Doula, Baby Nurse or Nanny?


As postpartum doulas grow in popularity, the confusion about what exactly they do seems to grow as well.  Some staffing agencies and childcare websites have begun using baby nurse, nanny and doula interchangeably which further adds to the confusion. The biggest difference between a doula and a baby nurse (or nanny) is that a nurse does for while a doula does to show how.

The term baby nurse can be confusing because few are actual RNs. The term nurse used to simply mean care for but now it is associated with a licensed healthcare professional.  While some using this title may have formal education and training the title itself does not implicate any specific qualifications.  A baby nurse provides infant care and has knowledge about normal newborn behavior and development.

A nanny may or may not have formal education and training related to infant and child development.  Often a nanny’s role is to provide childcare when the parents are otherwise occupied.  Some nannies are experienced in teaching parents about infant care but it is not necessarily associated with their role.  Often nanny’s begin care after the initial postpartum period once a mother might return to her normal activities.

A postpartum doula is a trained and often certified professional. A postpartum doula has experience and education in evidenced based infant care but her primary role is to support, educate and build confidence during the adjustment of adding a new addition. While a doula does offer infant care she does so in a way to model that care and teach parents how to do it. She has education and experience in lactation so she can support normal breastfeeding initiation and refer mom to a lactation consultant when necessary.  Postpartum doulas are familiar with normal postpartum adjustment,  mom’s physical healing and changes, and postpartum mood disorders.  A doula cares for mom so mom can care for and bond with baby.

Definitions aside,  does it really make that much of a difference who you hire? It definitely can.  The breastfeeding relationship,  bonding and postpartum emotions are fragile during the early weeks. What happens during the postpartum period can have a long impact on the duration of breastfeeding, and a family’s overall adjustment. An ounce of prevention is worth a pound of cure rings true during the postpartum period. During a typical visit a postpartum doula might:

*Arrive and check in to be sure mom has recently eaten. If she has not, assist in making sure she eats.
*Ask if mom has any questions. Answer her concerns about engorgement, infant sleep patterns and postpartum physical changes
*Assist with breastfeeding, offer encouragement
*Show mom infant soothing techniques so she can get baby to sleep. Keep an eye on baby while mom goes to rest
*Assist mom with breastfeeding and arrange a snack and drink for her while she’s nursing
*Keep an eye on baby so mom can shower
*Ask mom if she has any other concerns or questions.  Leave her settled with a support plan in place until the next visit

Each family has unique needs so every visit will vary.  The overall role of a doula is simply to support mom which will mean different things for different moms. Some utilize doula support just a few hours a few times while others have near round the clock support (especially families with multiples). With hiring a doula a family gets the rest and support they need without interfering with bonding and they are given the tools to enter parenthood with confidence after the doula’s job is done.

As of now neither baby nurses, nannies or doulas are regulated so the titles can be used by anyone.  When seeking care be thorough and inquire about any certifications, trainings and experience, regardless of the title used. There are many qualified and caring providers around but be sure they are able to support your parenting goals and facilitate a healthy family bond.

If you are in the Philadelphia, Bucks and Montgomery area learn more about postpartum doula services: