The NCS Credential Exam is designed to test a candidate’s working knowledge of newborns and infants, their developmental needs, and how to meet those needs in an in-home child care environment. The questions range in difficulty and are meant to provoke thought and learning. The exam is not meant to replace thorough interviews by agencies and families, observation of NCS applicants with infants of prospective employers, and complete reference checks. It can, however, be a gauge of the individual’s knowledge of what infants need and how they develop, as well as common difficulties they face. Professional newborn care providers continuously learn about babies. Both experience and education keep us abreast of developments in the newborn care field. Our commitment to learning as much as we can about them will enhance infant health and development as well as help them to feel secure and safe.

The exam has 75 Multiple Choice Questions.

This exam is designed to evaluate knowledge, skills, and attitudes of candidates taking the exam in the following areas:

• Health and safety principles for infants from premature through 6 months.
• Infant physical and emotional development.
• Caring for infants and their environment to meet daily needs and utilizing best practices as a newborn care specialist.
• Professionalism, including communication, personal qualities of a newborn care specialist, management skills, and adherence to ethical guidelines.
• Information needed about the birthing parent and their needs.

Study guide resources to accompany this exam prep can be found on this page. Please be sure to visit the links to explore credible research findings, the latest statistics, safety guidelines, videos, articles, expert reviews and best practices from authoritative sources around the world.

Focus on the assessment areas to hone your skills and review best practices for caring for and teaching young infants. It will also be important to revisit the latest CPR and First Aid training materials.

Starting out with a positive attitude is very important.

• Don’t aim for perfection. Focus on the big picture of improving your skills to make a positive impact on your charges and their family.
• The study process should be focused on exploring best practices when caring and teaching infants rather than memorizing every word and phrase.
• The new information you read and explore helps to demonstrate that you are a dedicated newborn care specialist, and that learning is a lifelong pursuit.
• Studying should be scheduled in smaller chunks of time rather than a marathon of reading.
• When reading materials, try to visual the information and connect it to your current job or past experiences.
• Create an outline or graphic organizer to help you divide the information for easier processing.
• Ask a friend to help you study or talk about new information with others. Talking about the information will help you to retain it longer.
• If possible and age appropriate, apply new strategies or techniques into real-world experiences with your current charges.

• Proper Storage and Preparation of Breast Milk
• Infant and toddler health
• How to Take Your Child’s Temperature
• Car Seat Recommendations for Children
• Playing Outside in Winter: Tips to Keep Kids Warm & Safe
• Are You Using Your Rear-Facing-Only Car Seat Safely?
• Bathing Your Baby
• How should I care for his uncircumcised penis?

• Developmental Milestones: 3 Months
• Nurturing Care for Early Childhood Development
• Reactive attachment disorder
• The Growing Child: Newborn
• Creating Routines for Love and Learning
• How to Prepare Your Older Children for a New Baby
• Olfaction and human neonatal behaviour: clinical implications

• Newborn Reflexes
• Effects Of Non Treatment of Lip and Tongue Tie
• Circadian Rhythms in Infants
• Neonatal Ankyloglossia & Breastfeeding
• Newborn Reflexes
• What reflexes should be present in a newborn?
• The lower oesophageal sphincter
• Pregnancy – week by week

• Diet for Breastfeeding Mothers
• Breastfeeding
• Why Breastfeed: Benefits for You & Your Baby
• Getting started with breastfeeding
• Milk, human, mature, fluid
• Colostrum: Your Baby’s First Meal
• Amount and Schedule of Baby Formula Feedings
• Breastfeeding FAQ
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• How to Keep Your Sleeping Baby Safe: AAP Policy Explained
• Should I wake my newborn for feedings?
• Healthy Sleep Habits
• Developing Circadian Rhythmicity in Infants
• Blue light has a dark side
• Sleep and Infant Learning
• Reduce the risk of sudden infant death syndrome (SIDS)

• Learn how to protect your baby from Cronobacter
• Mastitis
• Thrush and Yeast Infections
• Pyloric stenosis Diagnosis
• Pyloric stenosis symptoms
• Tongue Tie and Frenotomy in the Breastfeeding Newborn
• When a Baby’s Head is Misshapen: Positional Skull Deformities
• Pyloric Stenosis
• Respiratory syncytial virus (RSV): guidance, data and analysis
• Infantile Haemangiomas
• Strabismus (crossed eyes)
• Types of vascular access for premature babies
• Flat Head Syndrome (Deformational Plagiocephaly)
• Postpartum Psychosis
• Congenital Muscular Torticollis
• Your newborn baby
• Tongue-tie (ankyloglossia)
• Postpartum depression
• Slow weight gain

• INA Recommended Practices for Newborn Care Specialists
• INA Recommended Practices for Nannies

• Respect the contributions of individuals involved in professional in-home child care.
• Maintain high standards of professional conduct
• Respect and support families in their task of nurturing children.
• Promote the physical, emotional, intellectual and social development of children.
• Support the lifelong process of personal growth and professional development.

When the INA decided to offer an international credentialing exam for Newborn Care Specialists, it was an important goal to include reliable, authoritative sources from different countries, supporting the credentialing of NCS from diverse locations around the world. Resources such as the American Academy of Pediatrics and the U.S. National Institutes of Health are not the only organizations who are considered to be reliable and authoritative in the field of newborn care, and in fact they are not necessarily even considered authoritative in other countries besides the US. Thus we chose a wider array of reliable sources from the United Kingdom, Canada, Australia & New Zealand, plus the World Health Organization as a global resource, to be the foundation of the study guide and of the questions in the exam. In

reviewing the content from these sources, we found some small discrepancies in how newborn care is interpreted and implemented, because our diverse sources sometimes have slightly different guidelines.

However, in the entire study guide, the practices as described by all of the reliable and authoritative sources (both private and governmental) are considered acceptable child and  newborn care practices for an INA credentialed Nanny and NCS, and the INA does not rate one system or set of practices from one region or country above any other.

For example, in the United Kingdom, infant safe sleep requirements include placing the infant so that the feet touch the end of the crib or bassinet. In the United States, infant safe sleep requirements do not include anything about the position of the infant’s feet, or the infant’s body within the sleep space. These kinds of minor variations in care practices are the natural result of different professional and governmental bodies reviewing the data available to them, and thus are fully reasonable differences in standards of care between different countries. 

An INA credentialed NCS can place the infant with the feet touching the end of the crib, especially if that has been their professional training and their authoritative source has instructed them to do so. Likewise, and INA credentialed NCS can place the infant without the feet touching the end of the crib, because reliable and authoritative sources have also stated that is considered a safe sleep option.

These are NOT material differences in the standards of care; a material difference would be for example, if one organization said that placing infants to sleep on their tummies is a safe sleep practice while all the others agreed that it is unsafe.

Recognizing the inevitability of these minor variations in care practices, and committed to honouring the authentic diversity in our sources, the INA made an immense effort to be sure that no exam question tests on any point that is implemented or interpreted differently among the various sources in the study guide. 

Using the example above, the UK safe sleep requirements include feet touching the end of the bed and US safe sleep requirements do not, so that exact point is not tested on the exam, but only the common elements of safe sleep requirements. Thus, exam questions on safe sleep might test knowledge about back vs tummy sleeping, or about using blankets or pillows with newborns, but exam questions will not test knowledge about the infant’s position in the sleeping space or the infant’s feet touching the end of the crib, since those are considered to be acceptable variations in newborn care practices. 

The questions range in difficulty and are meant to provoke thought and learning. It is not meant to replace thorough interviews by agencies and families, observation of nanny applicants with children of prospective employers, and complete reference checks. It can, however; be a gauge of Nannies’ knowledge of how children think and act at different ages, basic assumptions about guiding children’s behavior, and awareness of developmentally appropriate activities for children. 

Professional child care providers continuously learn about children. Both experience and education keep us abreast of developments in the child care field. Our commitment to learning as much as we can about them will enhance children’s development, help them to feel secure and confident, and increase their ability to make thoughtful choices in regards to themselves and others.

Sample Question 1

Which statement does not describe the typical physical development of children? An infant who does not have normal reflexes may have brain or nerve damage.

1. Coordination develops in large muscle groups before small muscle groups.
2. The sequence of motor development differs with each child.
3. Physical skills such as running become easier as a child’s body proportions change.

(Correct response is C)

Sample Question 2

A nanny should get help immediately when a child
 

1. is under four months and has forceful vomiting more than once.
2. is three and has greenish drainage from the nose.
3. is five and has not urinated at least once in four hours.
4. is seven and has an axillary (armpit) temperature of 100 degrees Fahrenheit.

(Correct response is A)