Doulas, Nannies, and Beyond: Choosing the Right Type of Care for Your Family

Doulas, night nannies, and baby nurses, oh my! While the wealth of postnatal care options in Brooklyn is wonderful, it can also leave you with option paralysis. Below, find info on the distinctions between different types of caregivers.

 

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Post-partum doula

  • Family is first priority; baby is second priority
  • Can do laundry, help with household chores, prepare meals

 

Night nurse (a.k.a. night nanny)

  • Probably not actually a nurse! (see note below)
  • First priority is the baby
  • Works nights (likely a 12-hour shift or similar) and takes care of the baby (gets up to feed with a bottle, or brings to mom to breastfeed)
  • May be a "regular" nanny who works nights for higher pay
  • Typically employed for 1–4 weeks
  • If you need heavier coverage (7 days/week) during the first couple weeks and lighter coverage once you get into the swing of things with the new baby, you might be able to negotiate that with your night nurse as long as you're transparent

 

Baby nurse

  • Again, probably not a nurse! (see note below)
  • Newborn care specialist employed to take care of the baby
  • Deals with baby-specific issues such as diaper rash
  • Organizes the nursery and handles baby's laundry
  • May work 24 hours/day or just during the day

 

A note on the "nurse" designation: Some caretakers use the term "nurse" without having a medical degree. While this is colloquial and we do not think people do this to intentionally to mislead, it may give some employers a false sense of credibility. Do your research and investigate your employee's credentials before you take the plunge. Night nurses and baby nurses may hold one or more of a variety of non-medical certifications (e.g., NCSA), which you should request during the hiring process. Certifications may address feeding, sleep training, CPR, and managing medical conditions for preemies.

 

Rates: Night nurses and baby nurses may charge upwards of $200/night,  $350–$700/day,  or $18–$30/hour. Post-partum doulas may charge $25–$35/hour. Of course, rates will vary from person to person,  so consider your budget, do research, and compare costs.

 

Bottom line: Choosing which type of caregiver to hire—and whether to hire one at all—depends on your personality and level of control.  If you’re someone who worries a lot about money and wants a lot of control over what the caregiver does, it might not be the best to have one more person to manage. If you live in a small apartment, even one more person can feel like a lot. Some moms have been known to send their family away because it was just too much to manage a new baby, a caregiver, a partner, and an older child. Some people want to hibernate with their new baby, so they end up not hiring any help and instead traversing things by themselves. On the other hand, quality help (whatever the form) can educate new parents, allow for much-needed sleep, and lighten the load tremendously.

 

Thoughts and experiences from PSP members:

 

Postpartum Doulas


Worked better than a baby nurse: "I had a postpartum doula and I loved her. It made that ten days of learning how to care for my baby stress free. I had a dear friend staying with me so didn't go the baby nurse route--and also it felt very important to me to be the primary person caring for [my baby] and I didn't want a stranger living with me. So, if your philosophy is somewhat akin to mind, and you don't need the coverage of a baby nurse because you have some other support to help you get through the night, (or if you can afford to hire the PP doula for a lot of hours) I would definitely without a doubt go the PP doula route instead of the baby nurse route. Having my PP doula there meant I didn't have to remember info from classes or go paging through books or be faced with not knowing what to do. I just had a patient, kind, loving person there showing me what to do when issues arose--so I learned how to bathe her when it was time for her first bath etc. It took so much stress out of the first 10 days."

More worth the money than a birth doula: "I also had a birth doula, who was great, but if I had to pick where to put my $, I'd do the PP doula. That is if you have a friend of someone who can act as your birth partner. Just think about who you trust most in your life, who will be most even tempered and comforting and most psyched to be there."

Great for part-time: "This is another plug for hiring a part time (babysitter or doula) for a few hours over the week once your partner goes back to work, rather than a night nurse. I was breastfeeding so to me it made more sense to do this, and we loved our doula. While I can't speak to what an amazing night nurse could offer a breastfeeding mom, I cannot recommend highly enough the post partum doula. I'm not sure if all of them do this, but ours was happy to do whatever we needed for those three hours at a time. Sometimes that meant a bottle; sometimes it meant holding the baby for a long nap while I slept and putting her to sleep after I fed her; often times, it meant some advice; often times, it meant arriving with coffees in tow for us (a very soothing luxury) and often times, it meant making us breakfast or lunch and most often, it meant all of these things. It was a godsend to have her, and I think the closest thing to having family around (once my mom could no longer stay with us past those first two weeks)."

Better fit than a night nanny: "I went with post partum doula and could not be happier for these reasons:

-doulas have an international certification, there is no standard training applicable to night nannies (that I know of)
-doulas are there to help the family - with whatever is your most pressing need that day (food, your post partum recovery, baby care, straightening house, relief for a nap etc)
-I found it essential to have someone who wanted to give an ear for my delivery experience, how I was physically recovering etc. it truly felt like a family member you pay (but without any guilt that I would typically feel in asking for help - which is one of the things that I liked about doula - conditioned me in how to ask others for the help I need! I wanted this experience prior to having family stay with us after delivery because it can be a sensitive time of healing and bonding and I wanted to figure out how I wanted to navigate that with family.
-focus is also on supporting your instincts as new parent - whatever methods you want. Rather than someone coming in who may follow their own default ways of doing things
-Can be daytime or overnight, I felt daytime was most helpful to me so that I could be present/alert enough to use doula for information.
-you hire a person, not a rotation of several dif people from a service"

Pricey but helpful in challenging times: "I had twins and we also went with a postpartum doula over a night nanny. I wanted to make sure I also had help when it came to recovery and breastfeeding and the doula seemed to fit that more than a night nanny.

We booked our fantastic doula (Heidy Ramirez) about 2/3 months before my due date but I ended up giving birth at 36 weeks. She knew there were big chances that would happen so we just stayed in touch for her availability and made it work. The babies ended up spending a few days in the NICU and we were in touch with her that whole time as well. She ended up being there the first night we brought the babies home and she was a lifesaver. My husband and I are first time parents and bringing two very tiny babies home was daunting. My milk had also just come in and no one at the hospital had given me any guidance, and Heidy was incredible. She helped through the whole breastfeeding journey (getting my supply up, trying to breastfeed, pump, dealing with clogs, and then stopping around 8 weeks because of PPA/D). She ended up coming 2/3 nights a week for the first two months, and then a couple more nights when the dreaded 4 month sleep regression happened. She would come around 8 or 9pm, allowing my husband and I to have a couple hours alone to have dinner and watch a TV show, and then allowing us to sleep for more than 1 or 2 hours at a time. The twins had to be fed every 3 hours for a while and with two babies, only one of us had to be up with her rather than both of us which was incredibly helpful. She also really helped guide us when it came to bathing, feeding, nail cutting, etc. all the stuff that seems so evident but really takes a while to get used to. The babies ended up with reflux and one of them with a milk protein allergy which she first noticed. I was really comfortable with her and trusted her, which is really important when you leave you two babies with a stranger!

It is a big financial commitment for sure but it was absolutely worth it for us. I would do it again for one or two babies. We have no family around and wouldn't have survived the first two months without her. I think for people who know they want one, it might be worth adding a "fund" onto the registry to help with the financial commitment."

 

Night Nannies/Nurses


Helps you get sleep: "I’m 4 weeks postpartum and have a night nurse currently. I’ve found it incredibly helpful - I was even able to get a few nights of total sleep by pumping and having my nurse feed my daughter during the night when she woke."

Great for unexpectedly hard situations: "My husband and I did not decide in advance (we thought we could do it in our own) and had a sudden realization a few days after coming home from the hospital that My recovery made it difficult to get out of bed, my husband had to work, we had two other kids who needed time and attention and to get to school. Thus, panic, find a night nanny. In addition to our reasons some people have jobs like ER doctor where they need to sleep, or they simply prefer to have the help at night and then to enjoy taking care of baby during the day. A night nanny can also help give advice about feeding diapering, bathing etc. ... I would do it again if we had another and could afford it. I did find after they left and I was up at night it was sweet bonding time with baby even if exhausting."

Felt like an intrusion: "I thought that paying a night nurse would allow me to sleep and recover better. But there is absolutely no way that I could sleep with that precious little baby boy expressing any need for me, a bottle, a blanket, a hug or anything else. ... If you’re not feeling well you might be happy for the extra help. But it’s also possible you’ll be incredibly annoyed having a stranger intruding on your bonding time."

Not that helpful: "Ultimately, I found her not that helpful....as I was breastfeeding at night anyway and it wasn't that hard to get the baby back to sleep in those first days when they're sleeping non stop....so ended the contract early after 3 nights. It may be have been more helpful for week 2-4 when harder to get them back to sleep."

Depends on your situation: "One more thought on the PP doula/night nurse decision. I know people who have done both, but I think it can be hard because the philosophies can be different. The PP doula is focused on teaching you and empowering you to take care of your baby. They are also focused on helping you--they really are partially there to care for you. ... My sense is that a night nurse is there to take care of the baby at night so that you can sleep. In doing so, they will also get the baby on a sleep schedule. If you are going back to work soon for instance, and need the baby on a sleep schedule sooner rather than later, that might really be the best thing for you. I'd also consider what you want to do about nursing. If you want to exclusively breast feed and are going to be around to do it, a night nurse might be less useful to you because they let you sleep by doing bottle feedings. For a lot of couples, this is really useful because even when the nurse leaves, the non-nursing partner can still do a nighttime bottle feed. But if you're going to be nursing and no one else lives with you, unless you're going to keep the night nurse for a while, it might not be all that useful to get the baby on bottle feeding at night. (Obviously, you don't know how nursing is going to go until you start but it's something to think about.)"

Didn't seem necessary: "My husband and I considered getting a night nanny but ultimately decided that we didn't want a new person in our space in the early stages of having a newborn. I was also breastfeeding, so I knew I was going to be up in the middle of the night anyway---I wasn't going to hire a night nanny just to bring me the baby. With that said, if we were going to bottle feed the baby I probably would have more strongly considered having a night nanny as then my husband and I could actually sleep. In hindsight what I wish I did was get someone to come part-time during the day (once my husband went back to work) so that I could just have a little time to myself to workout, run errands, etc. Because parental leave isn't necessarily relaxing and I think it's important to have a little break to focus on you once you have gotten those initial weeks of parenthood/connecting with baby under your belt."

Great for first-timers: "I would 100% recommend it, especially if you don't know much about babies and don't have very capable family members willing to help you a lot. We had them for both of our girls for 3 weeks and it was so crucial to our sanity. I didn't have a c-section but if you wind up with one I think this help is even more valuable.

If you are a first time mom, the night nanny will teach you everything you need to know about how to care for your baby. She'll teach you how to learn their cues, what order to do various things in and help with breastfeeding if you're doing that. Happy to answer any more specific questions you have about the logistics. Even the second time around, the help was so important...honestly everything can be so grueling with a newborn, feeding them, burping them, soothing them, it just takes forever and can be so taxing...having someone else be able to even do some of it is incredible."

Flexible hours would be ideal: "I had some serious complications and was rehospitalized a couple of weeks after my son was born so my husband basically hired [our night nanny] on the spot!

That said, if I were doing it again, I would probably see if someone was willing to sign up for a couple of weeks and maybe have some flexibility built in about which hours. My son was actually a great sleeper but was really difficult and fussy during the day and I really relied on her during that time. [Our nanny] could get him to take a solid 3-hour nap in the middle of the day and though she showed me all of her techniques as soon as she left we could literally never replicate that again. She just seems to be magic!

One thing I will also say, if you do plan to breastfeed, I found having a night nurse a little complicated with that. [Our nanny] did nudge me a bit toward giving him bottles so that I could get more rest. I don't think that's necessarily a bad thing. I really did need the rest and my son got plenty of breastmilk but it's just something to consider. If that's something you feel really strongly about, postpartum doulas are another option to think about, though they generally don't put in nearly as many hours."

Worth it for twins: "It was a great experience. I had an older child and had not hired a night nanny with her. But with twins I knew there was no way I could make it on my own! She came over a few days after we came home from the hospital (I had some family staying over right when we came home and they helped me then) and stayed over every night for a few weeks. I think pretty soon after you have the baby is the best time because the early weeks are incredibly exhausting and stressful. It is great to have the extra help and just to have someone around who knows a lot about babies (because I also worried that I was doing things wrong, why was the baby crying, how do you make a swaddle stay, etc.). I also had a complicated C-section delivery, so I was not in great shape when I first came home. As the first few weeks pass, you recover from delivery, you figure out feeding, you get to know how to do things, and the baby is just physically able to eat more and sleep longer, so things start to feel easier.

Everyone (and baby) is different, but I thought it was really worth it. The exhaustion is real and it is so great to have another person there at night. Even if you are waking up to breastfeed the baby, then someone else can be there to hold the baby for the 20-30 minutes of crying after the baby eats, or for that random 2 hours of crying at night for just no reason (maybe your baby won't do this but, you know, just in case)."

Having someone living with you can be intense: "I currently have a night nurse in my home so hits home. It’s my second child, I had several friends do it, and the thought of more sleep sounded magical.

A few things I wish I thought of… 

She is living with us. The cost for 24 hours was the same for just over night. At the time it sounded like a great deal, and it is, but having someone who is not family with you 24/7 is a little intense.

Make sure you personally speak to referrals. Ours was referred by a friend of a friend and it was a glowing text message so I left it at that. In retrospect I should have asked for a voice conversation.

Make sure you are very clear about your parenting philosophy and expectations. I took for granted we’d be on the same page.

Overall I’m happy I did it, am sleeping at night more than I would have otherwise, and can do things during the day like nap and go to grocery store. But the first few nights were a little weird with misalignments.

Also yes leaving your child with a stranger over night is weird but you get used to it. Make sure you ask for a photo of ID, nurse ID, etc."

Sets you up for success: "Hiring a night nanny is one of the best decisions I have ever made.

I reached out to Baby Nurse Guru, whom I found on PSP in April, just as I was entering my second trimester bc I know they book up fast. ... They are flexible with when they start based on your due date. I selected 8 weeks initially, but wound up extending a few because she was so amazing and I wasn't ready to part with her yet. By 10 weeks my baby was sleeping through the night and we've had no issues since."

 

Baby Nurses


Great if your mobility is limited: "I did have a baby nurse for the first 3 weeks.  She was 7pm-7am.  I had a very difficult birth and postpartum experience and would not have been able to manage physically on my own.  She literally carried the baby to me in the middle of the night when I could barely walk to feed and then she held him upright for 40 minutes till he burped while I slept."

Not cheap but priceless: "I hired a baby nurse for the night. 7pm to 7am. It’s not cheap but was priceless. Amazing to get sleep and recuperate after difficult birth."

Helps with sleep and essential skills: "We are first time parents and our family could not be with us to help due to covid restrictions. But even if they were here we would hire a baby nurse. Worth every penny ... she helped me with breastfeeding, showed me everything that needs to be done around baby from grooming to bathing. Feeding basics (is he eating enough, how to measure when breastfeeding), eliminating cradle cap if it appears, changing, preventing diaper rash, dealing with post vaccine side effects, Most helpful was ability to sleep even for a 3hrs stretch. Before I fed the baby she changed him, after I fed the baby she burped him and put him to sleep. ... that gave me 2 hrs till next feeding. Once the baby transitioned to formula we could sleep the entire night. Additionally, she established bedtime routine which helped with sleep training.

We would definitely hire baby nurse again if our budget allows."

Lifesaver if you have medical complications: "I am a single mom and was going to be staying with my parents for the first months. I really booked because my mother insisted, but as I told her a million times, she was absolutely right. I wound up with serious medical complications after birth and having a baby nurse there was a life-saver. My parents are older and it would have been really hard for them to help with nights. While I thought I would breastfeed, my daughter wouldn't latch and my milk took a long time to come in and then the supply sucked, so I was doing formula from the beginning, and the baby nurse helped a ton. Because of my medical issues and PPA/D I wound up extending the time with a baby nurse and would 100% do it again. We had someone 24 hours, which doesn't cost much more than having someone for nights and allows you some breaks during the day plus the help/instruction."

 

Logistics: booking, hiring, and financing


"If you ultimately decide to have a night nanny you can book them in advance as soon as baby is conceived and they hold the time around it and just take short assignments to make sure they are on call for you. Or before baby is born or after birth if you decide last minute you need help.

There are agencies and then there is the informal network where the night nannies know each other and pass work to each other to balance their commitments.

It can be a big financial commitment so that can be a deciding factor for many. We found many are 5-7 nights a week, 12 hr shifts 25/hr plus transportation.

Make sure you speak with them and decide you are okay having someone in your home! Also, the baby is yours so if you have certain requirements on care (schedules, feeding, etc) be sure to speak up throughout the time they are there."

"-I started looking 4ish weeks ahead of due date and talked to people who were flexible around that time - I think the contracted start was flexible depending on birth date and just booked a certain # of hours.
-I planned to move to my parents place in CT (an hour from the city) once baby arrived...so researched options there/or those who would commute and options were limited.
-The person I hired lived close by, was flexible to add hours if needed, was vaxed, and my mom interviewed her in person."

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"How early did you look into booking a night nanny? - in nyc as early as you can. I was 4/5 months pregnant when I started to gather contacts and interviewed baby nurses

How did you arrive at a specific start date (since babies can be unpredictable!) - once you commit to a specific baby nurse you provide the baby nurse with a due date and you keep in touch with her as you getting near the date. If she agrees to work with you, she will be on standby around the due date time waiting for your call. She will be ready to start working on the day you bring the baby home. Many baby nurses work in teams so if your particular one for whatever reason won't be able to come due to some emergency, she will send a back up (another baby nurse that she knows very well)."

~~~

"How early do you book? This depends. When you go by word of mouth you should start early. I started 2 months in advance and everyone recommended to me (except the one person who was unvaccinated, which was not acceptable) was already booked. Many of them referred me to their friends/back ups and I wound up hiring one of them. She was not great. However, when she left, I was not well and needed someone new. I went through an agency this time (Lullaby). They were cheaper than the people via word of mouth, and I liked both the baby nurses I got through them much better (I had two because the first one had a family emergency and had to leave).

- How do you settle on a start date? This confused me too. However, they tend to try to be available the week before your due date. Basically, you tell them your due date and they tell you how they handle it. That said, many of my friends have told me that they wound up with different baby nurses than the one they booked. One of them had that happen to her even though she had a planned C section and there was no question about her due date."

~~~

"I looked for doula about a month or two before birth, used boober to gather range of candidates and experience, interviewed them and then agreed on certain number of hours for initial “package” (for me - about one week) with flexibility on continuing after that."

 

General thoughts on postpartum helpers


You'll be happy you did it: "I lined up almost two months of support post partum. I had friends and family come and stay in rotation. You will need it darling. You will need someone to feed you and make sure you have showered etc. you cannot do it alone. You will be so sleep deprived at times that you will need a break. Sleep will be a huge determinant in how you fair hormone changes and how you adapt to becoming a new mum."

You might not need it: "I think it’s good to have people like a doula lined up or some friends who you know you can call, but I personally just wanted the quiet time with my baby. I did pack the freezer with easy to make food though. I had cleaners come every other week. I knew my birth doula, friends and neighbors were only a phone call away. And when friends came over and made me brunch it was pretty heavenly. All birth experiences are different and I think it’s good to have someone to call but not everyone needs it."

 

Should you decide to hire a post-partum doula, night nurse/night nanny, or baby nurse, be sure to check out PSP members' recommendations for Post Partum Doulas And Newborn Care Specialists! And if you're considering whether to doula during delivery, read our article on To Doula or Not To Doula During Childbirth.


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