One of the biggest ways expecting parents are failed by society is not explaining the phenomenon known as the fourth trimester. It’s real, people. It’s real. So what is it? How do we prepare? What are our babies telling us, and how do we respond?
Human babies are born the most dependent of all mammals. The brain of a human baby is less than 30% the size of an adult brain. Our closest relatives, chimpanzees, are born with a brain 40% the size of an adult. A newborns brain will increase by 64% in the first 3 months, will double in size by the age of one, and reach 80% of adult size by age three. That is A LOT of growth in a short period of time! You can imagine how this may be really overwhelming to a little one who has only ever known the warmth and security of the womb.
Dr. Harvey Karp, pediatrician and author of “Happiest Baby on the Block,” describes the fourth trimester as considering your newborn as an extension of yourself, much like when a child is carried in the womb. These first three months are a huge adjustment period for both baby and parents. They are figuring out the world around them, experiencing different sights and smells, the feelings of being a little hungry or full, cool or warm, wet or dry. These are all new, and the safest place they know is the arms of their parents. As a result, many newborns don’t want to be put down… ever. A parent (especially a first time parent) has also just been born. If this is not your first child you have still experienced a big shift in the family dynamic. This adjustment takes time, so give yourself grace. This adjustment looks different for everyone so don’t compare yourself to how others handled it.
Your baby will go through a few big growth spurts and leaps in development in these first few months. You will have weeks where they’re nursing extra and they’re more fussy than usual. It will be easy to think that your supply has dropped, but if you have had a good supply up until then you can rest assured you won’t experience a sudden drop overnight. Your body won’t sabotage breastfeeding like that. Remember, look at the whole picture. Is the baby peeing and pooping? Moist lips? Swallowing at the breast and seeming satisfied? Then the whole picture of your baby is pointing to a growth spurt or just an off few days. Your baby will change week to week so try to go with the flow. It’s very hard- if not impossible- to develop a feeding or sleep schedule when who your baby is at 4 weeks old is so different than who they are at 8 weeks old. If you have any concerns with supply contact your lactation consultant.
I have helped a lot of new families who wonder why their baby cries so much, or why they only sleep while being held, or why they want to nurse so much. The best way I can explain it is this- your body is their home. Being skin to skin is grounding to them. Being at the breast or on the chest of their parent is the closest thing to being in the womb. Research shows us that breastfeeding and being skin to skin regulates a baby’s heart rate, breathing, and body temperature. Cortisol levels increase when they’re separated from their parent, and decrease when they’re reunited.
Wanting to be held all of the time, or not sleeping well apart from their parents is very normal for newborn babies. Humans don’t like to be alone. We are considered “carry mammals,” in the same way apes and kangaroos are. Your babies expect that once they are born and exit the womb you will continue to keep them close, carry them, keep them on your skin smelling your smell and listening to your heartbeat. They expect to sleep close to you and fear being alone. This is their instinct, and fighting it will cause a lot of stress for both of you.
If you have a healthy, neurotypical child with no medical conditions you can just roll with this phase. However, there are some red flags to look for that may signal this is not in the realm of normal for fourth trimester. You want to be sure that your baby is eating and gaining weight at a proper rate. Be sure baby is peeing and pooping as much as they should. You want to be sure that baby does not have a fever or any other signs of illness or issue. Make sure you have taken the baby to their doctors appointments and voiced any and all concerns you have to their pediatrician. If you have concerns in any of these areas you can call it a red flag and consult your pediatrician. Trust me, they’ve heard it all. I mean I once asked the pediatrician if we were sure my 18 month old could feel pain because she had shut her fingers in a drawer and just calmly said “Mom, I stuck.” No tears, no fuss, and I had seen the condition on a Grey’s Anatomy episode once. What can I say? Parent’s worry.
We also need to remember all that a birthing parent’s body is going through. Aside from the physical healing, which can be extensive and take a good while (longer than the 6 weeks we’re told to expect), there is a lot going on hormonally as well. While pregnant you experience a rise in progesterone and estrogen, and in the 24 hours after birth these two hormones will drop rapidly to their pre-pregnancy levels. You could also experience a fluctuation in your thyroid levels. 80% of women report having the baby blues in the first couple of weeks after birth. Post-partum depression can emerge any time in that first year. You cannot discount the recovery after pregnancy and childbirth and must voice any concerns you have so that your self care is a priority.
I’m going to level with you. These first few months are tough. You spent 9 months preparing for this little one to be here, even longer for many whose journey to parenthood took them down unexpected paths. You’re constantly being asked if you have a “good” baby… as if they could be bad? Or “are they sleeping?!” Um no, lady, they’re not. They’re a baby. Or you could have a child like mine who screamed bloody murder any time I dare put him in a car. I swear if I had one more person tell me “oh but babies love cars!” I would have lost my mind. People expect us to be basking in newborn bliss… and we are! We are also tired. And hungry. And need a shower. Or just need a break. Saying so does not make you a bad parent. It does not make you ungrateful. It just makes you honest.
You can be tired AND savor those quiet middle of the night moments when the whole world is dark and it’s just you and your baby. You can be over the moon in love with your baby AND still be sad your birth didn’t go as you had hoped. You can feel it all, because you will. You’re raw and emotions are just extra in this phase of life. Your happy feels REALLY happy and your sad feels really sad. I remember talking to my mom one day when my oldest was about 6 months old. I had just finished crying because I was imagining him getting picked on at school one day. I love him so much the thought of anyone ever hurting his feelings just had me sobbing. I asked “Does loving your children this much ever get less painful?” She laughed in an understanding way that told me she knew the feeling. She said I’d adjust to it, but the worries for our children will always be there They’ll just be different worries.
When a baby is welcomed into a family the family and friends around you are also overjoyed and anxious to meet your new little one. Their help is out of love, and well intentioned, but can sometimes miss the fact that it wasn’t just a baby who was born, parents were born, too. If everyone is focused on the baby, who will focus on you? This is a big adjustment. Everything changes now! How do I shower if I can’t put the baby down? My baby wants to nurse every time I eat… sooo I have to figure out how to eat with one hand. You figure it all out, but it takes a minute. You always hear that when your baby is born you’ll “just know” what to do. But sometimes you don’t! Sometimes your baby will cry, and you can’t figure out why, so you just cry with them. That is okay. Cry if you need to! If you need space during this phase, you can say so. It is okay to say so. If you need help during this phase, you can say so. It is okay to say so. Surround yourself with the support that will be most helpful to you during this delicate time.
It is okay to make yourself and your needs a priority during this fourth trimester. No… let me rephrase. It is NECESSARY to make yourself and your needs a priority during this fourth trimester. If you need a nap, TAKE IT. If you need a week with no visitors, SAY SO. If you need to take a really long hot shower then do it. If you have a support person or partner in the home verbalize your needs. They won’t read your mind. Do this with no guilt. If you are the birthing parent, then you carried this person for 40 weeks. You birthed this person. You are recovering. Whether or not you birthed your baby, you are nourishing this person and that takes A LOT of work. You need to take care of you in order to take care of them. You need to take care of you to be the best you.
Like I said, the first few months are tough. You know what makes them tougher? Having unrealistic expectations and feeling like you’re doing something wrong. Your baby will not be on a schedule during this time. Breastfed babies eat on demand, and newborns will sleep when they’re tired. This is what is normal for them at this stage of development. Your baby will not sleep through the night. A normal sleep pattern in these first few months is one longer chunk (maybe 4 hours) and then outside of that waking to nurse every 2 hours. So when someone asks if they’re sleeping through the night you may take that to mean they’re supposed to be but they’re really not. Unicorn babies sleep through the night and if that’s what they naturally are doing then that’s fine! It just does not in any way mean that other babies should be.
Your baby will cry when they want to be held and picking them up to comfort them will never, ever spoil them. It will teach them security and trust. Some old parenting wives tales still float around, but if you follow your instinct you will never go wrong.
My husband and I got a lot of advice when we were expecting our first baby. My favorite piece came from a guy he worked with. The day before our c-section he emailed my husband “Congratulations. You’re about to get a lot of advice. Just remember, no one actually knows sh*t.” We laughed then, but I get it now! Everyone knows what worked for THEIR baby. You are the only you and your baby is the only one of them. Guess who knows them best? You. You know what works best for your family, in your home, for your child.
A parent’s intuition is a beautiful thing. Use it, unapologetically, and this fourth trimester will be a little bit easier.