Baby Nurse vs. Newborn Care Specialist

Nanny or Babysitter? At this point, we have put this issue to rest in our industry and have very effectively worked with agencies to educate families on the differences between a babysitter and a nanny. Now, a different terminology issue continues to surface, despite the fact that the industry leader, the INA, adopted an official term 9 years ago after a meeting of industry pioneers in Washington DC. This meeting of industry pioneers, including two current INA board members, came to a common goal of a unifying, professional term to describe a specialty niche of the in-home child care industry: Newborn Care Specialist.

So, what then, is the issue? Unfortunately, even though it has been 9 years, we still see confusion between the terms Newborn Care Specialist and Baby Nurse (or babynurse). It is time for caregivers and the agencies that place them to come together to correct this terminology issue, once and for all. Not just for the sake of professionalism, but also for the sake of legality.

The INA has done an excellent job of recognizing the professionalism of the Newborn Care Specialist by adopting an official term, setting a new standard definition, having a full training track at the annual conference since 2011, and by adopting standards of professionalism, as well as currently working on a Basic Skills Assessment and Credentialing exam. In the last 5 years, two Newborn Care Specialists have been awarded the INA Nanny of the Year and our President and two other current board members are Newborn Care Specialists. It is a well-established and recognized segment of the in-home childcare profession. So why do we continue to see people both outside and WITHIN our industry continue to use the term baby nurse?

One of the first reasons is that it was a common term for many years, but the term created confusion for parents and created anger and resentment within the nursing community. Parents thought they were getting RN’s in their homes to care for their babies and RN’s were unhappy that childcare providers, no matter how excellent, were using a term they felt was theirs. While there are some Newborn Care Specialists who are indeed RN’s, they are not common.  Nursing boards in many states pursued this issue because it is illegal in ALL states to claim a license which you do not hold, and the majority of states also have laws on the books that specifically ban the use of the term “nurse” unless you are a registered nurse. For a state-by-state list of specific laws, go to and search under State Legislative Agenda Reports. At the time the INA addressed this issue in 2007, one Newborn Care Specialist was even being sued by a state nursing board for using the term in her state.

Another main reason the term is still used is because agencies have typically not been active in embracing placement or referral of Newborn Care Specialists, so they have not had a compelling reason to correct the few families they do work with when the term is misused.

There is also a large population of immigrants working as infant caregivers, particularly in the two largest US cities, New York and Los Angeles. Many, but not all, of these women are untrained and sometimes not legally eligible for work in the United States. They typically work for very low wages (often far below minimum wage) and call themselves baby nurses. Most agencies in these areas continue to use the term “baby nurse” as well. Some even have it in their business name! Newborn Care Specialists do not want to be viewed as working in the same category as the untrained “baby nurses” that are so common in these metropolitan cities, as many have worked very hard to become well-educated specialists and they take pride in that professionalism. They want to be viewed as distinctly different because they are different, but when agencies continue to place or refer untrained caregivers and lump all of them into the same category, it is harder to combat the issue.

Finally, we have the issue of caregivers themselves still using this antiquated term. Many caregivers continue to use the name simply because they don’t want to change and they find it easier to use the term “baby nurse” than to educate families that the term is no longer an industry accepted standard and often times outright illegal.

So, what are we to do?

First, we need to recognize that the INA, as an industry leader, adopted a correct, professional and legal term 9 years ago. It is time to insist that all INA caregivers and the INA agencies who refer them to families use the correct terminology, only using the term baby nurse when they are actually working directly with RN’s and LPN’s and using the term Newborn Care Specialist (or Doula if the appropriate training applies) when referring to in-home childcare providers who specialize in the first few weeks of life.

Second, it is time for INA members to speak up in professional forums (both agencies and caregivers) and kindly but firmly educate others and insist that they use the proper terminology for our industry.

Third, it is time for agencies, in particular, to fully understand exactly what a Newborn Care Specialist is and what training she should have. Agencies must then take the extra step to educate clients about the correct terminology, education, duties, and standards for NCS and their work with families.

Just as it took time and effort to eradicate the term babysitter when referring to nannies (and I don’t know any professional nanny who is okay with being referred to as the babysitter), it will take time and a conscious, collaborative effort on the part of all INA members to firmly establish the term Newborn Care Specialist, but we as members and an organization need to continue the effort, both for professional and legal reasons.  Please join us in this effort and do your part to provide a unified front to clients, caregivers, and the public.

If you have any questions about the education, responsibilities, or industry standards of Newborn Care Specialists, please contact Tonya Sakowicz, INA NCS Mentor Chair and owner of Newborn Care Solutions.


Tonya Sakowicz is an INA Credentialed Nanny, Newborn Care Specialist and Parent Educator who does both consulting and in-home sleep conditioning for her clients as well as teaching seminars through local organizations and agencies and mentoring new Newborn Care Specialists. Along with her husband Todd, Tonya has founded Newborn Care Solutions, a website dedicated to education for families with newborns, both through the training of Newborn Care Specialists and for helping families adjust to life with their newborn baby.

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