Navigating the 4th trimester: supporting successful breastfeeding

By Amanda Marks,
Parenting & Infant Care Expert

When I first started my breastfeeding journey 27 years ago, the concept of the 4th trimester - those crucial first 12 weeks after birth - was barely acknowledged. Back then, as a junior breastfeeding advisor, there was little focus on colostrum collection, hand expressing, or how critical those early days are for long-term breastfeeding success.

Fast forward to today, and thanks to training with UNICEF and Sure Start, as well as the privilege of learning from pioneers like Dr Jack Newman, Dr Nils Bergman, Dr Yehudi Gordon, Peter Walker, and Janet Balaskas, I’ve built a tried-and-tested approach that has supported over 5,000 families across the UK and internationally.

Why the 4th trimester matters

Unlike animals that carry for 12–18 months, human babies arrive sooner, and need to remain close in those early weeks, craving the rhythm, warmth, and connection of the womb. That’s why skin-to-skin, calm environments, and responsive feeding are so important.Breastmilk is a powerful, living fluid - rich in immunity, antibodies, and gut-healing properties. And the first milk, colostrum, often goes uncelebrated. It’s vital in protecting the gut, reducing future digestive issues, and breaking down bilirubin levels to help prevent jaundice. I see its magic in my clinic every day.

baby breastfeeding

Preparing before birth

My programme begins at 37–38 weeks. Mothers learn gentle hand expressing, twice daily when prolactin levels are highest. Whether you produce a few drops or fill syringes, it’s not about quantity - it’s about preparing your body and mind.Clients tell me this early expressing builds confidence: “It’s the milk for my baby, and my body is responding.” We increase to three sessions daily just before term, helping mums connect with their babies and prepare for birth emotionally and physically.

The first few days after birth

After the baby arrives, we express small amounts of colostrum into syringes to support feeding and reduce pressure on mum. It helps with:

  • Supporting latching and preventing fast let-down
  • Reducing risks of jaundice or sleepy feeding
  • Avoiding engorgement around day 3–4

Yes, it’s intensive - but by day 5–7, most of my clients have regained birth weight (even after C-sections!) and are confidently, exclusively breastfeeding. I often hear the same question from amazed midwives: “Are you sure you haven’t topped up with formula?”

Reflux, rest & reassurance

In the early weeks, many babies experience unsettled periods, and too often, reflux or “silent reflux” is wrongly blamed on breastmilk. But breastmilk isn’t the cause - it’s the solution. It contains natural pain relief, sedatives, stem cells, and antibodies. What babies usually need is:

  • To be held
  • Skin-to-skin contact
  • Gentle motion, warmth, and comfort

When milk alone doesn’t calm them, I tell mums: pick up your baby, wear them, bounce, sing, walk - this is the 4th trimester.

Mother breastfeeding

Easing into routine

By 4–6 weeks most clients begin gentle pumping and may introduce a dummy if they choose. Their milk supply is now strong and steady. Babies feed efficiently, sleep more deeply, and mums start getting their evenings back.By now, most families are finding their flow. And when the 4-month regression hits? We’re ready for it - no panic needed. My clients are supported, milk supply is adjusted, and we guide babies through that transition smoothly.

The next chapter

From 5 and a half months, most of my families start and then move into my Food & Sleep Programme from 6 months - weaning, allergen exposure, baby-led feeding, and the foundations of deep, independent sleep (no controlled crying, ever). It’s such a joy to support families again at this stage.

With nearly 40 years of experience, I could write books on breastfeeding. But I hope this short blog brings reassurance and guidance to any mum on this journey. You’re doing an incredible job - and your efforts today are building your baby’s future health and resilience.

Sharing knowledge, supporting one another, and celebrating the power of breastfeeding is how we shape healthier generations to come.

For more information about Amanda’s work, head over to @throughtheeyesofaparent or visit throughtheeyesofaparent.co.uk

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by Folk & Thread