Friday, September 29, 2023

Parenting Pointers - Tips for the Fourth Trimester


Congrats, you’re a new mother! However, you’ve also now entered a brand new world filled with brand new responsibilities. What are a few must-know tips for the first 12  weeks after you have your baby, sometimes referred to as the “Fourth Trimester”?


Maternal Health Expert Alan Lindemann, M.D., author of "Pregnancy Your Way: Choose a Safe and Happy Birth," has over 40 years of experience delivering over 6000 babies, and can provide must-know tips for the “Fourth Trimester.”


“There was a time when new moms were allowed to stay in the hospital until the doctor and the nurses felt they were ready to go home,” says Dr. Lindemann. “Today, 24 hours is the usual hospital stay for vaginal delivery, which means a bunch of CDs are tossed at the new moms before they are quickly ushered out the door — often before they are ready to deal with the demands of a new baby. For that reason, I strongly advise you to consider making a ‘Flight Plan’ (my version of a birth plan) that includes the Fourth Trimester.”


1) Create a Division of Labor Plan Before Leaving The Hospital: Who is going to do what, when, and where? You and your significant other need to know all of these things before you leave the hospital. Make a plan around how your baby is eating, how much milk you’re making, when to feed formula, when and how to breast pump, who cooks and when, who cleans the bathrooms, who gets the groceries, and how to find and choose daycare.

2) Don't Be Afraid to Supplement Breastmilk With Formula: If your milk hasn’t come in yet and your baby is hungry, supplement with formula. Your baby needs to eat and gain weight. Because Hospital CEOs / insurances pressure physicians to send new mothers home before their milk comes in in order to "save money," too many babies wind up being readmitted to the hospital for "failure to thrive.” Lactation specialists often advise no formula be given, but if your baby is hungry, supplement your breastmilk with formula.

3) Stay Regular With Prune Juice or Apple Juice: Prune juice and apple juice contain a lot of sugar. The sugar draws fluid into your digestive system where it can help move bowel contents along. Sometimes fat from something like bacon can also help. Be sure to drink lots of water!

4) Keep a Journal: Writing down your thoughts and concerns, especially with attention to consciously thinking of things to be grateful for, can help you in many ways. Research indicates that journaling can at times be as good as cognitive behavioral therapy (counseling) for dealing with depression and anxiety (though it should never take the place of a counselor). I recommend starting a journal at the beginning of your pregnancy and continuing it through your fourth trimester.

5) Watch for the Baby Blues: If you feel unable to deal with taking care of your baby or become overwhelmed, call your doctor. Postpartum depression can develop for up to a year after your baby is born and left untreated can last for decades. Postpartum depression is both treatable (with psychotherapy, medication, or a mix of both), as well as preventableWomen often don’t realize that there’s an element of grieving with the birth of a child, such as grieving for the person they were and will never be again. Successful grieving occurs when women recognize this element of grieving and allow themselves to move through the stages of successful grieving described by Elisabeth Kübler-Ross.


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About Dr. Lindemann:  An obstetrician and maternal health expert, “Rural Doc” Alan Lindemann, M.D., teaches women and their families how to create the outcomes they want for their own personal health and pregnancy. A former Clinical Associate Professor at the University of North Dakota, he served as a clinical faculty member and preceptor with medical students in rural rotations. In his nearly 40 years of practice, he has delivered more than 6,000 babies and achieved a maternal mortality rate of zero! His new book is "Pregnancy Your Way: Choose a Safe and Happy Birth." Learn more at

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