“Birth no more constitutes the beginning of the life of the individual than it does the end of gestation. Birth represents a complex and highly important series of functional changes which serve to prepare the newborn for the passage across the bridge between gestation within the womb and gestation continued out of the womb.” (Montagu, 1986, 57)
Welcome to The Fourth Trimester
The Breast Crawl
Creating a breastfeeding plan and making sure your caregivers inform you how interventions might impact your goals is important. Learning how skin to skin contact and an uninterrupted first hour support breastfeeding establishment will help you decline non-essential interference and separation.
Kangaroo Care
Kangaroo Care (also referred to as Kangaroo Mother Care) has become a familiar sight in Neonatal Intensive Care Units (NICU) around the world in recent years. The image of fragile premature babies cradled against the chest of their parents highlights the importance of skin to skin contact and touch in the days and weeks after a baby is born.
Breastfeeding Positions
Older babies can breastfeed in almost every position imaginable! But in the early days, they are most likely to attach well if held close against your body. Every mother finds her own most effective way to position, which can change from day to day, feed to feed - and even breast to breast! Explore your options and find what is most comfortable for you and your baby.
Breastmilk and Your Newborn baby
Your full-term newborn baby might arrive without a suitcase but she has brought her own packed lunch and water bottle!
Special stores of fat are set aside to support your baby in the very first days of life. This extra energy allows the digestive system time to gently adjust to life outside the womb without the need to process large volumes of milk. Instead, colostrum provides highly concentrated nutrition plus key factors to establish digestion and immune systems.
The Newborn Reflexes
Babies are born with key instincts pre-loaded for immediate use from birth. These reflexes are checked and assessed as part of the APGAR score recorded immediately after birth and a short while later as an indicator of typical development and well-being. These involuntary movements are not controlled but occur in response to stimulation.
Self care without separation
hose offering you support can be quick to suggest they look after your baby while you take some time for yourself. They might urge you to express your breastmilk or introduce formula so you can spend longer periods apart from your newborn. While they do have your best interests at heart there can also be an element of wanting to spend some time with your baby themselves. Partners, parents, family and friends can mean well but you do not need to separate from your young breastfed baby to take a break and practice some self-care.
In our modern society, self-care has come to be defined by many as going for a massage or facial at a spa! While this sounds delightful, most new mothers would really just like to go to the toilet in peace. So let’s look at more realistic ways you can practice genuine self-care while still being close to your baby for feeds.
SIDS risk reduction
Around 30 years ago, a significant change in baby sleep advice was made and the death rate from Sudden Infant Death (SIDS) was consequently halved. Parents were no longer advised to lay their babies on their tummies to sleep, instead to lay them on their backs. The “Back To Sleep Campaign” has been recognised for its role in educating parents and saving lives.
Crying Babies
The sound of a baby crying gets our attention, it is nearly impossible to ignore.
Research suggests men and women respond differently to the sound of a crying baby: in women, the sound triggers feelings of sympathy and caregiving – in men, the responses include irritation and even anger.
The sound of your own baby crying goes much deeper – it reaches inside you and sets off all sorts of instinctive responses.
Safer cosleeping
Co-sleeping can be either room sharing where adults and babies have separate sleep surfaces in the same room or bed-sharing where adults and babies share the same sleep surface. A sleep surface is a bed, cot, bassinet or other space intended for sleeping on. This doesn’t include armchairs, couches, sofas, bean bags or other places an adult might fall asleep.
Laid-back breastfeeding
Although Laid-back Breastfeeding has a lot in common with Baby-led Attachment, it is not only a technique to help new babies learn to attach to the breast but is also an approach to breastfeeding which enables rest and relaxation for mother and baby.
Also called Biological Nurturing, the idea of reclining to breastfeed somehow disappeared in the dark years of the 20th century when the modern world almost lost all wisdom around feeding our babies at the breast. When bottle feeding became normalised and breastfeeding became a hidden task not seen in public, the only image of feeding babies was the upright position sitting on a chair.
Breastfeeding in the first 14 days
Nearly all breastfeeding problems can be fixed. But you need to find the right help when you need it and that can be hard. . It can feel like your calendar is filled with appointments with your child health nurse, local doctor, IBCLC lactation consultant and breastfeeding counsellor. Each will have different opinions and strategies for you to try. And then there are friends and family members whose own experience of breastfeeding might be limited. They might be more comfortable talking to you about formula feeding and seem unsupportive.
Baby-led attachment
Nature designed a perfect system: keep the baby within reach of the breast day and night. Create subtle feeding cues easily noted by their mother long before the desperate crying which will alert predators. Allow the mother to quickly move the baby to the breast from their position on her chest. When baby falls asleep at the breast, continue to keep them close. In the learning days, lean in to staying close. Contact naps lead naturally into baby-led attachment. Nappy changing can nearly always wait until a break between breasts or even longer. Aim to move baby from chest to breast with minimal delay in the early days.
Circadian Rhythm and the Newborn Human
In the womb, your baby shares your natural body clock. It takes at least 3 months for infants to develop their own circadian rhythm.
It is normal and natural then for your baby to have no discernible day/night pattern to feeding and sleeping. They lack the hormonal control to establish one. And it is not something they can be taught, no matter how much parents try and self-styled "sleep trainers" promise. What is more likely to occur is various techniques and programs are tried until one "magically" works coincidentally as the natural development stage is reached and circadian rhythm begins to function. Most babies naturally begin sleeping longer stretches at night around 3 months.
Breast storage and the Magic Number
Breastfeeding works by supply and demand: take milk out, make more milk. Leave milk in, make less milk. This feedback loop between baby and breasts works around the clock, reliably keeping production running.
But there is another factor at play which you might not be aware of. It explains why breastfeeding frequency can vary so much between mothers.
Fast-paced postnatal period
The reality is most new mothers are up and about, attending appointments with nurses, lactation consultants, breastfeeding clinics, doctors, physiotherapists and other professionals who used to come to your bedside. There is shopping to be done (smaller onesies after all!), older kids to get to school and meals to prepare. The village network of support has evolved to videos shared on social media and face time when you get a minute.