The whole idea of a 4th trimester was completely foreign to me.  This is basically treating the first 3 months of a baby’s life as a whole separate trimester than runs from 0-3 months.  I guess this makes sense as there will be some serious changes that both parents and baby are going to have to get accustomed to!  New routines take some time to develop and it only makes sense to refer to this as a whole extra 3 month trimester. 

The addition of this trimester would take pregnancy and birth into month 10,11, and 12.  This trimester is the one that seems to be causing us the most amount of stress and anxiety for the sole reason that we don’t know how to take care of a baby!! I guess we are going to have to figure it out, ready or not!  Being in this trimester, means that we will have survived the stay at the hospital and have managed to white knuckle our way home with our precious cargo!

A few years ago, we came across the show Life in Pieces.  The premise of the show was 4 short stories between an American family.  In the first episode, Jenn and Greg are expecting their first child and as the episode progresses they are admitted into the hospital, discharged and getting settled into their new home.  I am assuming there will be some comparisons as to our experience as well.  

Weeks 43-46

During the tenth month, most expecting moms would have already delivered, however, some may enter into this month with their delivery date coming very soon! During the tenth month, is when it is the partners time to shine and help mom recover whether that is taking over the chores around the house, midnight feedings, bill payments, pretty much anything and everything to ensure that mom gets the rest she needs.  In a previous post, I mentioned the lack of care for moms after they have given birth.  Now would be a good time to set up or visit health care practitioners that can give some aid to help in the recovery process.  

During this month, your baby will be around 7lbs.  There are some significant things to note that are normal during this time.  Weight loss during the first week is normal, communication through crying, feeding times will get longer and more frequent, umbilical cord will dry out and fall out and facial expressions like smiles will begin.

Like mentioned above, babies will lose about 5% of their weight during week 43 and this is completely normal.  They will also become pros at latching during feedings and expel meconium which is black, tar like poop (completely normal).  Babies will also have their first weeks pediatricians checkup and if there is trouble latching to feed, there may be a consultation with a lactation specialist. Mom’s hormones will once again begin to change now that she is postpartum and she may be experiencing some effects from the birth process such as discharge and tender breasts.  The post-partum blues may also be starting to set in – 80% of moms experience this to some degree.  

Week 44 means that the baby will begin putting back on some of the weight they lost last week and may return to their birth weight.  Babies will also be much hungrier this week and feeding times will need to be longer and more frequent to accommodate.  Their movements are more focused and controlled.  If mom is breastfeeding, she may be experiencing some discomfort and may experience some weight loss.  Sleep is becoming a thing of the past, her hormones are starting to level off and the post-partum blues may be present.  Mom’s hunger and thirst level will be high as she is requiring a lot to be able to feed. 

Through week 45, babies will continue to gain weight on a 5-7oz/week trend and their digestive system is kicking into high gear.  Their eyes are now focusing on more complex objects and shapes and they are sleeping an average 15-17hours sporadically throughout the day.  Mom is still recovering and is not yet cleared for physical activity.  Her abdominal muscles are still stretched so she may still look a little pregnant.  Incontinence may also be experienced as a result of stretched and weakened muscles from delivery.  

During week 46, babies are now ready for some tummy time – which means resting on mom or dad’s belly to work on strengthening those neck muscles.  They may also be starting to mimic facial expressions that they see throughout the day and they may be beginning to grasp at objects.  You may also get to experience their little laugh for the first time this week.  This is also the week for the first 4 week peditrician’s appointment.   Mom’s hormones are really starting to return to normal but she is still feeling some discomfort in her breasts and other areas of her body.  As the 10th month begins to wrap up, Mom is starting to feel as if she is getting the hang of this momming thing which can lift her spirits and help with the post-partum blues and some light exercise like walking will also help mood.

Weeks 47-50

This would mark the beginning of the 11th month and most parents and families have now started to settle into and feel comfortable in their new routines.  The baby is now heading towards 2 months and is about 10lbs.  During this month, they will become less colicky, starting to sleep 6-7 hours at a time, their appetite continues to grow, they are now able to respond to lights and sounds, will experience their first major growth spurt, and are considered a tummy time beginner.

During week 47 you may see more of the baby’s cute toothless smile and that they are responding to social clues.  They can now recognize music so it is worth having a baby play list that they enjoy and can work to help calm them down.  They will continue to grow like a weed, around 1 inch per week and are now eating every 2 hours or 8-10 times a day with each feeding around 2-5oz per meal.  Mom is slowly returning to her normal physical condition.  Utilizing kegels can help her battle the incontinence if it is still a lingering problem.  Her breasts have now started to adapt to nursing and the discomfort should be starting to dissipate.

Week 48 means that the baby is consuming more at feeding times and possibly going a little bit longer between meals.  They are still eating around 10 times per day, with 2-5oz per meal and continue to grow an inch per week roughly.  Mom’s uterus has returned to her pre-pregnancy size and she continues to drop weight, especially during breastfeeding.  Mom may still be carrying a little of the baby weight, but is starting to lose more.  This week marks the time for mom’s 6 week postpartum checkup.  

During week 49, babies will begin to experience less crying jags as they may have had beforehand, unless they have colic (1 in 5 babies are affected).   They are hopefully sleeping 6-7 hours at a time, which is giving mom and dad some much needed rest time.  Growth continues with around 1 inch and 7oz per week.  Babies are now consuming 4-5oz per feeding.  Mom’s hormones are changing and may be beginning to produce less milk which means a switch to bottle/formula feeding may be occurring soon.  Swelling and other other pregnancy discomforts are starting to return to prepregnancy levels.

In week 50, the baby should now be able to follow routines and is beginning to develop into a creature of habit.  They are now likely feeding six times in 24 hours, consuming more and more each time.  This week is a common week for another growth spurt.  They continue to get stronger and sleep for longer stretches of time.  Baby’s 2 month check up will also likely be happening during this week, with immunizations possibly starting as well.  Most of mom’s systems are back to normal unless she is still breastfeeding.  If mom is not breastfeeding, her monthly period may return which also means she will be ovulating and as a result can become pregnant once again – be careful!  Her body is continuing to balance out its postpartum hormones and she may seem to be on a more even keel.  

Weeks 51-54

This marks the 12th month of pregnancy/afterbirth childcare.  These are the final weeks of the 4th trimester which means new routines are likely settled into already.  Mom should be starting to feel more and more normal as the weeks go by.  You should be proud of yourselves as you have gone through the mental and physical rigours of pregnancy and remained supportive of each other.  They are on their way towards being 3 months old and by the time they are 3months old, they will be around 15lbs.  Baby may be sleeping through the night, self soothing, moving from side to back during tummy time, sucks their thumb, coos, smiles and laughs. 

During the 51st week, the baby may be sleeping through the night, but some relapses may occur.  They are able to self-soothe with a pacifier or thumb.  If they wake up, it is good practice to let them cry for a few minutes as this may be all they need to fall back asleep.  More supervision will be required during tummy time.  Mom may continue to nurse exclusively because it is beneficial for weight control.  Pregnancy brain has been replaced with baby brain, which all of a baby’s needs distract mom.

During the 52nd week, the baby is adapting well to routines: waking up, feeding times, playtime, nap and repeat until bedtime.  They continue to gain weight and grow.  Feeding times are stretched out to every 3-4 hours and they are eating 4-6oz.  They will continue to sleep 15-17 hours per day, with the bulk being 8-10 every night.  Mom’s physical changes this week have to do with her sleep, diet, and exercise, as well as breastfeeding.  She may feel guilt towards the fact that she may not be enjoying all aspects of motherhood.  Partners need to reassure that this is a normal feeling and it is ok.  

In week 53, the baby can begin indicating preferences to you.  They have become familiar with your personality and they continue to coo, smile and laugh at certain things.  The feeding and sleeping schedules are clearly set and the baby is thriving with them.  They may now have begun the phase of putting everything in or near their mouth.  As the baby inches closer to 3 months, Mom may be feeling a bit nostalgic and want to slow things down.  Now is a good time to reminisce about the entire process thus far and marvel how much mom, dad and baby have grown.  

Week 54 marks the end of the 4th trimester.  They will continue to grow like a weed,  maintaining around 2lbs/month up to 7 months old.  They are now eating 5-7oz during each feeding and are sleeping 15-16 hours a day with sleep routines normalizing.  Mom may now be dealing with some separation anxiety when away from the baby.  If the decision to pump or transition is usually done during this week.  

Until next week, 

Bret