Understanding the 4th Trimester: Decoding Your Newborn’s Crying & How Central Coast Parents Can Cope

by LukeAdmin

By Lynne Campey – Registered Nurse/Midwife, and Child & Family Health Nurse

Becoming a parent is a crash course in skills that there is very little preparation for! Often our exposure to babies prior to jumping into the parenting pool is limited and the newborn period (the first three months) can be very challenging trying to understand our baby’s needs.

From womb to world.

It is important to acknowledge the significance of all the changes that the baby has gone through from life in the womb to life in the outside world. This transition is the most radical period a human experiences in their entire life. At the moment of birth, babies suddenly need to manage all their own breathing, eating, pooping, temperature regulation, as well as adjust to a rather scary, loud and bright big world!

The 4th trimester

One descriptive term that I find helps to understand the newborn period is to label it “The 4th Trimester”. Just as we have expectations of our baby’s growth and the physical changes that occur during the pregnancy trimesters, it is helpful to understand that our baby does not arrive to the world fully ready to manage all the changes that come with being born. Typically, it takes around 3 months for the baby to start to settle in to all these system changes which explains why the intense newborn crying period often starts to self–regulate at around 3 months.

What is normal crying?

The newborn crying period is sometimes called “colic”, which unfortunately can give the false impression that the crying is digestion related. The crying can be intense lasting up to 5 hours a day and can cause a lot of parental anxiety. This crying period typically starts in week 2 and peaks around week 6. Studies show that in most cases this normal developmental stage will pass no matter what treatment is implemented. Although this pattern of crying through the newborn period is quite universal, every baby comes with their own little personality too. Some babies just have a lot more to say and sometimes a very loud way of saying it!

Period of PURPLE crying

A great tool to help understand the normal stage of newborn crying is “The Period of PURPLE crying” (http://purplecrying.info/what-is-the-period-of-purple-crying.php). This website can be helpful to look at the type of behaviour the baby is demonstrating and see if it fits within this framework of normal development.

The acronym PURPLE stands for:

  • Peak of crying (starting around week 2, peaking around 6–8 weeks, and resolving around 3–4 months)
  • Unexpected crying that seems to come and go and you don’t know why
  • Resists soothing no matter what you try
  • Pain–like face (baby looks like they are in pain)
  • Long lasting (crying can last up to 5 hours a day!)
  • Evening (most babies will fall into an unsettled period in the evening).

How can we manage this period?

Once we understand that periods of crying are a part of a baby’s normal adjustment to life outside the womb, we are then more able to understand them and comfort them. Some ways to help them as they make this transition is to provide an environment that emulates the womb.

Things like:

  • Reduce the level of environmental stimulation and go to a quiet, darkened room
  • Securely hold them or use a (not too tight!) wrap to help them feel supported
  • Good old rocking or patting and shooshing
  • Allow them to have a suckle for comfort even if you think they can’t be hungry
  • Learn to recognise their “tired signs” and start to settle your baby before they become over stimulated and over tired
  • Depending on the time of day, go for a walk outside. It’s amazing how much better crying sounds when you are outside and not in the echo chamber of four walls!
  • Leaving them momentarily in their safe sleep space is perfectly fine. Use that moment to “phone a friend” or simply have a moment alone in the shower or have a cup of tea. Babies will not hurt themselves with a few minutes of crying – in fact, sometimes the baby will actually calm down because their level of stimulation is reduced, and they can finally rest! Crying can really push our buttons and recognizing when you need to step away to gather yourself is important
  • Keeping a “cry diary” can be helpful information to take with you to your health professional visit.

Crying that should be investigated

Of course, it is important to rule out any red flags of crying and when medical advice should be sought.

These include:

  • Any sudden or acute changes in crying behaviour
  • If baby is not demanding enough feeds – they need a minimum of 5 milk feeds a day (8–12 feeds a day is quite normal)
  • If they are having less than 5 heavy wet disposable nappies (or 6 cloth nappies) a day or if their urine appears concentrated and smelly
  • If there is blood in their poos (remember a breast–fed baby will have liquid yellow poos and a formula fed baby will have more pasty greenish poos)
  • Poor growth.

Help is out there!

If you have any concerns with the health of your baby or you are struggling to manage with the level of crying don’t hesitate to seek help! You can see your GP or Child and Family Health Nurse, and they can check baby to be sure all is okay and offer relevant resources and referrals. You can also check out raisingchildren.net.au which has lots of helpful information and includes subheadings for the newborn period.

Lynne Campey is a Registered Nurse, Registered Midwife, and Child and Family Health Nurse with more than 20 years’ experience on the Central Coast. She is passionate about helping family’s transition to parenthood and understand their baby’s normal development expectations. She currently works at Your Family Doctors at Erina.

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