Questions for night nannies/maternity nurses please

[minipie]

Hi, I am thinking about a maternity nurse/night nanny for when we have DC2 and have a few questions, hoping people on here can help.

1. We had a bit of a surprise with DC1 as she was 6 weeks early. No idea why it happened but I have to assume there is a somewhat increased risk of it happening again. How does this work with a maternity nurse? When would I book you for, and what happens if DC2 arrives earlier or later than you are booked?

1. Sleep training/getting into a routine. DD1 was a very bad sleeper (partly inevitable, partly due to us getting her into bad habits). We ended up doing CC at 5 months. Really don't want to do that again if we can avoid it. I would love someone to teach or help me teach DC2 to self settle and nap well at an early stage. Is this something a maternity nurse/night nanny would do? If so, how is it done? I have never seen any description of what maternity nurses do to encourage good sleep so I have a slight concern that it involves leaving newborns to cry...?

Also at what age would this sort of routine/sleep help be best done? I am wondering if we actually want someone from newborn, or actually if it would be more useful to have someone at, say, 4 weeks? (as I recall, Dd's sleep got a lot worse around 4/5 weeks). or are habits already formed by then?

1. What hours does a maternity nurse generally do (if working nights)?

Thanks

Hi

1. You can book a night nanny for a start date and then if needed earlier see if they are available or book an earlier start date and then have to pay if not used some will charge 50% fee for time booked but not required

1. Night nannies will advise and support with routines and use a variety of methods. I always say go with the flo for first two wks see if a natural pattern forms and build a routine around that and family lifestyle.

1. Nanny normally arrives at 9pm and has handover from you and then takes over all baby care they will sterlise bottles prepare feeds bring baby to you if breast feeding settle baby if unsettled in night change baby. Nanny will need somewhere to rest most doze but don't go into full on sleep but will need a bed usually in room with baby. They usually finish at 7am. Some do 10-6 as families find this reduces cost a little for them.

Sorry for short reply am on a kindle

Hi
normally we work 24/5 or 6, that's 24 hours for 5 or 6 days a week. Its best to get us in place for when you get out of hospital to stop getting into bad habits and help you recover

Babies should NEVER be allowed to cry themselves to sleep. "controlled crying," basically leaving a child to cry themselves to sleep should never be done before 8 months. New borns can cry so hard they are sick, choke or fit and all can result in death. As well as bad associations resulting in not wanting to sleep .Never allow anyone to do it.
Normally we leave after 6-8 Weeks after sleep and feeding routines have been established. Most girls are fine with it if you want to contact them after they have left for advice.
You could speak to an agency - maternally yours, maternity solutions and Eden are all very good.

My reply is for a maternity nurse, not a night nanny

Thanks v much both.

Re 50% for time booked but not used - does that still apply if you do manage to get another booking in the unused time? or only if you can't?

So would you actually teach the baby to self settle? For me this would be the main value of a maternity nurse so want to find out if this is something you would do. (Appreciate nobody could guarantee this, depends on the baby, but is it something you would usually aim to have taught by the time you left). And how do you teach it if not with crying?

Totally agree Sarah I don't want any leaving to cry especially not a newborn! We got someone in (ex maternity nurse) with DD at 5 months who did CC and although it worked, I think it was too early for that, hence my concerns/curiosity about what other maternity nurses would do.

Self settling doesn't exist per se. A child under 3 isn't psychologically capable of it. What you want is to create good associations of being calm, dark, in crib etc and avoid feeding to sleep, rocking and patting if you aren't prepared to continue. Those habits are set around the 4 month sleep regression so IMO prime time for a night nanny to set good habits is 12-20 weeks. If you want to avoid total exhaustion in the early days then a night nanny between 2 and 12 weeks is better.

I disagree that little children can't self settle/soothe. We had horrible sleep issues with DS1 and I was determined not to have the same with DC2 and DC3 and we didn't. Both slept from 7-7 from 8 weeks (and they were both breastfed at that stage too - til 20 weeks).
I agree with the always keeping it dark and quiet etc though.

Neither child was ever screaming themselves to sleep, but they did object a bit and we wouldn't go to them immediately in the night if they did wake up and they would generally go back to sleep by themselves, (although not always, especially if teething). From about 6-8 weeks, I would do the evening feed upstairs at 7.30pm and then put them in their cot, ignore them a bit and they would go to sleep. We dreamfed both at around 10.30 until 12 months.

Anyway, we had a maternity nurse with DS1, but it really annoyed me having someone around, so maybe it would be better at 4 weeks, when you don't have DH around and are feeling more like yourself to have help. All mine have been very sleepy during the 10 days.

I would also push a bit to find out why they thought DC1 was very early. 6 weeks is quite early!

Babies can self settle to an extent and its about not rushing to every squeak they make or a single cry thinking quick feed them as they then associate waking with feeding obviously in early days this is true but as time goes on even in day you want to have some time between waking and feeding also not feeding baby to sleep getting them to settle in cot drowsy. I do not advocate controlled crying in small babies however I do advise waiting until they are awake properly crying before going to them. Some babies wake fidget around coo n gurgle n then go back to sleep on their own.

Agree that if they are just babbling then let them have that time as "quiet time" and don't rush in. but any signs of distress must be answered - babies cry for a reason!

Have you looked into kangaroo care? Its not just for prem babies; all babies like it. It help them to settle (keep the room dark) then when they are dozing put them into the crib. As the baby is relaxed they'll sleep well and avoid getting over tired (and the upset that goes with being tired) and create positive associations.
When they are in a routine of sorts then only Kangeroo before the night sleep and during the day put then in a cot but stay close (over time move away). always have great success with that method no complaintss from parents or the baby! And the parent staying close when crib settling gets some time out too!

Thanks for starting this minipie, I have similar queries. I'd like to hire a night nanny but I'm just wondering whether there's any point if I want to breastfeed? If you plan to exclusively bf is it better not to get a night nanny until the baby is a little older? Sorry to hijack the thread...

If you express milk it helps your supply and the maternity nurse can give it when you want to rest. Also means your supply is good enough to cope with growth spurts.

Thanks Sarah.

You can skip one night feed, and I'd recommend the 10pm-ish one. Evening cluster feeding is important to manage because it's priming you for the next day - it lets your body know what the deficit is. It's best to feed in the small hours directly as it really boosts prolactin which is important for maintaining supply.

Baby putting themself to sleep isn't self settling IMO. Self settling is resolving something that makes them unhappy and putting themselves back to sleep. Getting to sleep is a different ball game and that can be learnt from a young age with good associations.

Thanks everyone! Really helpful.

Ok, when I say self settling I just mean going to sleep (and most importantly back to sleep) by themselves. not self comforting when something is wrong as Nom describes, I agree that's not possible till a lot older.

Ok so it sounds like it's not CC but leaving them to have a little whinge/gurgle and seeing if they settle back to sleep ? Also about putting them down "awake but drowsy"... DD never did either of those things, she was fully awake and then conked out on boob, then crying when she woke.

Sarah very familiar with kangaroo care! for the first few months (up to about 2/3 months corrected) DD would only sleep on my chest, both in the day and at night. if I put her in crib once asleep she would wake and cry... at best she'd stay asleep for 20 mins then wake and cry. Really hoping dc2 is different, but if not... this is partly why I think I need help.

All, if you were looking after a baby who will only sleep on a person's chest, what would you do??

I was also curious about how it fits with BFing pink so thanks for asking! We did give one bottle of EBM per day with dd (late feed) but I had loads in the freezer from time when dd was in NICU, I don't know if I'd find time to express this time round. I guess I might if DC2 actually napped in crib unlike DD who had to be held...

Karole yes I will certainly be asking more about why dd was early!

With parental permission I would allow the child on my chest (done it with 4 babies in the past and the mums were just happy to have someone who was prepared to help)
with moving to cot put the baby in then you may have to stay with an arm touching them for comfort til they are in a deep sleep (trick that always works is putting a drop of breast milk on you wrist so your arm smells of "chest")

Or just let your baby do as they want then correct any bad habits with the "crying down" method when they about 5 months old. The name makes it sound bad but its not, its one of the gentler methods of habit correction

Would you Sarah, that's lovely. I'd be happy with that. good tip re milk on arm!

Hi minipie

I work as a maternity nurse/night nanny. Where are you based?

As for your questions, if you are worried about baby arriving early you could possibly book a mat nurse on a retainer period. I work like this frequently. So say baby came 6 wks early again, you would probably be in hospital for a short time, then potentially your husband would be on paternity leave/granny would come to stay then you could book your mat nurse on a 2 wk retainer period, start date 2 wks before your due date, where you pay then 50% of their salary for every day you are waiting to come home and they don't accept any other work so they are available for you at the drop of a hat. As soon as you are home the booking then starts so their salary is paid in full. The same is applied if baby arrives 2 wks late.

Routines and sleep really depend on the weight of your baby and any healthproblems they may have. I generally like to wait until babies in my care reach 7lb in weight then we start a very basic routine, 3 hrly feeds and sleeping at set times. I encourage babies to be swaddled and put down in their moses baskets half asleep so they can settle to sleep on their own but mum/me is always with them and there is no crying allowed, gurgling and the odd 'cry out' but no full on crying. Self settling will only happen if baby wakes and is encouraged to go back to sleep on their own, i.e not rushing to pick them up/feed them every time they make a noise and not falling to sleep on a feed.

If I was looking after a baby who would only sleep on someones chest then I would swaddle baby and start very slowly putting them down in the moses basket, at first when they were in a deep sleep and then moving towards putting them down when drowsy. Unless of course you were happy for them to only sleep on your chest and then I would continue doing that.

As for when to hire someone that's totally up to you. As this is your second child you may find it useful to have someone there from day one even if it's just for a second pair of hands so you can spend some time with your older child, equally if you have family help you may want to wait till baby is a couple of wks old before hiring someone.

As a maternity nurse I work 24/5, at a push 24/6. If I have a local family I will consider working days only with a minimum of a 5hr booking. As a night nanny I work 10hr shifts usually starting at 9pm and finishing at 7am but can work more hrs if required.

Hope all this helps!

I'm a maternity nurse and night nanny at times too.

I always recommend booking from due date or after if you can manage yourself for a while. I charge 50% of my daily rate for a retainer fee if I'm booked and not needed because baby is not born.

I don't do controlled crying at all in the early days and will hold baby to sleep or if they are a relaxed baby they will drift off to sleep themselves. In the early days its a lot of picking up and putting down. For a mum who is breast feeding I will take baby into mum to feed and then wind and settle baby.

If doing night only work I will make sure nursery is in order and wash bottles if needed and sleep while baby sleeps.

My current three week old charge I've basically held her a majority of the nights to encourage her to sleep while letting the mum rest. The last two nights she has slept really well between feeds.

YOu could alway look into a night nanny helping the first two weeks after birth so that you are well rested, then get them to offer advice over email the phone for a couple of weeks before coming back at six or eight weeks to help set up routine and show any tips for self settling.

I have a friend who had a baby a fortnight ago and her baby is feeding (ebf) every hour and a half. She feeds and then her husband does a nappy change. She is getting about 45 minutes sleep between feeds. If you were a maternity nurse or night nanny in this situation I'm wondering what you would do? If a newborn appears to be hungry you would definitely feed them rather than trying to hold off for any amount of time wouldn't you?

I'm very seriously considering booking a maternity nurse but I'm still trying to figure out whether it is worth it if you are bf and you have a baby who wants/needs to feed as frequently as my friend's baby.

I will always feed a bb if hungry. What I would do in above situation is make sure mums latch was really good, encourage frequent feeds during the day less than three hourly, also maybe breast compressions basically trying to get bb to eat more during day so that nights they may eat less. Depending on family mother may express earlier in the day and then I could do one night feed so mum can sleep a couple of hours. A majority of my clients breast feed and in the first month I spend a lot of time holding bb so that mum can get that extra bit of sleep. If you could talk to my clients they'd all say the best thing about having a mn is the extra support during all the feeding, someone to get a cup of tea while feeding, or hold the baby while you shower so that when I leave they feel well rested. Obviously we are not magicians and work with each individual bb and family to set up a plan that fits everyone.

Thanks mrswishy, that's really interesting and helpful to know. I live overseas and I'm wondering whether that means I need to book someone in advance? Are many good maternity nurses available at short notice? I don't have any family support here and my DH works very long hours so won't be around much to help + needs his sleep to function well at work. It's making me nervous about how I'll get on with a newborn for the first time.

Ideally you'd book someone in advance as then you'll get a good choice of MNs as its good to have someone match your personality. Although it does depend where you live as well as to how easy it would be to find someone at short notice.

Pinkandwhite I'm the OP not a maternity nurse but I'd suggest your friend sees a bf counsellor who is qualified to check for tongue tie - a very common reason why babies can't feed efficiently and need to feed often.