The Fourth Trimester

Baby Moon by Duvet Days

‘he won’t let me put him down’

‘she’s using me as a dummy’

‘he wants to feed all the time’

‘she will only sleep on my chest’

Why does my baby want to be constantly attached to me?

Unlike most other mammals, humans are born completely helpless. Most mammals can walk or move about shortly after birth, and other primates are born with the ability to regulate their own temperature and hold onto their mothers without any help. Our babies, in comparison, are born underdeveloped. If we were born at the same developmental stage as other primates, our pregnancies would have to be 18-24 months long.

Is there anything cuter than a baby giraffe?
Margot Raggett Photography

One theory for why our babies are born so ‘early’ is something called the ‘obstetric dilema‘ which explains that our pregnancies last only 40 weeks because if our babies’ brains and heads got any bigger we would not be able to give birth to them. Our birth canals are relatively narrow compared to our primate relatives because we need narrower hips to move efficiently walking upright.

Another theory is the ‘energetics hypothesis’. This explains that if our pregnancies were any longer, the amount of energy our babies require to continue developing en utero would threaten to exceed our ability to meet both the baby’s energy requirements and our own, so we birth our baby before the stress on our metabolism becomes too great.

What all this comes down to is, our babies are born much more vulnerable and needy than most other mammals. Making that transition from womb to world is a huge adjustment, and they’re just not equipped to deal with that on their own. This is why the first three months of your baby’s life are often referred to as the fourth trimester of pregnancy.

The transition from womb to world

Lucy Ruddle IBCLC

Inside your uterus, your baby is suspended naked in fluid, dark and warm, always the perfect temperature. They’ve spent 9 whole months in constant contact with you, listening to your heartbeat, and in constant motion as you walk and move about. They have never been hungry, because you provide a never ending flow of nutrition to them. Being tucked up inside this cozy dark bubble close to your heart is all they have ever known.

En utero embroidery art

Then all of a sudden your baby is brought into the bright, airy world. They feel hunger and thirst for the first time and can no longer hear your heartbeat and the swish of fluid around them. They experience long periods of stillness when they have spent their entire existence in constant motion. They are at a stage in their development when most other mammals would still be in their mother’s uterus, developing at a remarkable rate and going through so many big changes. Is it any surprise that they seek constant comfort in your warmth and your milk?

Responsive breastfeeding

A newborn’s stomach is very small, about the size of a marble, and breastmilk is digested quickly. This means that they need to feed frequently to keep their tummies full and to make sure that they’re getting everything they need to grow and develop. For most babies, this means feeding at least 8-12 times every 24 hours, and often more. This frequent feeding is important to allow you to build and maintain a good milk supply. Everytime your baby suckles at your breasts, you release a hormone called prolactin which tells your breasts to make more milk. Learn more about how milk production and the cycle of supply and demand works here.

Responsive feeding means feeding your baby whenever they show hunger cues AND whenever YOU need to. It’s about meeting your own needs as well as your baby’s. Feeding your baby whenever they want to feed is the best way to make sure you’re meeting their needs for nutrition and comfort. If your breasts are feeling uncomfortably engorged, or you just want to feed your baby, you don’t have to wait for your baby to ask for their next feed. Offer them the breast and chances are they will take it. Find out more about when and how often you should feed your baby here.

Beautiful artwork by Catie Waterworth Illustration and Design

Cluster feeding

Cluster feeding can be challenging, but it is also completely normal. This is when your baby suddenly wants to have lots of feeds very close together. They may also be quite fussy at the breast, showing all the hunger cues, latching for a few seconds and then pulling off and crying and then going back on again and so on. It can feel like they are glued to the boob for hours and commonly (but not always!) happens on an evening with young babies. This is normal. Grab yourself a drink and a snack and get comfy on the sofa with the TV remote in reach. Holding your baby skin to skin can help. We’ve all been there, and I promise they grow out of it!

During bouts of cluster feeding, and at other times, many women worry that their baby is not getting enough milk. Read this article to learn how you can tell whether or not your baby is getting enough milk, and what you can do about it if they’re not.

Find out how to tell if you’re making enough milk here

Your amazing milk

Your breastmilk is perfectly tailored to nourish your baby and allow them to thrive during the fourth trimester and beyond. Here are some of the components in your milk which protect your baby’s growth and development during those first few months in particular:

  • Stem cells: The stem cells in breastmilk, like embryonic stem cells, are pluripotent. This means that they can become any cell in your baby’s body. They travel through your baby’s blood to their brain, their kidneys, their pancreas, and various other organs where they become functioning cells for that organ
  • Beta-endorphin: a protein which binds to opoid receptors in the brain and reduces pain. This is found in the highest concentrations in colostrum, to help babies recover from birth
  • Oxytocin: the hormone of love, bonding, and relaxation
  • Leptin: the appetite control hormone which helps babies to recognise when they are full and may prevent obesity in later life
  • Alpha-lactobulmin: a protein with pain relieving properties and the ability to kill cancerous cells
  • Antibodies: our body’s natural defence against infection. When our bodies detect a pathogen (disease causing organism) it produces antibodies to fight them off. When you’re breastfeeding, these antibodies pass to your baby through your milk, giving them protection against infection

Find out more about this here

Take care of yourself, mamma!

Your baby is not the only one going through a period of rapid change and adjustment. You have spent the last 9 months pregnant and preparing to meet your new baby. You’ve just been through birth and are still recovering, and now you have to care for tiny baby who relies entirely on you for their survival, and you maybe have other children to care for too. You’re exhausted, probably quite sore, and are going through huge hormonal changes. Your body is changing, your breasts are leaking, and you feel like you could sleep forever.

We live in a society where mothers are often expected to snap back from birth and return to normal activity within weeks if not days. It’s completely unrealistic for most of us and potentially damaging to our mental and physical health, and to our breastfeeding relationship. In many cultures, it is the norm for mothers to spend these first few months being cared for by their loved ones whilst they focus on caring for and bonding with their baby.

Don’t rush it. The housework can wait, the visitors can wait, your partner/parent/friend/neighbour can help with the other kids and do the washing up. Accept help and don’t feel like you have to ‘have it all together’. Give yourself time to rest and recover and fall in love with this beautiful new life you have created. Though these early days might seem never ending, in reality they are short lived and you never get them back. Maybe you’re enjoying every second, maybe you’re just battling through it. Either way, you have achieved something remarkable, you’ve brought new life into the world, and you deserve to rest and be treated like a queen.

Post by Snuggle Me Organic

What might make it easier?

Baby wearing

Carrying your baby in a wrap or sling means that they can enjoy your constant warmth and motion and you still have your arms free to do everything else. Babywearing has been shown to be beneficial to your baby’s development and has been used all over the world since the dawn of time. With a bit of practice, you can also learn to breastfeed your baby in the sling, which makes those frequent feeds much easier! Your partner can also carry your baby in a sling to give you a break and to give them an opportunity to bond with their baby. For other tips on how the non-breastfeeding partner can bond with baby, without disrupting breastfeeding, click here.

Bedsharing (cosleeping)

It is the norm in most cultures for mothers to share a sleeping surface with their babies, but here where breastfeeding rates are low, it is less common to bedshare. The Lullaby Trust state that the safest place for your baby to sleep is in their own crib in your room, as some studies show that there is a higher risk of SIDS when babies are sharing a bed with their parents. However, the risk of SIDS while bedsharing is still small, and we know that 90% of bedsharing deaths can be prevented by following safe sleep guidelines, and research shows that breastfeeding helps some mothers to get more sleep and to breastfeed for longer. If you do decide to share a bed with your baby, it’s really important to make an informed decision and to make sure that all members of the household are aware. You can find information about how to make bed sharing safer here. And do have a look at the Lullaby Trust, UNICEF and BASIS for more information on infant sleep.

Read the UNICEF guidance on cosleeping here

Where to go for support

Information and support resorces for struggling to cope and/or facing postnatal depression

Breastfeeding support resources

Boobie Babies on Facebook

The National Breastfeeding Helpline

The information on this page should not be used in place of medical advice. Information found online should always be discussed with your own IBCLC, Dr or Midwife to ensure it is appropriate for you and your baby’s situation. Contact your Dr, Midwife or Health Visitor with any concerns about your own or your baby’s health and welfare.

2 thoughts on “The Fourth Trimester

  1. This was a great read. I am a first time mom of a 6 week old and sometimes it’s frustrating. But thinking about how new this adjustment is for him makes me just want to snuggle him all day. Thanks for the refocusing!


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