Fourth Trimester!
The 4th Trimester Overview
The first few months are known as the 4th trimester. Thinking of these months as a time when baby is still gestating but, on the outside, will help put you in the right mindset.
Baby thrives when the womb like environment is replicated. Think about how dramatic the contrast between their uterine environment is with the outside world. Suddenly they have to wear clothes, regulate their body temperature and breathing, eat, digest, be separate from their parent.
Even if you only hold your baby half the day, that’s a 50% reduction in the amount of closeness they are used to in utero.
Baby does not want to be put down, and supporting this contact has many benefits. It is normal for baby to fuss, cry, or immediately wake up when set down.
Baby usually sleeps best in arms or worn in a baby carrier. Many families find safe bedsharing or baby on a separate surface but right next to the adult bed to be good nighttime options. Information on safely sleeping together.
Sleep and feeding are irregular and trying to force a sleep schedule is likely to cause stress. Learning and following your baby’s cues is important.
Many babies have a period of increased fussiness, cluster feeding, and generally being out of sorts in the late afternoon or evening. This can start a few weeks after birth, peak between 6-8 weeks, and generally eases off by 3 months. This is often known as the witching hour.
Sleep
Newborn:
Between newborn to 3-months, babies generally sleep between 14-17 hours across a 24-hour period.
Babies are typically not able to stay awake for long periods, and awake times of 30-90 minutes are common.
Sleep cycles are short, with half of a newborn’s sleep cycle spent in REM sleep. This is protective for young babies.
Sleep is spread across 24 hours in the early weeks meaning that newborns sleep roughly as much during the day as they do at night. Planning to sleep, or at least rest, during the day is important.
Babies sleep in irregular, unpredictable chunks of time.
You will notice more of a difference between day and night sleep as baby approaches 2-3 months.
Baby does not have an established circadian rhythm, so they don’t know the difference between day and night. This emerges around 3-months.
What’s happening by 3-months:
Baby may be sleeping 9-10 hours at night with several wake ups.
Baby may have 4-5 hours of daytime sleep spread over 4 or more naps
Baby may be able to stay awake for 1-2 hours at a time.
According to a large study the majority of 3-month-old babies wake on average 2.2 times a night. Only 16.5% of babies slept through the night (Paavonen et al., 2020)
Circadian rhythm (body clock) starts to emerge.
Regular night waking and feeding is normal and healthy, although longer sleep stretches of 4-6 hours at night are common.
Longer sleep stretches at this age does not mean that your baby will always be able to sleep that long.
Short naps, contact naps, motion naps, and nursing to sleep are all normal.
Sleep is dynamic in the first year, so however your baby is sleeping at 3- months, expect it to change!
Feeding
0-3 Months
Baby needs frequent cue-based feeding day and night regardless of how baby is fed.
Newborn tummies are small, and human milk is designed to be digested quickly.
In the early months, babies feed between 8-12 plus times in 24 hours.
Especially if nursing, remember that everyone is learning in the early weeks. Feeding does get easier.
Nighttime feeds are important for babies growth and development.
Feeding to sleep is healthy.
Comfort sucking, whether nursing or a pacifier, is normal.
Development
Development:
Babies are up to all sorts of cool things during this time. Every baby develops at a slightly different rate, but here are some things your baby is working on.
Smiling and cooing
Showing interest in parents' faces.
Learning to hold their head up.
Beginning to push up their chest while in tummy time.
Tracking things, people with their eyes.
Turning their head towards sounds.
Communicating different needs to you.
Remember that your baby needs your help to calm down. Different types of movement, touch, closeness, and feeding/sucking are all great tools.
Activities and Play
The best time to play with baby is when they are quietly alert. You will also want to be aware of their signals when play is too much: looking away, arching their back, and fussing. These are signs to pause and comfort or give them a minute to regroup.
Make sure your baby is getting floor play on their back and tummy time. Tummy time is an important way to support development, especially with babies spending so much time on their back throughout the day and night.
Babywearing is a great tool for this age and beyond. It can be a sleep and soothing tool, but also an activity for your baby. Being worn gives them a great view of things as you move through activities, and it’s easy to talk with them and narrate as you move through your day.
Babies love rattles, soft, textured toys to feel, and high contrast toys such as black, white, and red. They also like to gaze at interesting toys so play gyms and mobiles as well as ceiling fans can all be entertaining.
Your face, expressions, and chatting conversationally with your baby are all a form of play.
Massage and gentle bicycling of their legs can be a way to relieve gas and also part of connecting and play.
Baby’s love mirrors. Hold your baby in front of a mirror or get a baby safe one and include it in tummy time.
Movement is play. Dance, sway, and rock your baby. This is great for their development, bonding, and can be fun. Pay attention to the types of movement your baby likes best.
This is a great resource on play and development: https://www.zerotothree.org/resources/312-stages-of-play-from-birth-to-6-months-a-full-body-experience
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