This week on the Blog we are joined by Tatiana, the founder of Fourth Trimester Friend. Tatiana is a neonatal ICU nurse, mum, business owner and an all round warm hug of a vibe. Thank you for being here today!
Ok, please tell us what is ‘Fourth Trimester Friend’ and how was this business born? (pun maybe intended haha!)
Ha, I’ll take the pun! And thank you so much for having me.
Fourth Trimester Friend is me, coming to your house in those early weeks when everything is new and nobody has slept. You were surrounded by nurses, there was a call button, someone checked on you every few hours - and then you came home with a whole new person and a folder of pamphlets. That gap is the entire reason I exist.
So we sit on your lounge room floor and work through whatever is actually happening that week. Feeding, whatever that looks like for you - breast, pump, combo, formula. No agenda, I meet you where you’re at. Blue book checks. Reflux, gas, and all the crying that comes with it. The rash you photographed at 3am. The weight that scared you at the last weigh-in. The evenings that fall apart at 5pm. The thing you’ve been consulting ChatGPT or your mums group for at 2am and getting five different answers to. The clinic visit that sent you down a spiral.
Because I’m a nurse practitioner, most of that I can assess and treat right there in your living room, prescribing if you need it, rather than sending you off to book something else. And then I don’t disappear. You have my number and you use it.
It started properly in 2022 when I was a NICU nurse in the U.S., because my friends kept texting me (LOL). My phone would go at all hours with photos of rashes, photos of nappies, “does this look normal to you?” It took me a while to realise they could have Googled most of it. They rang me because I knew babies and I knew them, and they could ask at 11pm without booking anything or feeling stupid.
What does a week in the life of look like for you? (work, family life, what do you do to wind down)
One day a week I have my nearly 3-year-old home with me, which is always reserved for swim lessons and typical toddler madness! I’m so grateful for our beautiful beaches and outdoor spaces that we get to roam. We’re usually putzing around Balmoral Beach. My big boy is in school 5 days per week (wahooo!).
Most of my week is in people’s homes across Sydney, or travelling to and from! The bulk of my week are home visits, and then the messaging that carries on between them, which is a bigger part of the job than people imagine. A lot of the real work happens by text or voice memo after bedtime :)
I still pick up shifts in Special Care Nursery and NICU. I’m casual in the public system plus agency work at some of the private hospitals. It’s such a treat getting to see both setups, and honestly it reaffirms why I do what I do, because postpartum wraparound care differs WIDELY depending on your delivery setup.
I also spend a chunk of each week filming and writing, because there’s only one of me and not everyone can book a visit. I’ve had my hands full recently recording Coming Home Confident, a nine-module digital course all about what happens when they kick you to the curb at hospital discharge.
To wind down, I catch up with my mum tribe or go for a run. I’m usually training for some sort of race, which is either a healthy outlet or a very elaborate excuse to listen to podcasts by myself, depending on the week.
What are some examples of reasons families access your service?
Great question, and it’s usually a cluster of a few! That’s part of why one person works - I can look at the feeding, the weight and the sleep in the same visit, instead of you chasing three referrals with a newborn in tow.
Feeding. A latch that hurts, a baby who won’t stay awake at the breast, supply worries, triple feeding a family can’t sustain, weaning off a nipple shield, or a bottle refusal a few weeks out from going back to work.
Growth and development. Someone said a number at a weigh-in and now you’re frightened, and nobody has watched a full feed to work out why. Blue book checks and infant assessments too, all done in the living room.
Unsettled babies. The baby who simply will not be put down. The evenings that fall apart, the screaming from 5pm, the families who’ve been told “probably colic” and sent home with that.
Sleep and day-night rhythm, realistic and age-appropriate for where bub is at. This one brings me a lot of families several months in, not just newborns (especially around 4–6 weeks when babies wake up and gone are the days of the set-and-forget newborn)! We work through what’s realistic for their age and how to consolidate overnight sleep if bub is ready for it. And because I already know their baby by then, we’re adjusting rather than starting from scratch.
NICU and prem graduates coming home. That’s my clinical background, so families often seek me out specifically for it as someone to ask the questions to, a NICU nurse in your pocket, and clinical help if anything feels awry.
Second and third-time parents. They’ve done this before, but THIS baby is completely different and they feel ridiculous asking for help. They’re not ridiculous! A supported postpartum changes how the whole matrescence feels.
The thread through all of it is the same. Most of them have already done the rounds, the fortnightly weigh-in, the appointment where someone new opens the file for the first time, five different answers to the same question from five different people.
So they want a north star. One person who knows their baby, who they can text at 11pm and get a straight answer from, without booking anything or explaining the whole story from the beginning again. It helps that the person happens to be a nurse practitioner with a decade of NICU behind her. Mostly though, it’s not having to start again.
Am I right in saying you’re one of the only people in Sydney offering this type of service?
To my knowledge I’m the only nurse practitioner doing private postnatal care in the Sydney area, though I say that carefully, because Sydney is big and I’d hate to be wrong! There are many gorgeous specialists who offer postpartum support, but I’ll do my best to explain my offer and why it might be different.
I’m an endorsed nurse practitioner, so I’ve done advanced training (mine specifically in acute care paediatrics). I have my doctorate in nursing practice, which is a fancy way of saying I can appraise research very well and know how to find the right guidelines to structure my practice! Practically, in your living room I can assess, diagnose, prescribe and refer. I can send a script to your phone. That usually means one visit can cover what would otherwise be three appointments, in three different waiting rooms, with a newborn in tow.
The difference is also continuity, and it’s a part I’m super proud to offer. You get me. The same person who watched the feed in week one is the person you’re texting in week nine, and the person who already knows your birth, your baby and what you’ve already tried. You’re never starting the story again from the beginning. Nobody hands you on. That sounds like a small thing and it is the entire difference.
And am I right in saying it can be claimed through medicare?
Yep! Because I'm an endorsed nurse practitioner, not just a registered nurse, I can claim Medicare item numbers and you don't need a GP referral to see me. Video consults attract a rebate as well, which matters for the check-ins between home visits.
The bigger piece is the Medicare Safety Net. Once your family passes the threshold for the calendar year (and if you’ve had a baby that year, you very likely have), the rebates increase and the out-of-pocket on a home visit drops to around $76. Steady Start, my continuity package, comes down to a bit under $400 for the whole six weeks. Which to me is SO incredible for that much postpartum support.
Most families have no idea any of this exists, which is why I ended up writing a whole guide on it. These are the current figures and Medicare updates its schedule, so the guide walks you through checking your own.
Ok maybe let’s use a real life example of something you might commonly be called for.. perhaps to review a collicy/unsettled baby?
Say you call me about a baby who screams every evening and you’ve been told it’s colic.
Before I come, I want the birth story, the feeding history, weights if you have them, and what the evenings look like hour by hour. How we’re feeding now, how that goes, how long it takes, what bottle, what formula. Colic is a description, and a diagnosis of exclusion. My job is to work out what’s underneath it.
A home visit is 90 minutes at your place. I check oral motor function, tongue and lip. I do a top-to-toe on the baby, looking for asymmetries or tension that could cause colic-like behaviour. Then I watch a full feed, start to finish. If you’re breastfeeding I weigh before and after so we can see how much is transferring, and I’m watching how efficiently baby drinks, your supply, whether there’s a fast letdown or gulping, etc.
I’ll look at how you’re settling them and what kind of swaddle you’re using, make suggestions, and demonstrate in real time. If a dummy needs introducing I’ll do that too (I keep a lot of products in my go-bag!). And I look at where baby sleeps, including how loud the white noise is, because I use a decibel meter and people are regularly surprised.
Afterwards you have seven days of messaging me directly, because the questions turn up at 11pm on the third feed in a row. For families who want it to run longer, that’s what Steady Start is for. We keep adjusting as baby changes rather than me handing over a plan and walking off.
A big part of the job is knowing when it isn’t mine. If there’s reflux that needs managing, I can start that medication. If it’s a musculoskeletal or positional picture i.e. a baby who only turns one way, or who feeds beautifully on one side and fights the other, that’s a referral to a physio or bodyworker. And if what’s going on is maternal mental health, that gets a real conversation and the right referrals too.
Fav coffee on the Northern Beaches and fav girls lunch or afternoon drink spot?
Just know these are both so hard to answer!!!
I am so obsessed with Serva in Seaforth (and now Freshie)! But TBH I am not across the best coffee spots in the NB. Please someone send me a DM with your favorites and I would be absolutely delighted to check them out. Coffee shops/cafes are a hobby ;)
I will legitimately never say no to a girls lunch. I physically can’t. My body rejects it. ;) Favorite girls lunch is probably taking the ferry or bus into the city and doing Zushi Barangaroo - something about that Wagyu roll!! Anywhere we go I’ll likely be ordering a margarita or a French rosè.
How do people find you/contact you?
fourthtrimesterfriend.com is the main door - services, booking, my course, and the good details all live there. I'm on socials @fourthtrimesterfriend — my DMs are always open! I visit families across Sydney and surrounds, so if you’re not sure whether you’re in range, just ask me.
Thank you so much for joining us!
