Life in the fourth trimester


fourth trimester

Have you heard of Harvey Karp’s theory of the Fourth Trimester? According to him, the secret to a calmer and less colicky newborn could be as easy as following 5 simple steps.

Isn’t it a strange paradox that our newborn babies fall asleep in the noisiest and most unlikely places, won’t settle until we take them out for a walk in the buggy or a ride in the car, fall asleep at the breast, and startle themselves awake with their newborn reflexes, yet we in the Western culture tend mostly to tiptoe around the house and shush our preschoolers once we’ve put the baby into a still cot with a flat mattress, alone in a quiet bedroom, sometimes restricting feeding to fit a 3-hour schedule and wonder why they’re crying, not sleeping.

Could it be that we are in fact understimulating our babies, and that their unsettled and colicky behaviour is a result of the stressful departure from the comfort, warmth and soothing noise of the womb? Author of The Happiest Baby on the Block, Harvey Karp believes that a newborn’s lack of independence and inability to fend for itself (unlike most other newborn mammals) shows that human babies cannot cope with being outside the womb immediately after birth and need the first three months to acclimatise. They require the same stimulation, comfort, touch, movement and constant noise that the womb has provided for the past three trimesters. Remember that fetuses are frequently jiggled, constantly massaged by the muscular walls of the uterus and surrounded by the sound of blood whooshing through the placental arteries (apparently it’s louder than a vacuum cleaner!). So, he believes it’s no coincidence that colic generally ‘disappears’ at 3-months and that at this age, newborns become more settled, are beginning to smile, sleep longer at night than in the daytime, feed less frequently and are more capable of self-soothing.

So what to do during those difficult first three months? Karp explains that “Recreating the sensory milieu of the womb is so important for newborns, not because they are nostalgic for the “good life” they had inside, but because it actually triggers an important, but previously unappreciated, neonatal reflex that I call the calming reflex. The calming reflex is a “primitive” reflex (or, group of reflexes) that is almost an automatic off-switch for a baby’s crying. I believe it evolved over the millennia not as a way to calm fussy babies, but as a way to calm fussy fetuses. During the last months of pregnancy, this inborn response virtually entrances fetuses, thus lessening the chance they’ll move around too much and accidentally kink the cord or get stuck in a position that would make delivery impossible.”

For a crying baby, there are five things a parent can do to activate their baby’s calming reflex while holding them:

Critics say that more research needs to be done before these methods can be endorsed, but as the first three months are generally the most difficult time with a newborn, the concept of the Fourth Trimester might help remind us that babies need extensive nurturing during their first 3-months and time to adjust to the world oustide the womb, and treating them accordingly might help make this transition easier for all.

The 5 S’s

  1. Swaddled – with arms down, allowing movement of the knees, and the hips to be flexed and open.
  2. Side/stomach position – you are holding the baby in this position while you swing them to calm their crying, not while sleeping – lying babies on their back is safest for sleeping.
  3. Swinging – try a gentle classic rocking motion or a fast and tiny jiggling motion, done while holding their head and neck, but definitely not shaking the baby.
  4. Shushing – loud, continuous white noise (Karp recommends volume to be as loud as a vacuum cleaner for a screaming baby, or as loud as a shower for the rest of the night) or making a shushing sound in the baby’s ear.
  5. Sucking – either on your breast, finger or a pacifier (sucking is calming to the baby).

hey  baby, did  you  know …?

  • Early experiences help to shape and form the brain. Crawling on the front is one of the most important stages in brain development. Touch and feeling through the skin are important for body awareness.
  • Bottom shuffling is often avoided by not propping your infant in the sitting position. No infant should be sitting until the protective reflexes develop to stop them falling (usually age 6- to 12-months).
  • Movement activities with rhythm and music experiences are very important, even during the first few months of life. Hearing classical music, especially by Mozart, Vivaldi and other Baroque composers, creates total brain stimulation which can affect the rest of the nervous system.

Ref: Smart Start by Margaret Sasse, Exisle Publishing

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