How To Manage The Fourth Trimester
How To Manage The Fourth Trimester

How To Manage The Fourth Trimester

You’re likely familiar with the first, second and third trimesters, but did you know there’s also a fourth? A term used to describe the 12 weeks following the birth of your baby, experts say it’s just as important for your newborn’s development and your health as the first three. From supporting postpartum recovery to the importance of asking for help, here’s what five leading parenting experts want you to know…
By Tor West

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Your Baby Is Adjusting To Life On The Outside

“It takes a newborn around 12 weeks to adjust to life outside the womb. By 12 weeks, your little one will be more interested in and aware of the world around them and will likely be able to hold their head up to some degree. Moving from the warmth, darkness, and quietness of the womb to a noisy, bright and often cold environment can be a big change for a baby. These first 12 weeks of its life in the world is about developing their senses and controlling their reflexes. When a baby is born their senses are limited and still developing. At birth they can see but their vision is blurred. They can hear but it’s tough for them to distinguish between individual sounds and voices. They can feel, but their mother’s womb, which is familiar, warm and secure, has been replaced with an unsettling open space. Your baby’s brain is like a sponge, soaking up everything that happens to them. The more their brain is stimulated, the stronger the connections in their brain will be.” – Dr Shazia Malik, consultant gynaecologist & obstetrician at The Portland Hospital

Your Body is Healing

“In the immediate stages of the fourth trimester, your body is recovering from birth. If you gave birth via caesarean, you will have needed stitches on the abdomen, whereas a vaginal birth may require stitching if you incur a tear or cut. The body will be working to heal and mend the skin in these places. Expect to feel sore in the first couple of weeks, especially when going to the loo following a vaginal birth. Drinking plenty of water will dilute your urine and make it sting less, and eating a healthy diet will prevent you from becoming constipated, as women tend not to have a bowel movement for a few days after the birth. This will also help you avoid piles, which are common post-birth.” – Shazia

Bleeding Will Happen

“Bleeding after the birth can be quite heavy at first, but will minimise within a few weeks. Use super-absorbent sanitary towels and avoid using tampons until your six-week postnatal check-up. Your bleeding should have stopped by six weeks, but if you have persistent bleeding or clots, get checked out by the hospital you delivered in or by your doctor. Bleeding tends to be lighter after a c-section, and much lighter if you breastfeed.” – Shazia

Moving from the warmth, darkness, and QUIETNESS OF THE WOMB to a noisy, bright and often cold environment can be A BIG CHANGE for a baby

You May Still Look Pregnant

“After birth, your tummy will still be bigger than it was before pregnancy, which is due to the muscles and skin having stretched over the course of the pregnancy. However, during the fourth trimester the tummy will gradually reduce and return to your regular shape. Your tummy muscles will have been stretching to accommodate for your baby for nine months, so expect them to be soft for several weeks after birth. After pregnancy your body can still retain a lot of fluid, and it can take around two weeks for a woman’s body to lose the extra fluid it took on during pregnancy. During this time some women may find their legs and ankles are swollen, but with time your body will rebalance the fluid levels in your body. Drinking plenty of water will help with this. As will putting your feet up whenever you can.” – Shazia

Your Milk Will Take A Few Days To Come In

“If you are breastfeeding, your breasts will begin to swell and may be sensitive as you begin to produce milk. At first, the breasts will produce a yellowish liquid called colostrum for the baby, but by the third or fourth day, they may start to feel tight and tender as they start to produce milk.  The milk normally comes in around day three after birth, and you will notice prominent veins on your breast as they fill with milk. Taking painkillers such as ibuprofen is safe and can really help with the initial discomfort, as can wearing a highly supportive cotton bra. It’s common to get afterpains (cramps) whilst you breastfeed. These will settle in the first few weeks.” – Shazia


The Baby Blues Are Normal

“The first few months with your newborn are a rollercoaster of emotions. In the first month, the hormones that were supporting your pregnancy come crashing down, which can leave you feeling teary. Then, as the sleep deprivation and pressures of new motherhood kick in, feelings of anxiety can step forward. Within these moments, however, there are also pockets of wonder and joy for your newborn and new life. After the first month, you may notice an increase in energy levels as your hormones start to plateau. However, if your teary period lasts longer than two weeks, or you find yourself not feeling joy for your newborn, chat to your GP and midwife. Getting the support you need as early as possible helps with both your recovery and your baby’s development.” – Dr Jo Mennie, PhD in women’s health & GP at Dr David Jack

Sleep Deprivation Can Be A Challenge

“A lack of sleep tests your patience and your relationship. Work on how to communicate your needs and recognise, with empathy, when one of you needs a break. This will set you up for healthy communication as your little one grows. Be comfortable asking for help. Often the ‘village’ are trying not to overstep or can’t see your needs, which can leave you struggling on your own. Be specific in what friends and family can do, and if you don’t want to hand over your baby you don’t have to, there are still lots of things they can help with. Ask them to bring a supermarket shop, a meal, tidy the kitchen, or wash the bottles.” – Jo

Having some FRIENDLY CONNECTIONS with women who have a slightly older child or toddler can help GROUND YOUR REALITY of what to expect

Your Pelvic Floor Should Be A Priority

“It takes around three months for your ligaments and pelvic floor muscles to return to normal, so it’s important to be careful with what exercise you do. Walking and light yoga can help new mothers regain strength and improve your mood, but chat to a healthcare provider before beginning any workout routine after giving birth, especially if you had a c-section. If you had a vaginal birth, it’s common to experience mild issues with lower bladder control, but if you suffer with incontinence, ask your midwife to refer you to a physiotherapist for an assessment. It’s helpful to do your pelvic floor exercises when you feed, so it becomes habit – even if you had an uncomplicated vaginal birth or c-section.” – Shazia

Connecting With Others Will Give You Perspective

“One of the biggest challenges is the external noise and societal pressures on motherhood, especially with social media, which often shows us unrealistic versions of both motherhood and baby. It is normal for babies not to sleep well during the fourth trimester – sometimes even for the first four years. Having some friendly connections with women who have a slightly older child or toddler can help ground your reality of what to expect and what’s normal. If you did NCT, chat to the other mums – these groups can be a great support network in the first year of your baby’s life. Having a network within walking distance is also helpful as it can encourage you to get out every day. As they say, your baby is only little once, so try and remove this pressure and enjoy this moment of motherhood and connection.” – Jo

It’s important for new mums to take care of themselves throughout the fourth trimester to ensure their own health and that of their baby. Nutrition plays a central role in recovery and also for your milk supply.

Here, three nutritionists share their tips...


Increase Your Calories If Breastfeeding

“A woman’s nutritional status during breastfeeding is not only crucial for her own health, but for the health of her new baby. Studies show a mother’s diet can have a direct influence on their baby’s growth and development. This makes sense when you consider that a breastfeeding mother provides all the nutrients and hydration that a growing baby needs for the first six months of life. If you’re breastfeeding, you’ll need 300-500 additional calories every day. There’s no one-size-fits all approach and everyone’s nutritional needs vary, but oats are great for sustained energy as well as a dose of fibre and iron; dark leafy greens are rich in many nutrients and will help you meet your folic acid needs; berries are rich in vitamin C to support the immune system and help you avoid constipation, which is common in the fourth trimester; while eggs contain choline, an essential nutrient for baby’s brain development as well as for postpartum recovery.” – Claire Hitchen, nutritionist & co-founder of Mini Tummies


Prioritise Iron

“As iron requirements increase during pregnancy to support your baby’s growth (alongside the potential blood loss that comes with childbirth), iron is an especially important nutrient to replenish when your little one arrives to prevent iron deficiency or anaemia, and to support your own healing process. Iron is essential for your energy levels, immune system, as well as helping to support your milk production if you’re breastfeeding. Know that tea and coffee can decrease how much iron your body can absorb, so it’s worth leaving at least one hour between eating an iron-containing meal and drinking tea or coffee.” – Claire


Get Plenty Of Calcium

“During pregnancy and breastfeeding, your body needs more calcium to support the development of your baby’s bones and teeth, and if there’s not enough coming from your diet, your body can take the calcium it needs from your bones. Studies show that breastfeeding mothers can lose up to 5% of their bone mass during the first six months after birth. Aim for at least 1,000 mg of calcium daily – dairy products, fortified plant milks and leafy green vegetables are food sources. Don’t forget your daily vitamin D supplement – it helps your body absorb the calcium from your food.” – Claire


Eat Dates & Porridge To Support Milk Supply

“Dates can increase a hormone called prolactin, which tells your body to produce more milk. A 2021 study found breastfeeding mothers who ate ten dates a day had an 11% increase in the amount of milk they produced after two weeks, and a 23% increase after four weeks. Eat as a snack or add to smoothies. Oats are also great for an iron boost, with half a cup providing 20% of your daily needs when breastfeeding. Low iron levels have been found to inhibit milk supply, so in theory, having a daily bowl of porridge could help. Be careful with parsley and peppermint, which have been linked to a reduced milk supply.” – Claire


Be Careful With Caffeine

“Consuming caffeine in large amounts can pass through to your breast milk and affect your baby’s sleep, meaning they may become a little more fussy or irritable. It’s best to continue limiting caffeine and stick to less than 200mg daily while breastfeeding – the amount you were having while pregnant is a good gauge.” – Claire


Keep It Simple

“Overnight oats are a great breakfast option in the early days as you can make them ahead and breastfeed or cuddle your baby without worrying about dropping anything hot. Ramp up the nutrition content by adding mixed seeds, crushed walnuts and peanut butter, and top with milk and yoghurt before adding fresh berries to serve. One-pot meals are brilliant as they minimise washing up – try a chickpea and sweet potato curry or lentil-based cottage pie. A slow cooker is also a brilliant option as you can prepare things the night before and then tip it all in the morning for a nutritious meal by dinner time. To save time and money, buy frozen fruit and veg rather than fresh. The nutrition content is the same and it means you can throw a load of veg in the oven to roast in seconds rather than having to peel and chop. Pair with a protein source (you can bake this on top of the veg) and you have a simple but nutritious meal. Frozen fruit is brilliant as a topper on overnight oats and porridge, or a speedy crumble.” – Lisa Simon, registered dietitian


Stick With Your Prenatal Supplements

“Staying on your prenatal multivitamin and other supplements for the first six months postpartum can help replenish your nutrient stores. It could also be worth taking a quality omega-3 fish oil to reduce inflammation and to help ensure adequate milk supply, as well as supporting your baby’s brain development. Top up with vitamin D, too, which can be low postpartum, and vitamin D requirements increase when breastfeeding. It could also be worth taking probiotics, which can be helpful to support your gut and also enhance the nutritional value of your breast milk.” – Julia Young, registered nutritional therapist at Surrey Centre for Nutrition

For more from the experts visit,, and ‘The Plant-Based Dietitian’s Guide To Fertility’ by Lisa Simon is available now in all major bookstores.

DISCLAIMER: Features published by SheerLuxe are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.

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