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The Fourth Trimester

Posted by Karen Faulkner on
The Fourth Trimester

There is little adjustment time for a newborn baby from living and being in the womb to suddenly entering the world; one minute they’re contentedly snuggled in the sanctuary of mum’s tummy, and the next they arrive into an overwhelming reality of lights, cameras and action.

There are a few ways to make transitioning easier for your brand new baby. From the first few moments after birth, through to the next few hours, and even after you’ve gone home, there are things you can do to help your baby be comfortable in the world around them. 

There are a theory babies should be in the womb till 3 months postnatal. But if this was the case, they wouldn’t get out of the birth canal because they’d be too big they are born before they are able to cope with the outside world. Humans are the only mammals who cannot walk and move unaided at birth. Relying on their parent/caregiver for all their essential needs. The first 3 months are a time of more than normal crying and we recognize this as the 4th trimester. It needs special and sensitive management to get a smooth transition to life. 

Babies benefit from lots of love and cuddles and love to be swaddled, almost like being back in the womb. Helping them feel secure and adapt to this new crazy world. Think of this as helping the baby adapt and not as spoiling them. I’ve never seen a baby spoilt with too much love. They’re only little for such a short period of time. Babies who are held and cuddled in a positive way grow to make secure attachments and healthy emotions as adults. Try and ignore, in a polite way, any well-meaning relation who says you are spoiling your baby with too much love! 

Seven Ways To Help Your Baby To Adapt

  1. Cosy Sleep Environment - Swaddling
  2. Baby Wearing
  3. Dim Lighting
  4. Bathing
  5. Sucking & Regular Feeds
  6. Kangaroo Care is also known as Skin to Skin
  7. White Noise

A Cosy Sleep Environment

Babies love the feeling of snug. The uterus, towards term, had become very snug and there was little room for them to move. Creating this in the outside world is essential to help your baby feel safe and secure and subsequently to be able to sleep well. There are several ways you can do this. One of them is swaddling. The other is layers of heavy blankets to recreate the feeling of the snugness of the womb. However, in a very hot summer in Australia this may not be practical from heat and overheating point of view. Consequently, the swaddle and use of swaddling were created.


Dim Lighting


New babies don't need a lot of baths as they don't do a lot to get very dirty! You may decide to only do one bath a day and the rest of the time to do a top and tail daily or twice a day. A top and tail as the name implies consists of washing the face and neck folds and the nappy area.

Keep skincare very simple and avoid soap with perfume and essential oils in it. Suitable cleaning products to help a delicate baby's skin include QV bath, sorbolene and Dermaveen. Bath products containing lots of ingredients and sodium laurel sulfate should be avoided. Sodium laurel sulfate is a foaming agent and can cause irritated eyes, skin and lead to eczema.,,1210215,00.html

If your baby dislikes their bath try putting a washcloth on their tummy and pouring warm water onto it. Another tip I've used a lot is to place the baby over your forearm and onto their front in the bath. Be careful of course to avoid putting their face into the water! Swish the baby body up and down to calm them. In 30 years this has not failed and I've never had a baby continue to cry once I've done this. Putting a baby on their front or prone reduces stress and the hormone cortisol.

To clean their eyes and face use separate cooled boiled water (especially for the eyes) and clean from the inside to the out with a damp cotton wool ball, dry with a dry cotton wool ball.

Wash their head or hair once a week to avoid the build up of oils to prevent cradle cap.

Sucking & Regular Feeds


Night breastfeeds are important and babies need at least 1-2 breastfeeds.

Prolactin is increased with night feed helping increase and maintain supply for the following day. By following a strict routine, where baby sleeps through the night by 6 weeks, you risk diminishing your supply, sabotaging your ability to successfully breastfeed. Then baby would probably lose weight and formula creeps in.

During the day following a feed-play-sleep model. Newborn to 6-week babies do well with a feed-play-feed-sleep model. At night it’s a straightforward feed-sleep model.

Formula feeding - generally they need 6-8 formula feeds in 24 hours. The mathematical formula to work out their required amounts in each feed is 150 X weight in KG and divide this by the number of feeds in 24 hours. There is no perfect formula that agrees with ALL babies. Start with a newborn formula or stage one from 0-6 months. When preparing a feed always put the cooled boiled water, hand hot or 40 degrees centigrade, into a bottle and add the exact level scoops next, shake to combine then offer to your baby.

A young baby at 0-6 weeks can generally take 100-160 mls within 20-30 minutes at each feed. My preferred bottle and teat is a Pigeon wide necked peristaltic teat.

Burping or winding is something I generally do and recommend but only for 5 minutes.

Always clean and sterilize feeding equipment.

A useful gadget for formula feeding is Perfect Prep by Tommee Tippee -


Sucking is a primal reflex and newborn babies can soothe using one. If your baby has reflux or is premature they can be a useful addition to help your baby adapt to extra-uterine life. However, once your baby is 2-3 months of age it is a good idea to wean of them to avoid a 4 month sleep regression. At 3 months the baby has hand awareness and likes to put them into their mouth. Then at 4 months the extrusion reflex makes an appearance and the dummy or pacifier is forcefully ejected from the mouth. Hence the perfect storm of trouble has arrived.

It is better to look at soothing and sleep from a preventative approach and move your baby on at developmental milestones. By continuing to use a dummy or pacifier longterm you are preventing the baby to use their own self-soothe reflex. Preventing the self-soothe reflex being used at 3-4 months has been linked (evidence-based) with sensory processing disorders. This is something we need to be talking about, parents need to know this. When you know things like this you can then make positive parenting decisions.

Kangaroo Care or Skin to Skin

Putting your naked baby on your chest and doing skin to skin can help increase your milk supply and help breast feeding. Especially if you do this within an hour of birth. Kangaroo care, as skin to skin is called when used for premature babies, decreases cortisol and helps keep heart rate and breathing constant, helps feeding and weight gain. If you're having problems with breast feeding doing skin to skin for half an hour before a feed will help your letdown and supply.

Mums who practised kangaroo care were more likely to breastfeed exclusively and, on average, these moms breastfed three months longer than those who didn't practice skin-to-skin care, says one study published in Neonatal Network.

Just 10 minutes of skin-to-skin contact reduces babies' levels of the stress hormone cortisol, and increases levels of the "cuddle hormone" oxytocin, which stimulates the parasympathetic nervous system to make babies feel calm and safe, says Ludington in the journal AACN Clinical Issues.

Less stress = better sleep. Premature babies who were cradled skin-to-skin slept more deeply and woke up less often than those who slept in incubators, reported the journal Pediatrics.

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