What Breastfeeding Really Looks Like in the Fourth Trimester (and Why Support Matters More Than Ever)
Introduction
You’ve chosen to breastfeed, and now the questions are coming thick and fast — ‘Is my baby getting enough milk?’ ‘Why are they feeding all the time?’ You’re not alone in asking.
So, what is the fourth trimester?
The fourth trimester (the three months after birth) can be hugely transformative and shape the long-term future of yours and your baby’s feeding journey.
Never has there been a time in yours and your baby’s life, where you will see such growth physically and emotionally, in such a short space of time. There’s so much that goes on in the fourth trimester, but I’m going to try and pull out the main bits.
The Golden Hour
Firstly, let’s step back. You’ve just birthed your baby. That first hour of your baby’s life is so transforming. They’ve arrived, new to the world, only needing one thing – you. If you had a relatively straightforward uncomplicated birth, then there should be no reason why you can’t have an uninterrupted hour with baby close to you. Just spend some time simply being with your baby. Skin-to-skin is amazing at this point. It helps to regulate your baby’s temperature, allows for connection to start between you both, and gives your baby the opportunity to root for your breast without the pressure of it being forced. It may even be worth writing in your birth plan if you have one, that you would like uninterrupted time following the birth.
The first feed - Colostrum
If you’ve chosen to breastfeed, Colostrum will be the first milk your baby receives. It’s a thick, sticky yellowy consistency, rich in minerals and protein and lower in fat. Over the next few days, your baby will get colostrum — a special early milk your body starts making in the second trimester to meet your baby’s nutritional needs at any stage of pregnancy.
The removal of your placenta and a drop in progesterone is what kick starts the change in your milk consistency and composition, so after a few days of receiving Colostrum, your milk will ‘come in’, your breasts might feel full, and you will start to feed your baby a different consistency of milk. While it’s often said that your milk ‘comes in’ a few days after birth, it’s more accurate to say that the composition of your milk changes — from colostrum to more mature milk.
Learning to breastfeed
Breastfeeding takes practice, so don’t put pressure on yourself or your baby to get it ‘right’ first time. Some mums find that their baby just latches on perfectly from the start, others don’t and that’s ok. It’s a bit like when babies first start to walk, they don’t instantly get up and start walking, they have moments of getting up, stumbling and falling. Then, over time and after practice, they get up and walk and don’t look back. Breastfeeding can take time, and in these early days to weeks, you and your baby are learning together, finding your rhythm. I can’t stress how important it is to find the right breastfeeding support around you to help during this time. Getting help can make all the difference to your breastfeeding journey.
Establishing Supply – The First Six Weeks
The first six weeks during the fourth trimester are important for establishing breastfeeding, and the more you go with the flow now and feed in response to your baby’s demands, the more flexibility you will have in the long-term.
Your baby should be feeding anywhere between eight and twelve times a day within the first few months, however it can be more than that. You should be able to tell that feeding is going well by checking the number of wet and dirty nappies that are being produced. Generally speaking, you should see at least one wee for each day of life for the first six days, so two wees on day two, three on day three etc. Wet nappies should increase to six in 24 hours after six days and two dirty nappies a day.
When your baby is born, their tummy is about the size of a cherry and will grow to be the size of an egg by about day ten. That gives you some indication as to how fast a baby grows and therefore how frequently they will need to feed.
When baby takes milk from the breast, they are signalling to your milk-making cells in your breast to make more milk. The more milk baby takes from the breast, the more your body knows to produce more of it. It takes around six weeks to establish your supply, and after this you may start to notice that frequent feeding might become less intense. If you try to stretch out your feeds during this time, then your milk isn’t being removed and your body is signalling that you don’t need to produce as much breast milk, which can impact your supply. So it’s important not to clock watch or stretch out feeds, and instead listen to your baby and feed when they’re showing signs of wanting to be fed.
Understanding Cluster Feeding
There may be certain periods during the day that your baby is feeding more often, and feeds seem to be closer together. It can feel relentless, and often you’re left questioning if your baby is getting enough milk, that surely, they can’t still be hungry. This is cluster feeding and it isn’t a sign that your baby isn’t getting enough milk. If your baby is gaining weight, and doing their wet and dirty nappies, then this behaviour is normal. This period is all about getting your milk supply established so that your baby can continue to feed successfully in the long-term.
Continue to respond to your baby and this phase will pass. It can be testing, but it will pass.
The Mind-Body Connection
Feeding in the fourth trimester is intense, and not always easy. Know that you’re doing great and being exactly who you need to be for your baby. You might be wondering how on earth Mindful Breastfeeding comes in. What is the ‘Mindful’ bit? It’s a question I often get asked.
Our brain and body are deeply connected, working together all the time. Our brain sends hormones around our body that signals our body to do certain things, like breastfeeding for example. There are two hormones that are needed for breastfeeding – Prolactin and Oxytocin. Prolactin tells the milk-making cells in our breasts to make more milk, and Oxytocin tells the squeezy cells in our breasts to release the milk. But when we are in a state of anxiety, or fight or flight mode, our autonomic nervous system is telling our body to stay in a state of stress, which can hinder the flow of our hormones, and therefore impact breastfeeding.
Oxytocin, otherwise known as the ‘Love’ hormone is crucial for breastfeeding. But it’s a shy hormone and flows best when we’re in a relaxed state. If we’re stressed, feeling uptight, overwhelmed, which of course is totally normal as a new mum, then the flow of oxytocin will be restricted which can affect the flow of breastmilk.
Having a basic understanding of our nervous system and the connection between our mind and body, can help us become more aware and in tune with how we’re feeling, particularly in those moments that are proving more difficult than others. For example, if it’s hurting to feed, or you feel like your baby isn’t latching properly, and it’s causing you to tense up, take a moment to actively switch your mindset. Practicing simple techniques to calm your nervous system down and bring you back to a level of calmness, can help you connect again, feel in control, and take on breastfeeding in a more relaxed state. Examples can include:
- Simple breathwork
- Listening to some music
- Skin-to-skin with your baby can make a big difference
- Asking for help whilst you take a moment to step away to make a drink or take a breather
- Listening to a guided relaxation
Ask For Help – You Deserve It
At this point, you may feel like it’s impossible to do any of the above. But it is possible and can help you on your feeding journey. It may feel like you just can’t see how it could work, and this is where asking for support is essential. You’re doing the ultimate job of feeding your baby, you deserve to be supported and to be held too.
Please reach out for help, whether it’s from a family member, lactation practitioner, peer support group, or me. You can find more about what I do here or get in touch to arrange a call to discuss. Help in the early days can have significant benefits for the long-term success of breastfeeding for you and your baby. If you feel that you have deeper concerns for your baby, reach out to your GP or other health professional.
Final Thoughts
The fourth trimester is raw, beautiful, and full of unknowns. Breastfeeding can feel overwhelming at times, but with support, knowledge, and self-compassion, it becomes more manageable. Remember: you are not alone, and there’s no “perfect” way to do this — only what works for you and your baby.