Survive the “fourth trimester”: 5 and 1 ways to deal with baby crying17.08.2022
The first months of a baby’s life, in addition to the expected joys, often become a difficult test for the baby and his parents. The fact that newborns cry is a fact that does not require proof. However, not everyone knows how to understand the reason for crying, and most importantly, how to calm the child in practice. The fourth trimester theory has been around for more than thirty years, but is only now gaining popularity with mindful parents.
Together with pediatrician Vitalia Prima, official representative of the Colix brand, manufacturer of gas tubes for babies, we understand how effective the concept of the fourth trimester is.
Before applying the method of Dr. Karp, who proposed to consider the first three months of a child’s life as the fourth trimester, I recommend that you determine the condition of the child and exclude painful manifestations, advises Dr. Prima. – After all, the crying of a child can talk about a disease or a banal physical discomfort caused by colic.
Research shows that the cause of screaming during colic is pain, not hunger or anxiety. With colic, the pain syndrome develops due to overstretching of the intestinal loops with gases. That is why it is important for parents to help the baby first cope with the symptoms, and only then with emotional manifestations. The good news is that colic usually stops by three months, although 15% of babies may experience it for longer.
An effective method for determining colic in newborns is the Wessel criterion, comments Vitalia Prima. Or , to put it more simply, the rule of three: crying at least three hours a day, at least three days a week, at least three weeks. This means that the baby is hindered by accumulated gases in the intestines and acute painful spasms. You can stop them with the help of a gas outlet tube: according to surveys, a rectal tube helps to improve the child’s condition by 75%.
Before the procedure, wash your hands thoroughly, put the child on his back and gently massage the tummy in a circular motion two to three times. Pre-lubricate the tube with baby oil, petroleum jelly or hypoallergenic cream. With the baby’s legs up, gently insert the tip into the rectal opening and twist clockwise. With the correct technique, you will hear the sound of exhaust gases, and the baby can also empty. For convenience, choose devices with a waste bag.
If you are convinced that the child is healthy and does not want to eat, sleep, he has a dry diaper, but he still continues to cry, then the “5P” technique, which was introduced by the American pediatrician Harvey Karp in the concept of the fourth trimester, will be useful.
The ideal term for bearing a child, according to biologists, is one year. However, this is impossible, because if the fetus spends a year in the womb, then childbirth will be difficult: the baby’s head simply cannot pass through the narrow birth canal. But nature has thought of everything for us, reducing the gestation period and shifting the responsibility for caring for their offspring to humanity. We can only take into account the “fourth trimester” and recreate the conditions of the mother’s womb. This is what Dr. Harp’s 5 principles are based on: swaddle, side or stomach position, habitual noise, rocking and pacifier. Let’s talk more about each.
In order to create a feeling of comfort, safety, security and to prevent flinching from throwing up the arms, Dr. Karp first of all recommends swaddling. However, this is not the same Soviet swaddling from the experience of our mothers and grandmothers, when the child was tightly twisted with a diaper, straightening the arms and legs, like a soldier at attention. Use a diaper with Velcro or a zipper. At the same time, Dr. Vitalia Prima recommends observing the following rules:
- do not swaddle tight – let the baby feel some freedom of movement;
- avoid overheating – choose a thin shirt and diaper if the room is warm;
- do not fix the hips and do not prevent the baby from bending the knees, as tight swaddling can contribute to the development of diseases of the musculoskeletal system.
Sleeping position on side or stomach
It is this recommendation that raises the most questions among pediatricians, because they consider the supine position to be the only safe option for sleeping in children from birth to six months. But when it is necessary to calm a crying baby, it is better to put him on his side or on his stomach. This position will help the work of the intestines and the discharge of gases, give the baby confidence. For bouts of crying, lay the newborn on your forearm with your tummy. To make it comfortable for you to hold the baby in this position for a long time, sit or walk around the room.
Did you know that in the uterus, the internal sounds of the body are louder than the buzz of a vacuum cleaner? In the womb, the child constantly heard the noise of blood moving through the vessels and the beating of the heart.
To remind the baby of the sounds he heard while in the womb, Dr. Karp suggests turning on white noise. The white noise method triggers the “soothing reflex” in babies, a natural mechanism for self-soothing. As white noise, both the sounds of nature and the low hum of household appliances, such as a hair dryer turned on in the next room, are suitable.
Vitalia Prima warns that the white noise method should be used carefully: the sound should not exceed 50 dB – the level of a calm and quiet conversation.
““We are told that it is harmful to rock children!” – you will rightly be indignant. However, Karp’s jiggling is different from the intense shaking of the past. A newborn, feeling gravity on himself, experiences approximately the same sensations as a sailor when adapting to life on land after a long stay at sea.
Make very careful, and at the same time, fast and short movements – like a boat or a raft on light sea waves. At the same time, let the baby’s head gently sway in your palms. For rocking, traditional motion sickness in a stroller or electric chair is not suitable. But the fitball (the same rubber fitness ball that you exercised on during pregnancy) can come in handy. Sit with the baby in your arms on the ball and lightly spring. Such motion sickness will help not only the baby, but also the mother – it will reduce stress and relieve stress from the back.
The final element of Dr. Karp’s training manual for the most desperate parents. If the previous tips did not help and the parents were exhausted, the last resort to calm the baby is a dummy.
Sucking affects deep levels of the nervous system. Self-soothing occurs due to the production of natural hormones of happiness: dopamine, serotonin, oxytocin. However, Dr. Prima notes that attachment to the breast gives the same effect, and prolonged sucking of the pacifier adversely affects the development of bite in children. In any case, the maximum age for using a pacifier is 2.5 years.
Dr. Vitalia Prima notes that although the fourth trimester technique is valid, it is not universal and will not necessarily work in all cases. After all, each baby is unique: for one child, rocking will be enough, for another, due to its peculiarities, it will be difficult to calm down even if the mother applies all five principles at the same time.
Remember that difficulties pass, and the contact of an infant with parents and the world in the first months is especially important for its development.
- Parga, JJ, Lewin, S., Lewis, J. et al. Defining and distinguishing infant behavioral states using acoustic cry analysis: is colic painful? Pediatr Res 87, 576–580 (2020). https://doi.org/10.1038/s41390-019-0592-4 .
- Salynn Boyles. Colic Usually Gone in Three Months // WebMD, website
- Colix website