The Fourth Trimester and Sleep

Everyone has heard about the three trimesters of pregnancy but what exactly is the Fourth Trimester? Well, the Fourth Trimester describes the three months after birth when your baby is adjusting to life outside the womb and new parents are adjusting to their new lives as Mums and Dads.

What’s the Fourth Trimester like for babies?

Babies have been used to continuous feeding in the womb, sleeping when they want to, regular movement and always feeling warm and cosy. Through the Fourth Trimester, babies are adapting to having gaps between feeds and learning to sleep in a different place. Babies are also getting used to the variety of noises, lights, smells, sounds and sensations of the outside world. You can make this transition into a noisy, bright and colder environment easier by offering your baby plenty of love and support.

What is normal for newborn sleep?

It is normal and necessary for your newborn baby to wake frequently during the night for a feed or comfort. Newborns have short sleep cycles of about 40 minutes and spend at least half of this time in REM (lighter dreaming) sleep. The importance of the preference towards REM sleep appears to be for brain development. In fact, the blood flow to the brain almost doubles during REM sleep, with almost all of that blood flow being directed to the part of the brain that controls automatic breathing. Frequent night waking and feeding is protective of Sudden Infant Death Syndrome (SIDS). This lean towards lighter sleep is also why you might need to hold your baby for about half a sleep cycle before they are in a deep enough sleep to be put down without waking up.

As a baby sleep coach, I frequently have parents tell me:

“My baby will only sleep in my arms, as soon as I put him in down he wakes up”

“She sleeps really well lying on my chest but cries the minute I put her into the moses basket”

Although this can be extremely frustrating it is also perfectly normal and understandable as babies prefer to be close to you and not lying alone on a cold mattress. You can’t spoil your baby in the Fourth Trimester. The more you look after them, respond to them and care for them, when they’re crying, the more reassured and confident they will be.


7 ways you can support your baby through the Fourth Trimester

1. Bonding and Attachment

The priority at this age is closeness and bonding between you and your new baby. The closer your baby feels to you, the happier they will be. Holding, cuddling and soothing so your baby can feel the warmth of your body and the sound of your heartbeat will help your baby feel safe.

2. Prioritise feeding

Feeding is your main priority and is likely to consume a lot of your time.  Newborns have small tummies and need feeding frequently. As you get to know your baby you will begin to understand the cues and signs that they are hungry. Try and be flexible, having a strict feeding schedule is not necessary so ensure they are getting enough by feeding whenever you see hunger cues. Use the time you spend feeding your baby to bond and connect through eye contact or even enjoy skin-to-skin. Breastfed infants are exposed to melatonin via their mother’s milk so breastfeeding can help optimise sleep regulation.

Some sleeping issues under 6 months of age are linked to feeding issues. Conditions such as tongue-tie, wind, shallow attachment/latch or low milk supply can manifest as problems with settling to sleep or sleep disturbances so if you are in any doubt, I suggest finding an International Board Certified Lactation Consultant (IBCLC) to check everything over for you.

3. Create a day and night routine

The day-night rhythms of a newborn are often all over the place at first. This will begin settling down once their circadian rhythm (internal body clock) starts becoming established. To speed this up try to expose your baby to broad spectrum daylight for 12 hours a day with normal noise and activity levels and then a 12 hour period of dark, dark and reduced stimulation.

4. Remember your baby’s awake windows

It is also important to ensure that your newborn in not kept awake for any longer than they can cope with. Sleep pressure builds over the day and this increases the drive to fall sleep. Trying to get your baby to sleep when their sleep pressure is low (they are not tired enough) or high (they are overtired) is harder. Some babies can stay awake longer than others but the key thing is looking out for how your baby appears. Are they getting upset and fussy or are they calm and content. As babies age, the length of time they can stay happily awake increases and it’s useful to have a rough idea of average awake windows:

0-6 weeks = 30-60 mins

6-12 weeks = 60-75 mins

3-4 months = 1.25-1.75 hours

5. Don’t worry about short naps

It is really common and normal for your baby to only take short catnaps of 20-40 minutes throughout the day. If your baby only naps for a short time, it is likely that they will need more frequent nap opportunities throughout the day. Try experimenting with naps in different locations as you may find that your baby naps for longer in a sling or lying next to you on the bed but sleeps for a shorter time in their crib or moses basket. Giving your baby a full feed before a nap may help them nap for longer.

6. Don’t worry about creating bad habits

Try not to panic if your baby will not sleep in their crib or moses basket and prefers to sleep being held. Don’t worry about trying to promote independent sleep at this age. The most important thing you can do is be responsive to your baby’s needs and spend time getting to know them.

7. Be kind to yourself

Simplify your life as much as you can in the early days and weeks. Relax your housekeeping standards and do not be afraid to accept help. Your first priority is to care for your new baby. To do this well you need to look after yourself and take time out for yourself. Make time for the things you need to feel well, both emotionally and physically such as exercise, eating well and getting outside in the fresh air.


Tips to help with soothing and sleep during the Fourth Trimester

1. Skin-to-skin – This is a great way to calm your baby. Being in contact with your skin helps to stabilise their body temperature, heart rate and stress hormones and stimulates the release of oxytocin (love and bonding hormone) in you both.

2. Swaddling – Safe swaddling may help your baby sleep better and soothe them if they are crying. Swaddling creates a feeling of containment similar to that in the womb.

3. Babywearing – Using a sling helps to mimic the gentle movement and closeness that your baby had in the womb. Walking around whilst you hold your baby is usually more soothing than sitting down and cuddling. In the womb your baby will have been used to plenty of movement and so swaying, dancing and rocking your baby can help to comfort them. Babywearing is also a great way for Dads to bond with babies.

4. Scent of mum on a muslin – Sleep with a muslin up your top and then use this as a sheet in your crib or bassinet. The recognisable smell of you, their Mum, can be a great comfort to babies.

5. White Noise – The environment in the womb was filled with constant sounds which may explain why babies find white noise sounds soothing and helpful to relax, fall asleep and stay asleep. Try playing white noise continuously when your baby is sleeping or shushing when settling your baby. White noise is also helpful as it drowns out other noises such as dishes clanking or dogs barking which can wake your baby up.

6. Learn early sleep cues and get them down at the first signs of tiredness. These might include a glazed expression, going quiet or looking away. An overtired baby is cranky, cries more and won’t fall asleep easily or stay asleep for very long.

7. Warm the bed before putting them down – You might have better success when transferring your baby into their crib or moses basket if you have warmed up the mattress slightly with a hot water bottle beforehand. Obviously this needs to removed before placing your baby in.

8. Safe bed-sharing – This can help parent and baby get the most sleep. The advice from La Leche League is that if you bed-share, you should be a breastfeeding mother, who has not drunk alcohol, smoked or taken drugs, and who is not exhausted. Don’t swaddle your baby if you bed-share, sleep your baby on their back and make sure the bedcovers cannot cover baby. The bed should be a safe, firm surface with no gaps.

Remember all babies are different. Some will not like being swaddled or rocked and you will soon work out your baby’s preference. Enjoy getting to know your baby.

As a qualified baby and child sleep coach I am here to help you with your little one’s sleep. For parents of babies from birth to 6 months I offer a ‘Sleep Shaper’ consultation which is designed to help you to understand the basics of sleep science, your baby’s sleep cues, their sleep needs and help create sleep conducive routines as well as giving you the tools to optimise your baby’s sleep.



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