Lets talk about sleep in the 4th Trimester

What is the 4th Trimester?

The fourth trimester describes the concept of allowing your baby to get used to life outside the womb. Before your baby was born, they were enveloped in a world of subdued light, constant but muffled sounds, constantly held and supported, never experiencing what it is to be cold or hungry.

Compare this to their environment now, a world of bright lights, unfiltered noise, fluctuating temperatures, sensations of hunger and thirst, and periods where they may not be held and supported.

Your baby’s expectations of life post birth are that it will be like life before birth, they have no other experience to compare it to. In those first weeks following birth they are getting used to their new environment, and it can be very overwhelming, everything is new except you, you are their comfort their protector, they know they are safe with you. This is a time to empathise and communicate with your baby that you understand it’s hard but that you will be there for them, helping them to feel safe and secure.

What does the research say about the 4th trimester?

As a concept itself it is not something that has been researched but the elements of responsive care have been well researched:

Feeding to cue rather than scheduling.
Picking up and comforting your baby if they are unsettled or upset.
Allowing your baby to sleep when they are tired, rather than scheduling sleep.
Talking to your baby.

These aspects of responsive care are often at odds with modern baby care advice where parents are advised to put babies down drowsy but awake, encourage self-soothing, routines, limiting contact overnight, the multitude of gadgets available that encourage us to put babies down (utilising things that bounce, vibrate, swing, rock, squeak, flash) rather than holding or cuddling babies.

But what do babies need? I love this quote from Unicef

New babies have a strong need to be close to their parents, as this helps them to feel secure and loved. When babies feel secure, they release a hormone called oxytocin, which acts like a fertiliser for their growing brain, helping them to be happy babies and more confident children and adults. Holding, smiling, and talking to your baby also releases oxytocin in you, which helps you to feel calm and happy.

How can you support your baby through this period?

Your baby does not have an established circadiam rhythm and it can take a number of months for this to develop so they will sleep in short intervals and feed regulary throughout the day and night.

It can help to put yourself in your baby’s position, think about the environment your baby was in before birth and try to replicate some its features, here are some ideas to get you started:

Subdued lighting.
Soft and gentle background noise.
Feeding in response to your baby’s cues rather than to a schedule.
Using a sling or baby carrier when you need to get things done but your baby wants to be close.
Skin to skin snuggles.
Movement and motion. A 2022 study found that babies calmed and relaxed much more when held and whilst walking.
Going for a walk.

We are developing a deeper understanding about how responsive care supports a baby’s growing brain and helps them to understand the world around them. Responsive care is about observing your baby, interpreting their behaviour, and acting to support them. Your baby is trying to tell you something, by being with them and spending time getting to know them you will soon start to understand their cues, be able to read their body language and respond to their needs swiftly and efficiently.

Being aware of the signs of tiredness that your baby displays will help you to recognise when they are ready for sleep.

Early signs of tiredness

Yawning 
Fussing
Losing interest in toys or people
Turning face away
Glazed expression
Waving arms and legs
Looking pale 
Going quiet

Late signs of tiredness  

Many families experienc a period of increased crying and fussiness from babies typically starting around 2 weeks of age and peaking around 2 months. It's important to remember that this phase is temporary and usually resolves by around 3 to 4 months of age as your babies grown and their brain devopment and understanding of the world increases.

During this time, babies may cry for extended periods of time, often inconsolably. It can occur at any time of the day, but it tends to be more frequent in the late afternoon and evening. The crying may seem more intense, longer, and harder to soothe compared to regular fussiness or crying.

This period of increased crying and fussiness is often attributed to a combination of factors, such as a baby's developing nervous system, increased sensitivity to stimuli, and the adjustment to life outside the womb.

The ICONCope website has lots of useful infomation regarding this phase in your parenting journey. Its important to remeber that infant crying is normal, its ok to put your baby somewhere safe or hand them to someone else whilst you take soime time to relax and regulate yourself.

How can you help your baby? 

Lots of daylight and fresh air can be beneficial.
Prioritise feeding, feed responsively.
- Breastfed babies are exposed to tryptophan (a precursor to the sleep hormone melatonin) via mother’s milk, so breastfeeding may help to optimise sleep regulation.
Helping your baby with womb to world transition:
- Holding, cuddling, and soothing.
- Feeding in reponse to your baby's cues, rather than to a schedule.
- White noise.
- Skin to skin.
Learn your baby’s individual tired cues.
Using a sling or carrier, which keeps your baby close, offers close contact and comfort in amore adaptable way.
Prioritising attachment and bonding, spend lots of time talking to your baby, making eye contact, singing to them, reading them stories, cuddling them. This boost their oxytocin and helps them to feel safe and secure.
Seek help for any medical conditions you or your baby may have, including management of postnatal pain and postnatal depression.
Consider where your baby sleeps and ensure you are aware of safer sleep guidelines.

How can parents support themselves?

It can be hard to cope with a young baby who doesn’t sleep well, here are few suggestions of how to support yourself feel more positive and confident:

Prioritise your rest – you will find it much easier to cope if you have taken opportunities to rest.
Eat and drink, try to stay hydrated. Eat things that you enjoy and make you feel good. Ask visitors to bring food as a gift. Don't forget to treat yourself every now and then.
Pause all non essential activity or ask your visitors to give you a hand with house work, cooking etc.
Fresh air/exercise, this is good for you and your baby. Getting out and about will help to regulate your circadiam rythym which will help you to sleep better. Sunshine and daylight boosts your vitamin D and increases wellbeing.
Meet others – peer support groups, baby groups, chat with other parents. There is great value in peer support. You're more than welcome at one of the P BY Cheshire Pudding clubs!
Use a sling (sling info and safety info here)
Ask for help – friends, family, doula, cleaner.
Consider where baby sleeps, can bed sharing help? take a look at the safer sleep guidelines.
Celebrate your sucesses, and recognise that you are doing a great job at parenting. You are good enough!

How can a doula help in the 4th trimester?

A doula can be on hand to support you in your transition through the 4th trimester whether it is your first baby or fifth. Supporting you to become the parent you want to be with practical, emotional, and non-judgemental support.

This can be especially useful in the 4th trimester when you and your baby are just getting to know each other. Around the world this is a period where new mothers are encouraged to rest and recuperate whilst getting to know their new baby. In a more dispersed society, we don’t always have the support we need from family and friends to facilitate this, and this is where the support of a doula can be beneficial.

As a doula I offer practical support around the home, with older children, supporting you as you get to know your new baby. I offer compassion and empathy without judgement as you find your way, listening and reassuring. My real goal postnatally is to empower you, support you to feel more confident. I want you to not need me anymore, to feel like you have the energy, skills and knowledge to be the parent you want to be, and do that in way that feels right for you and your baby.

If you would like to know about how I or the the othe PBY Cheshire doulas can support you head to the directory and search for doulas!

Pregnancy, baby & you