Realistic Sleep Expectations during the Fourth Trimester & How to Take Care of Yourself

Have you ever heard any of that advice? As a first-time mom, the unsolicited advice I received from friends, family and strangers on top of information on social media I would compulsively consume in the months leading up to my son arriving made my anxiety rise, particularly advice around sleep (not only my baby’s sleep but also how I would get sleep). When my first born arrived in April, 2020 I soon realized that none of the advice I received or information I consumed via social media was helpful to my mental health when it came to baby sleep. After becoming a certified pediatric sleep consultant and working with many families with a wide age range of babies, I realized that there is a plethora of unrealistic information being circulated on baby sleep during the fourth trimester in addition to a lack of knowledge of how to truly take care of yourself while taking care of your baby during this time. 

One of the first sleep guides I created for clients was titled “The Newborn Sleep Guide.” The goal of this guide was not only to help parents/caregivers understand what biologically appropriate baby sleep looks like but also how to take care of themselves during this period. The following touches on some of what I have included in that guide, and if you find the below helpful I would encourage you to pick up the full guide from my website: ownthenightsleepsolutions.com.

During the fourth trimester (the first 12 weeks of a baby's life), their sleep is wildly erratic and unpredictable. Again, this is biologically normal. Why? Two reasons 1) An underdeveloped circadian rhythm and 2) an immature pineal gland. The circadian rhythm is what helps you and I feel tired at night and awake during the day and it is greatly influenced by light. Babies are never exposed to light in utero so when they are born, the circadian rhythm is understandably under-developed. The pineal gland produces melatonin and helps you and I feel tired. This gland in newborns is immature and therefore not nearly as effective. 

It is also completely normal for babies to need a significant amount of help to sleep during this period. Why? Because they have spent the past nine months being lulled to sleep by your movement and you are their safe space. They can recognize your smell, your heartbeat and your voice all from spending the past nine months in the womb. 

So what can we do during this time to help our mental well-being?

1. Accept that this is a temporary, biologically normal stage of both you and your baby’s life - there is nothing wrong with your baby if sleep is all over the place, it is rather normal. 

2. Find ways to incorporate self-care while helping baby sleep. 

Here are some ways to help incorporate self-care during the fourth trimester.

• Get outside - not only is getting outside beneficial for you but studies have shown babies who are exposed to sunlight sleep better at night than those who are not. Getting outside does not have to be a huge production - it can simply be sitting on your porch for a few minutes every few hours.

• Invest in a baby wrap and/or carrier that is comfortable for you - many local practitioners offer babywearing classes to help you determine which wrap/carrier is best for you and how to use it; Bri Blakenbicker at the Boobtique in Lake Norman offers a baby wearing class and some doula agencies offer a class as well.

• Ever heard of the term, “nap trapped”? It is a very real term that you will become all too familiar with during the fourth trimester (remember that it is completely normal for babies not to want to be put down to sleep during those first 12 weeks). The following are self-care things you can do while holding your baby for naps 

  • Breathing Exercises or Meditations - there are many free apps to experiment with so find one that works for you. Insight timer is one of my personal favorites, but there is also Headspace, Calm, Expectful, Mindful Mamas, Simple Habit and many others. 

  • Find a good podcast or audiobook to listen to 

  • Find a show to watch 

  • Call a friend or a family member - you don’t need to be silent while assisting your baby to sleep, especially for naps during the day; babies actually sleep better with some sort of background noise (hello white noise!) given how loud it was in the womb (70-90 decibels) 

  • Go for a walk. Remember that carrier you invested in? Get it out and on and head out for a walk around the neighborhood - nap trapped doesn’t necessarily mean you are trapped inside the house!

• Take shifts at night with your partner/secondary caregiver if you are able to. Even splitting the night into 4-5 hour blocks can do wonders for your sleep. If you are exclusively chestfeeding, have the non feeding partner handle everything but the actual feeding (diaper change, PJ change if needed, and resettling/assisting baby back to sleep) during their shift and only have them get you for the feeding itself. Don’t have a partner/secondary caregiver who can help with shifts? Consider an overnight postpartum doula or night nurse. Even if it is just a few nights a week it can make a world of difference during those first few weeks at home. Many local doula agencies offer overnight postpartum support including Mama Bear &  Newborn Care.

• Ask for Help - It truly takes a village to navigate the fourth trimester, period. If you find yourself struggling with who to ask for help from during the postpartum period, consider attending one of the Mind Body Baby support groups. Many close relationships and village building is a product of our many support groups. In addition to our support groups, many local doulas offer daytime postpartum support. Postpartum doulas are wonderful and they are very good at not only holding the baby, but holding mom too. Allow your postpartum doula to help in whatever way you feel helps you take care of yourself - whether that is preparing meals, cleaning bottles and doing laundry; holding your baby for a nap while you take a nap or shower; or let them do both! Many doulas are pros at baby wearing while getting things done around the house (something I’m not even good at 2 kids later..) 

This period is hard and often unpredictable. Say it again, this period is hard. Give yourself permission to take care of yourself without feeling guilty. Taking care of yourself and your needs IS taking care of your baby.

Written by Mary Formella. Mary is an occupational therapist, certified pediatric sleep consultant, and owner of Own the Night Sleep Solutions: https://www.instagram.com/own.the.night.sleep.solutions/