Originally posted here.
During my work as a newborn care specialist (NCS), I have assisted many families in training their nanny to start care immediately after my contract with them ends. These training sessions often include a few days of shadowing and observation of the nanny at work. Based on my experiences, I have compiled a list of the ten most-common mistakes I have observed of nannies caring for newborns.
Missing Sleepy Signs
Sleepy signs can be easy to miss if you’re not sure what you’re looking for. Yawning, rubbing eyes, becoming quiet, avoiding eye contact, jerky movements, fussiness, and crying are all signs of a sleepy newborn. Many newborns are ready for a nap after being awake for 45 minutes to 2 hours. There is a common misconception that allowing a baby to stay awake longer will mean a longer nap. Unfortunately, however, if the baby is allowed to become overtired, they may become inconsolable and nap poorly. Because sleep is so essential to a newborn’s development, newborns need as much as 16-18 hours of sleep per day.
Using Motion for Naps
Parents, nannies, and other caregivers often resort to motion when baby won’t sleep. Common forms of motion include swings, car rides, and walks in the stroller, to name a few. If motion becomes habitual, the baby is likely to develop a need for motion to fall asleep, making it extremely difficult for the child to sleep in a crib. Therefore, the need for motion during naps can quickly become a problem when baby outgrows the swing or if the weather is bad.
Unsafe Sleep Settings
This is one of the most dangerous things a nanny can do wrong. Babies should always be placed on their backs to sleep; and, until a baby reaches one year of age, the only things that belong inside a crib are the child and a sheet. This means no bumpers, blankets, or stuffed animals. I feel this is so important that I require parents to empty cribs before I accept work. The American Academy of Pediatrics (AAP) saw a significant decline in Sudden Infant Death Syndrome (SIDS) incidents after starting their “Back to Sleep” campaign in 1994.
Improper Formula/Breast Milk Storage
Unfortunately, many nannies are unaware of proper formula/breast milk safety guidelines, and that lack of awareness can put babies at risk for illness. Once formula is prepared, it should be used or discarded within 1-2 hours. If the bottle is prepared and immediately stored in the refrigerator, it may be used up to 24 hours later. Each formula is different so be sure to check the label for exact time recommendations.Breast milk can be stored at room temperature (70°F) for up to 6 hours. However, there is some debate about the storage of remaining breast milk after a feeding. The main concern with the storage of leftover formula/breast milk is the introduction of bacteria into the bottle. Because there are many factors that can influence the amount of bacteria in breast milk, nannies should consult their MomBoss on how they’d like their breast milk to be handled and stored.
Putting Baby Down Fully Asleep
Babies should be put in their cribs in a drowsy state rather than fully asleep. Babies need to learn how to fall asleep on their own and this is a great start. The end goal of this technique is that the child gains the ability to fall asleep completely on his or her own.
After nine months in the womb, newborns are used to the quiet and continuous swooshing sounds of their mother’s heartbeat. From the color of your clothing to the toys in front of them, newborns can become overstimulated very easily. Signs of overstimulation can include fussiness, uncontrolled movements of the arms and legs, arching the back, and avoiding eye contact. Often, swaddling or taking baby into a dark quiet room will help calm the baby back down.
Incorrect Car Seat Usage
This is also incredibly dangerous. If the nanny is using the car seat in any capacity, she needs to read through the car seat manual. Car seats and car seat recommendations are continually changing. Rules and guidelines that applied to the last infant a nanny cared for may not be the current recommendation. Nannies and parents can check with their local police department to find a car seat inspection station.
Improper Product Usage
Straps were made for a reason. If straps are included with the gear, they need to be used. You never know what could happen. The baby could flip over in the swing for the first time, fall backwards out of a seat, or the stroller could suddenly stop and fall forward. This also applies to leaving the baby unattended on a high surface like a changing table, sofa, or bed. Falling from such heights can be very dangerous for babies.
Not Maintaining a Three-Hour Feeding Schedules
Newborns should be fed at least every three hours during the day to take in enough calories to sustain them through the night. Look for early hunger cues such as smacking lips, opening and closing mouth, sucking on lips or hands, rooting, or fussiness.
Because noises can be stimulating to newborns, nannies should be sure to use white noise during nap time. The white noise helps to drown out other noises in the household and allow the baby to have a deeper sleep. There are several white noise apps or tracks available online. A CD on repeat is also a good option.