The role of the Registered Nurse or Newborn Care Provider is to feed, soothe, bathe, change & provide all other gentle care to baby through the night.


Why You Want a Birthing Friendly Hospital

In June 2022 the White House unveiled the Blueprint for Addressing the Maternal Health Crisis, which aims for better birth outcomes. Successes of the blueprint include expanded Medicaid postpartum coverage and increased access to care. One of the most powerful improvements however, is the Birthing-Friendly Hospital designation. This blog, Why You Want a Birthing Friendly Hospital delves into what Birthing-Friendly means and why it’s beneficial.

Why You Want a Birthing Friendly Hospital

Why You Want a Birthing Friendly Hospital – the Facts

Over 80% of pregnancy deaths are preventable. And the rates of death for Black women are significantly higher than rates for White and Hispanic women. (CDC) To help address this, the Centers for Medicare & Medicaid Services (CMS) has implemented the Birthing Friendly Hospital designation.

In short, from the CMS website: “Birthing-Friendly” is the first-ever CMS designation to describe high-quality maternity care. To earn the designation, hospitals and health systems:

  1. Participated in a statewide or national perinatal quality improvement collaborative program; and
  2. Implemented evidence-based quality interventions in hospital settings to improve maternal health.

Hospitals and health systems also continually report their progress the the CMS Hospital Inpatient Quality Reporting (IQR) Program.

Further, the designation as a Birthing Friendly Hospital involves meeting certain criteria that focus on patient-centered care, evidence-based practices, and equity. As CMS Administrator Chiquita Brooks-LaSure says: As maternal health inequities persist across the nation, the designation offers a tangible marker of the evidence-based practices that hospitals and health systems can pursue to close these gaps and ultimately provide the kind of care all expectant parents deserve.

  1. Evidence-Based Practices: Hospitals must implement evidence-based protocols for labor and delivery, including practices that are known to improve maternal outcomes and reduce complications.
  2. Equitable Care: Addressing disparities in maternal health outcomes by providing equitable access to care, particularly for marginalized and underserved communities. Additionally, this includes respectful and culturally competent care
  3. Continuous Improvement: Committing to ongoing quality improvement initiatives that monitor outcomes, address any disparities or issues identified, and strive for excellence in maternal health care delivery.
  4. Delivery Rooms: Fully stocked with life saving equipment for use during labor, delivery and postpartum. (VP Harris, July 10, 2024)

Click the Map to find a Birthing Friendly Hospital

Click to find a Birthing-Friendly Hospital or Health System

Postpartum Doulas and Newborn Care at Home

For help once parents arrive home with their newborns, postpartum check-ups are now covered by Medicaid in 44 states. On the other hand, families that do not participate in Medicaid, postpartum care is typically an out-of-pocket expense. However, there are options to make the cost of a night nanny or postpartum doula more manageable.

There is still more work to be done for better birth and postpartum outcomes, but expanded access and life-saving interventions are steps in the right direction. These are the reasons Why You Want a Birthing Friendly Hospital.

How to Get Insurance to Cover my Night Nanny

The newborn and postpartum care industry is unregulated but growing. There are many reasons why your family might need overnight care, so understanding payment options becomes crucial. How to Get Insurance to Cover my Night Nanny explores insurance coverage for postpartum doula and night nurse care.

The Role of a Night Nurse or Nanny for Newborns

A night nanny, also known as a newborn care provider or postpartum doula plays a vital role in providing specialized care during the nighttime hours. Responsibilities typically include:

  1. Feeding and Nutrition: Whether through breastfeeding assistance or bottle feeding.
  2. Healthy Sleep: Supporting healthy sleep patterns and routines for the newborns, twins and parents.
  3. Monitoring and Documentation: Keeping track of the newborn’s feeding patterns, diapers and overall health.
  4. Support for New Parents: Evidence-based education and reassurance to new parents on infant care.
  5. Medical Need: Infants with medical conditions require specialized care and monitoring.

It’s important to pause here and note that the term “nurse” is still used coloquially, but is a legally protected term. It’s correct to refer to Licensed Practical Nurses (LPN), Licensed Vocational Nurses (LVN) or Registered Nurses (RN) as “baby nurses” or “night nurses” . When insurance coverage includes Night Nurse care, care must be executed by a clinically licensed Nurse.

Here’s the thing- when a newborn has medical need, health insurance overwhelmingly covers the cost of pediatric night nurse care. When a parent has medical need however, the chance of insurance stepping in is rare. But not impossible! Here’s how to answer the question, how to get insurance to cover my night nanny:

How to Get Insurance to Cover my Night Nanny when having Twins

Situations Where Health Insurance Might Step in for Night Nanny Care:

Pre-Existing Conditions: Again, if your newborn or twins (or higher order multiples) are in need of medical care, insurance will almost always cover care provided by a licensed nurse. For you though, coverage typically hinges on medical necessity. If you have a pre-existing condition, and sleep is a necessary means to control that condition, insurance may step in. For example, the frequency of seizures in a person with certain type of epilepsy may be triggered by lack of sleep. For this reason, overnight newborn care could be “prescribed” by the parent’s physician before baby arrives.

Doctor Directed Care: Similar to if there is a pre-existing condition, postpartum doula or night nurse care may be directed by a healthcare provider after birth. An example of this is if postpartum psychosis or anxiety presents in a parent with a documented history of mental health issues. In this instance the doctor may advocate for health insurance coverage on behalf of the patient.

Both of these situations depend heavily on the parents’ doctor advocating on their behalf. The first step is to discuss your need for night nurse services with your primary care physician or obstetrician. They can provide documentation and medical justification for why such care is necessary, which is crucial for obtaining insurance approval.

What if insurance doesn’t cover postpartum help?

If insurance coverage is limited or unavailable, you can consider alternative funding options. Flexible spending accounts (FSAs) or health savings accounts (HSAs) can help. If using Let Mommy Sleep postpartum doulas, you might consider paying with Affirm, a pay over time option. Lastly, if insurance isn’t an option you can start a shared-funding account where loved ones can contribute to a monetary baby registry.

How to Pay for a Postpartum Doula

Yep, we wish postpartum care was universally covered by insurance too. We’re getting there, but the cost is still out of pocket for most parents, even though the need is there. Until newborn care is accessible to everyone through insurance, we’ve got options of How to Pay for a Postpartum Doula below.

How to Pay for a Postpartum Doula
How to Pay for a Postpartum Doula

Be Her Village

Be Her Village is a cash registry expecting parents can use to adds funds for newborn and postpartum care services. Parents-to-be add Let Mommy Sleep to their registry. Loved ones then send money directly to the new parents’ registry. Instead of a baby registry full of “stuff,” parents opt for overnight newborn care support! This is especially helpful for parents of newborn twins.

Creating your registry is free and you get your FULL gift everytime, with no fees taken out. If your family member sends you $100, you get the full $100 every single time. The beauty of Be Her Village is that you can spend the money you receive from your loved ones however you see fit.

Choose your location to start your Baby Registry here!

Boca RatonBoiseCharlotteChicagoHoustonSan AntonioWashington DCWichita

Night Nanny and Postpartum Doula Baby Registry
Postpartum Doula services

Pay Over Time with Affirm

Every Let Mommy Sleep location has partnered with Affirm, the pay over time financing option for night nanny and doula services. Checking the terms of an Affirm purchase does not affect your credit score. There is a zero interest option. Families can purchase packages of nights through Affirm and then use the nights however they wish. (You have probably seen or used Affirm when making an Amazon purchase!) Look for Affirm to begin July 1 2024!

et Mommy Sleep partners with Affirm

How to Pay for a Postpartum Doula – Employer Benefits

There are corporate benefit programs which pay for overnight postpartum doulas. The most widely known is called Carrot Fertility. In addition to night nanny care, Carrot helps cover fertility treatments, adoption and more. Private companies can also offer Let Mommy Sleep Night Nanny care or postpartum check-ups for a fraction of the cost it takes to implement them.

Private Insurance

While pediatric care is covered in the home when a newborn has medical need, it’s not as common for private insurers to cover night nurses for a parents medical need. However, when coverage is doctor directed, insurance must cover the cost. The parent’s physician usually needs to write a letter attesting that the parents health will be positively impacted by getting sleep.

An important note is that “night nurse” is often used as a colloquial term for “overnight caregiver.” In terms of health insurance coverage however, insurers may require that services are provided by a licensed Nurse. This means the newborn or postpartum care provider must be 1 of the following: Registered Nurse (RN), Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Learn more about Insurance coverage here.


Medicaid offers postpartum benefits varying by state. If you are eligible for Medicaid, coverage typically includes pregnancy and delivery. But you can check online if your state includes postpartum visits and breastfeeding support.

Free Baby Sleep Schedules by Age

People ask us all the time if we can help their babies and twins sleep through the night. And we say no. The facts are that we don’t have access to any fancy information that you don’t already have. You can do this! A sleep plan can absolutely be helpful if you want to be sure you’re on the right track with baby sleep but your own instinct as a parent in knowing what’s best for your family is also a vital tool. This blog, Free Baby Sleep Schedules by Age links to the real sleep plans we’ve done over the years. We hope it helps!

Free Baby Sleep Schedules by Age – What We Know

We’ve learned that when it comes to infant sleep, two things are true:

1. all babies are different but also,

2. all babies are the same!

Personalities and dispositions differ; some (many!) babies naturally fight sleep, while others happily switch gears to rest time. The blueprint of sleeping through the night is almost always the same though, because biologically we all follow the natural cycles of circadian rhythm. Because newborns physically mature differently and they might mentally fight sleep, it can be hard to know when they’re developmentally ready to sleep uninterrupted. For this reason we recommend a gradual transition to sleeping through the night. Also have this conversation with the pediatrician at the 4 month well check.

Here are the Free Baby Sleep Schedules by Age

–> Free Baby Sleep Schedules, Sleep Training FAQ’s and Actual Sleep Consults <–

When it comes to helping infants sleep through the night, one of the biggest challenges is wondering if your child is physically ready. What if they’re hungry? Are they starting to get sick? Do they feel abandoned? Even with all the data out there, these are all valid worries! For parents that would like a guideline to beginning a gradual change from waking through the night to sleeping through the night, here are all the Free Baby Sleep Schedules by Age. We also include the actual consults we’ve conducted over the years so you can read more in depth about specific issues you may have questions about.

Free Baby Sleep Schedules by Age

Things to Remember

Twins and More – To help infant twins, triplets and higher order multiples to sleep through the night, follow the same method you would use for a singleton. It may be helpful not to intervene at all overnight so they learn to sleep through each others wake-ups when they share a room.

What if I’m Nursing? – Remember that your body needs a gradual step-down from waking overnight too. Slow, gradual weaning is recommended for your own comfort and health. It’s always best to consult with a lactation consultant. They can help make the process gentle for baby and you.

But I can’t stand to hear the crying! – Please know this is normal! Even with the best lead up to sleep training, babies cry! Some even do it as a normal part of their bedtime routine. And if you don’t want to sleep train, or want to wait til they are older that is perfectly fine!

Free Baby Sleep Schedules by Age
this photo courtesy of Cribs for Kids

All the Infant Sleep Schedules in One Place

You might be highly respected in your career, an organizational whiz everywhere else in your life, or a Type-A genius. Your baby does not care! Because these babies do whatever they please, new parents often seek routines and schedules; humans love predictability! So our team of Night Nannies and Baby Nurses made these Infant Sleep Schedules to help. Of course these are just examples of typical infant sleep, but if you need a starting point, All the Infant Sleep Schedules in One Place is for you.

All the Infant Sleep Schedules in One Place – Expectations

While sleep schedules can be helpful, we all know that every baby is different and there are so many things that can affect infant sleep and feeding. Illness, growth spurts and older siblings’ activities are just 3 examples of instances why we can’t expect an exact schedule everyday. Babies also grow into their next daily routine gradually over the course of weeks and sometimes months. Your baby will show you when they’re ready for a change in nap or sleep schedule.

When your baby is ready to sleep through the night, a step by step guide can help.

Til then, use the schedules below to help!

Why Not Before Four Months Old?

Before 4 months of age (16 weeks!), infants have not yet developed a mature circadian rhythm, which regulates their sleep and wake cycle. Their sleep patterns are still evolving. They’re also still very little! So the need to wake up during the night for feeding and other essential needs is normal and healthy. Please do not try to sleep train a newborn, we can’t coach them not to be hungry or need a diaper change.

And of course if you’re breastfeeding, your own body will still wake you in the night. It’s perfectly normal for baby to nurse through the night for nutrition and comfort well after 4 months old. This is true of formula fed babies as well but it’s important to note that breastfeeding doesn’t just “stop” cold-turkey. La Leche League talks about weaning much better than we ever could here. You can begin the discussion about sleep training and sleep expectations at the 4 month pediatrician visit.

Simply put, newborns can’t be taught to not feel hunger, need a diaper change or need to be held by a trusted adult.

All the Infant Sleep Schedules in One Place
All the Infant Sleep Schedules in One Place photo courtesy of Cribs for Kids

All the Infant Sleep Schedules in One Place – What About Toddler Sleep?

Allowing your toddler to sleep through the night is easier -but also harder!)- than helping your infant sleep without interruption. It’s easier because you can talk about sleep expectations and your child will understand! It’s harder because it can be uncomfortable and even scary for them to sleep in a whole new way, without visits from you or being in the big bed through the night.

Patience is the key here. There are 4 basic steps to allowing toddlers to sleep through the night and repetition and consistency is key. There are many variation of sleep training toddlers and you can search for the one that feels right for your family, but the 4 basic steps are almost always:

  1. Talk about the expectation of sleep before the formal sleep training begins.
  2. During the first few nights, stay next to the bed until your toddler is sleepy. If toddler is standing up, gently place them back in a laying down position.  Yes, you will most likely have to place them back into bed several times. Stay patient and calm, you’re there so they can feel safe and secure.
  3. Continue to stay with them but for less and less time.
  4. If your child wakes in the night, you can bring them back to their bed or stay with them in their room until they are asleep.

One note, even if your toddler sleeps in the bed with you try to remember it won’t be forever. You are their favorite person so of course they want to be near you. It’s comforting in the big bed.