can try taking a shower with your baby. Make sure you get information from the right sources first.
If, despite all your efforts, your baby does not calm down, remember that this is based on an ancient self-protection strategy that protects it from predators. Take care to keep your baby warm, close to a source of food and safe to keep them calm and peaceful.
Share this short but challenging phase with your partner and other family members who can help you. If everyone in the house suffers from sleep deprivation, consider following sleep guidance – it is much safer than sleeping on the couch with your baby.
Crying and colic
Your baby will cry moreduring the fourth trimester than at any other time in his or her life. Crying typically peaks at around six weeks and significantly decreases when your baby is three to four months old. 7
Acolicky baby is defined as crying for more than three hours a day, more than three days a week, three weeks or more for no apparent reason. 8 Colicky babies are more likely to cry in the evening, although it can happen at any time of the day. You may also notice that your baby is gassy and uncomfortable during this time. Colic affects a quarter of all babies and there is no proven cure. However, the baby soothing techniques mentioned above can help. Colic is upsetting for babies and parents but the good news is that it can usually disappear soon after the fourth trimester. 9
Breastfeeding and skin-to-skin contact
Breastfeeding gives your baby the best possible start because your milk is full of antibodies and protective factors and nutrients precisely tailored to your baby’s developmental needs. No formula comes close to providing the health benefits of your own breast milk.
About eight out of ten mothers in developed countries start breastfeeding, but many find breastfeeding more difficult than they expected. One study shows that ‘one in ten mothers who breastfeed their first baby experience at least one episode of breastfeeding anxiety by the third day. 10
Baby feeding guides often repeat the mantra that ‘breastfeeding doesn’t hurt’. But the truth is that many women’s nipples can become irritationally sensitive in the first few days. In addition, your milk will come in about two to five days and your breasts will be extremely sensitive as your body switches from producing small amounts of yolky colostrum to a much larger amount of breast milk.
Newborn babies have small stomachs and therefore need to be fed frequently, 12 or 13 times every 24 hours. Some babies feed quickly and empty the breast in as little as 12 minutes, while others are slower and sleepy and may take up to an hour to feed. 11 Feed your baby when he or she is hungry, not on any schedule or time schedule. Sometimes a breastfeed will keep him satisfied for four hours, sometimes he will want more milk after ten minutes.
Don’t worry, everything you are experiencing is completely normal. If your milk does not come easily, insist on breastfeeding with skin-to-skin contact with your baby as much as possible. Having only a diaper on your baby (or a thin blanket if it’s chilly) against your skin stimulates your baby’s desire to feed and releases the hormones prolactin and oxytocin in your body to increase breast milk production. 12
Lying in skin-to-skin contact also makes your baby (and you) feel safe, calm and relaxed, which helps the baby adjust to life outside the womb. Both of you release the hormone oxytocin, which helps to strengthen the bond between you.
Like all new skills, breastfeeding can take some time to master. Over time, your body will become more efficient at producing and storing milk and your baby will develop a stronger latch and a bigger stomach. So your breastfeeding sessions will be shorter, the gaps between them will get bigger 13 and your breasts will ache less. After the fourth trimester you will both have mastered this.
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How can your partner support you?
Research shows that when fathers are given breastfeeding information and advice, mothers are more likely to initiate breastfeeding and to continue breastfeeding for longer. 14
Your partner can help you with putting the baby to bed, changing diapers, bathing the baby, preparing meals, doing housework and taking care of visitors. This way you can rest as much as possible and spend more time on breastfeeding.
If your partner is not with you or cannot be with you very much, ask for support from other family members or friends. If your finances allow, you can also consider paid help from a doula or obstetric nurse.
Be kind to yourself
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Make life as easy as possible for yourself on the first few days and at the beginning of the parenting weeks. Many mothers recommend filling the freezer with meals before your due date. The ideal foods are those that you can eat with one hand while feeding, burping or rocking your baby! Use nutritious snacks to give yourself a quick energy boost while feeding your baby in short bursts. Bananas, granola bars, nuts, crackers, hummus, cheese, dried fruit and oatcakes are good choices.
Caring for a newborn baby takes an incredible amount of time and energy. So relax about other things in your life that are not so important. It doesn’t really matter if the house is left vacuuming or your makeup is not done.
Mother’s mood after childbirth
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After giving birth, large hormonal releases can cause ‘baby blues’. This happens in eight out of ten new mothers, usually on the fourth to fifth day.15Â If you suddenly feel achy, anxious or restless during the first week, it is probably a case of what is called baby blues.
If these symptoms start later or last longer than a few weeks, they can be a sign of postpartum depression, which affects one in ten new mothers. If you suspect you may have postpartum depression, talk to a health professional. There is a lot of support and various treatments available.
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Mental health and well-being after childbirth
As a new mom you spend so much time focusing on your baby’s well-being, it is important that you also make time for your own needs. Think about what is most important for your physical and mental well-being. Try to find time for at least one of these each week, perhaps meeting up with friends, taking a short walk, pizza and movie night, an exercise class or a long bath.
Surround yourself with a support network that keeps you feeling positive about your parenthood and helps with any problems. In addition to your partner, you can include other family members, friends, trusted health professionals, local baby groups, online forums or parenting books.
Dear visitors
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Try to arrange visits from friends and family on your terms, not the guests’ terms. If you want to spend some time getting to know your newborn before welcoming your visitors, that’s fine. Introducing your baby in person via video interview is also an option to help you get through the first few weeks more calmly.
Your body after baby
Immediately after delivery, you will still look like you are 20 weeks pregnant and you will still need to wear maternity clothes.
Over the course of six to eight weeks, your uterus will grow from the size of a watermelon to the normal size of a small pear as it fills with baby and placenta.16
Breastfeeding helps the uterine tissue return to its pre-pregnancy size. Oxytocin released during feeding helps the uterine tissue contract and helps reduce blood loss. During the first few weeks you may feel ‘post-pain’ contractions, especially during breastfeeding.
Pregnancy and childbirth have a great impact on a mother’s body. This is why you may still be feeling some pain and discomfort associated with childbirth in the fourth trimester. Painkillers and soothing baths can help with any genital pain, bruising, etc. Gentle exercises such as walking, yoga and stretching can help your organs, bones and muscles return to their pre-pregnancy position . If you are concerned about your weight loss or if you notice any signs of infection, bleeding (excessive blood loss), consult a health professional immediately.
Don’t expect to return to your old appearance quickly, no matter what you’ve seen in your favorite magazines. It takes months for your body to grow and for a baby to be born, and then it can take months to recover. Give yourself time to recover, to get to know the newborn and to redefine your relationship with your partner. Giving birth may have made you an instant parent, but it is the fourth trimester that shapes your identity as a mother.
References
1 www.nichq.org/insight/moms-deserve-better-care-fourth-trimester
2 www.sciencedaily.com/releases/2014/08/140811165817.htm
3 www.ncbi.nlm.nih.gov/pmc/articles/PMC4243010/
4 www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-development/art-20048012
5 www.parentingscience.com/newborns-and-the-social-world.html
6 www.sciencedaily.com/releases/2020/02/200203151158.htm
7 www.mja.com.au/journal/2004/181/9/1-problem-crying-infancy
8 www.nhs.uk/conditions/colic/
9 www.ncbi.nlm.nih.gov/pubmed/28385295
10Â www.ncbi.nlm.nih.gov/pmc/articles/PMC3784292/
[1]1Â http://www.infantjournal.co.uk/pdf/inf_063_cta.pdf
[1]2Â https://breastfeeding.support/why-skin-to-skin/
[1]3Â https://breastfeeding.support/why-skin-to-skin/
[1]4Â https://www.sciencedirect.com/science/article/abs/pii/S0266613819300841?dgcid=rss_sd_all
[1]5Â https://americanpregnancy.org/first-year-of-life/baby-blues/
[1]6Â www.naturalcycles.com/cyclematters/what-is-a-uterus