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

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Parent Category: Advice - Childcare and Education

Category: Childcare Advice

Doulas, night nurses, 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.

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!
• 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!
• 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

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.

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.

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 from PSP members on whether to hire and whom:

• "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."
• "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."
• "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."
• "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.)"
• "I did however 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."
• "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."
• "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."
• "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."
• "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."

Should you decide to hire a post-partum doula, night nurse, 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.