Surviving The 4th Trimester (and How to Calm a Fussy Baby with the 5 S’s)

Feb 5

As a new parent, you likely anticipate all of the baby snuggles and cuddles, and I’ll be honest, those are the best! But what you may not be prepared for during this 4th trimester are the intense periods of fussiness that can sometimes occur.

Whether your baby is dealing with colic, they’re overtired, or they’re just a naturally fussy baby, you may find yourself in situations where your baby just…cries.

And if you find yourself there, you may not know how to manage the situation. Well, friend, I have just the technique you can try: The 5 S’s.

Before we dive into that technique, though, it’s important to understand what the 4th trimester is and what you can expect during this time.

What is the 4th trimester?

First introduced by Dr. Harvey Karp, author of Happiest Baby on the Block, Karp’s theory is that babies are born too soon, since, if we gestated longer, babies' heads would be too large to fit through the birth canal.

Because of this, Harvey termed the first 3 months outside of the womb as the 4th trimester. Since babies are born essentially earlier than they are ready to, we want to help them adjust to the outside world by creating the movements, sounds, etc., that they experienced inside the womb. And that’s where the 5 S’s come in (more on that soon!)

What can you expect during the 4th trimester?

While all experiences will be different, here are some commonalities seen in the 4th trimester:

1: Erratic Sleep Behaviors

During the newborn stage, babies day and night sleep are unorganized and there are no patterns. They have what’s called day/night confusion - they are more wakeful at night because their biological rhythms do not exist at this point. Their longest sleep period is usually just about 3-4 hours, and can occur at any time of the day.

2: Crying/Fussiness

Crying or fussiness is very common during the first few months, and it can be very difficult to figure out exactly why your baby is crying. Is he/she hungry, in need of a diaper change, tired, just wanting comfort, etc.?

Typically, intense periods of fussiness peak around 6-8 weeks, subside around 4 months, and occur mostly in the evening (aka the Witching Hour).

The acronym Purple Crying Period describes what is occurring during the witching hour:

P: Peak of Crying

U: Unexpected

R: Resists Soothing

P: Pain-Like Face

L: Long Lasting

E: Evening

For tips on how to get through the witching hour, I have a blog diving into it here.

3: Irregular Feeding Patterns

Because a newborn’s stomach is so small (about the size of a fist), they aren’t able to eat very much during each feeding, so they end up needing to eat very frequently. Newborns tend to need to eat every 1 ½ -3 hours and will also need to be fed in the middle of the night. They feed more on demand (especially breastfed babies) than on a set schedule.

With all of the elements at play during the 4th trimester, the 5 S’s can be a real lifesaver for many families.

What are the 5 S’s?

Since newborns are technically born before they are ready, and because the 4th trimester can be challenging, Karp shares that one of the best ways to soothe a fussy baby, especially during periods of intense crying, is by replicating the womb environment as much as possible.

Now, to fully do that, we need to be able to know what it is like inside the womb. Is it dark, warm, quiet?

In Karp’s book, he discusses five techniques that can help mimic the womb outside of the womb…aka the 5 S’s of Soothing. Home outside of the womb is very different from the inside, so newborns aren’t sure how to adapt during this transition. And that’s where we, as parents, can help support them.

The 5 S’s help trigger the calming reflex and mimic what it was like in the womb. They help newborns adapt to the world outside the womb. The noise, the motion, the sucking, the arms close to the body…everything in the womb, which helps and supports your baby to calm down and sleep better.

1: Swaddling - The Cornerstone

Swaddling your baby recreates the snug and secure feeling of the womb by wrapping babies with their arms straight by their sides. Doing this also decreases the startle reflex, which can wake your baby up.

2: Side or Stomach - But Never for Sleep

Holding your baby on their back is not good for calming, as it can make your baby feel like they are falling. Instead, to help soothe them, hold them in your arm on their stomach or side (aka the football hold). But remember, when you place them down for sleep, always place your baby on their back.

3: Shushing or White Noise

Next, shush near your baby’s ear or play white noise. This mimics the blood flow in the womb and can help soothe your fussy baby.

4: Swinging

When the fetus is in the womb, the movement of your diaphragm makes the baby move up and down. When you’re holding your baby on their side or stomach, use fast, tiny movement, however, always make sure you are always supporting your baby's head! Slow rocking is great to keep a baby calm, but to help soothe a distressed baby, you will want to have quick movements.

5: Sucking

And lastly, let your baby suck. This can be from their thumb, breastfeeding, and/or pacifier - find what works for your baby. Sucking lowers your child’s blood pressure, stress hormones, and heart rate, which is very beneficial when they are upset.

All babies need the swaddle, however, some might need swaddling and shushing or swaddling and sucking, etc. Some babies may even need all 5!

Other Ways To Soothe a Fussy Baby

Aside from the 5 S’s, there are three other things you can consider when you’re trying to soothe your baby: perfect the environment, practice skin-to-skin, and give your baby a massage.

When thinking about the environment: To prevent overstimulation, keep the environment dark (pitch black) and have a white noise machine playing. You also want to keep the room cool – aim for 68 to 72 degrees – which can mimic the lowering of body temperature at night.

At times during the 4th trimester, you are going to feel that the constant neediness of your baby is never ending. However, there is an end game! If you ever feel overwhelmed, seek out support. This can include a friend, family member, your spouse, or even your pediatrician. You may even need to reach out to a mental health professional for your own well-being! Don’t be afraid to know what you need help with, and seek it out! Soak the newborn stage up - grab some extra cuddles and kisses, because you may not think this now, but you will miss it!