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 Nannyor Doula explores insurance coverage for postpartum doula and night nurse care.
The Role of a Night Nurse or Doula 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:
Feeding and Nutrition: Whether through breastfeeding assistance or bottle feeding.
Healthy Sleep: Supporting healthy sleep patterns and routines for the newborns, twins and parents.
Monitoring and Documentation: Keeping track of the newborn’s feeding patterns, diapers and overall health.
Support for New Parents: Evidence-based education and reassurance to new parents on infant care.
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:
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 about Employee Benefits like Carrot or Maven?
If insurance coverage is unavailable your company might offer employee funded benefits. These are corporate benefit programs which pay for overnight postpartum doulas.
Carrot Fertility– Carrot helps cover fertility treatments, labor doulas and postpartum doula help for the first 6 weeks after baby arrives. Let Mommy Sleep provides Carrot-approved doulas.
Maven – Maven offers comprehensive Maternity and Family Benefits: from preconception through postpartum all the way up to menopause. Let Mommy Sleep caregivers are Maven approved.
Flexible spending accounts (FSAs) or health savings accounts (HSAs) can also help. If using Let Mommy Sleep postpartum night doulas, you might also 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.
Yep, we wish postpartum care was cheaper too. The cost is still out of pocket for most, even though the need is there. Until newborn care is accessible to more families through insurance, we’ve got options of How to Pay for a Postpartum Doula below.
How to Pay for a Postpartum Doula
Yes We Have Carrot and Maven Approved Doulas
Companies sometimes offer employee benefits which pay for overnight postpartum doulas. The most widely known are Carrot and Maven. In addition to labor and night doula care, these private insurers can help you cover fertility treatments, adoption and more. Carrot and Maven coverage requires certified doulas who can provide proof of their education and experience. Let Mommy Sleep has Carrot approved night doulas and Maven approved providers listed on the Newborn & Postpartum Support (NAPS) Registry.
If your company does not offer one of these benefits, ask about including Let Mommy Sleep Postpartum Visits or night nanny care to the benefit program. The LMS package is very easy to implement and the impact on recruiting and retention far outweighs the costs.
Put Us on Your Baby Registry
Be Her Village is a baby registry solely for newborn and postpartum care services. Think of it as your night doula GoFundMe. As a Be Her Village partner, hours of Let Mommy Sleep services can be added to expecting parents’ baby registry. Loved ones simply deposit funds directly into the new parents’ account. Instead of a baby registry full of “stuff,” parents receive the support they need! ***This is especially helpful for parents of newborn twins. ***
Creating your registry is free and you get your FULL gift every time, with no fees taken out. If someone sends you $100, you get the full $100.
Pay Over Time and Finance with Affirm
Every Let Mommy Sleep location has partnered with Affirm. This means you have a pay-over-time financing option, sometimes without interest. Checking the terms of an Affirm purchase does not affect your credit score and there’s also is a 0% interest option. Families can purchase packages of nights and then use the nights however they wish or simply pay when they sign on. (You’ve probably seen or used Affirm when making an Amazon purchase!) Learn more.
How to Pay for a Postpartum Doula – Health Savings Accounts (HSA)
In-home night doula and postpartum services are sometimes HSA eligible. Acceptance depends on the parameters of your HSA issuer; some will only cover care that occurs in a healthcare facility, not in the home. If coverage is confirmed, you can use your HSA card just like a credit card and receive the tax savings of a Health Savings Account. On that note, Let Mommy Sleep services are also eligible to be included in the child-care tax credit during tax time.
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). We can provide this level of care and while we don’t communicate with insurance companies, we can provide invoices with the correct wording for you to receive reimbursement.
Medicaid
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. More and more states are doing this!
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.
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.
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!
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!
Infant Sleep Cycles Sample Sleep Schedule for a 6-7 Month OldGuideline for typical times awake for a full term baby typical awake times
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 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:
Talk about the expectation of sleep before the formal sleep training begins.
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.
Continue to stay with them but for less and less time.
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.
With all the information overload out there for expecting and new parents, our team of Baby Nurses & Night Nannies created this blog, Your First Week Home with Baby: Ultimate Q&A. Bookmark this article for evidence-based answers to frequently asked questions about postpartum and newborn care. #WeAreYourVillage
Your First Week Home with Baby: the Ultimate Q&A about Parent Health
What can I do to help myself heal after giving birth?
An abdominal binder is a postpartum must-have. Social media would have us believe it’s to get back your “pre-baby body,” but there are actually several important health reasons to use a binder. As Bridgett Miller Dixon, NP notes, In addition to helping with pain -particularly after cesarean birth- they help with internal and external healing by adding compression to the abdomen while improving blood circulation and oxygen levels. Binders also keep c-section stitches covered, protecting the area while it heals. They’re easy to find at your local drug store or Amazon and are priced at about $20-$30.
Some manufacturers of binders may claim that the products help a postpartum tummy go back to its pre-pregnancy shape, but there’s no evidence to support this claim. While an abdominal binder will help support your lower back and keep you comfortable, exercise and diet are the only ways to get stronger abs…if that’s your goal!
What About Mental Health?
“Baby blues” or feelings or sadness, irritability, fatigue and tearfulness are normal and typical for about a week or 2 after giving birth. It’s important to know that mild depression can alsohappen to non-birthing parents. If symptoms persist after 2 weeks or progress into feelings that scare you, it’s time to ask your OB for help. You can also contact the National Maternal Mental Health Hotline for help by calling/texting 833-TLC-MAMA (833-852-6262).
The good news about postpartum anxiety and mood disorders (PMADs) is they are 100% treatable with proper support and medication. Learn the difference between Baby Blues and PPD here.
How Am I Supposed to Sleep?
The link between sleep deprivation and postpartum depression has been seen over and over. Sleep is also recommended to help with post-birth healing, increasing milk production and following safe sleep guidelines for baby. But how the heck are you supposed to get real blocks of sleep when your baby is up every 2-3 hours to feed?
Here are 3 ways to get more sleep:
Swap blocks of time or entire nights with your partner – Each parent is in charge of baby’s feeding, diapering and soothing back to sleep for half the night. This ensures that you each get at least 5 hours of uninterrupted sleep. If possible, do 2 nights on and 2 nights off to get the deep, restorative sleep that keeps our immune systems strong. If you’re exclusively breastfeeding, simply stay in bed to nurse while your partner does all other care on your “off” night.
Accept Help – This should be obvious but there’s sometimes a guilt factor in accepting help when caring for our newborns. Now is the time to call on your village for a few hours so you can sleep! If your village is too far away or you don’t have one, you can call night nanny services like ours.
Be ready to sleep when it’s time – Resist the urge to scroll! Practice deep breathing if you find it hard to switch off when it’s time to sleep. A dark room that is always used for sleep and white noise can also help you make the transition from awake to asleep.
Your First Week Home with Baby: Ultimate Q&A about Feeding
Is My Baby Eating Enough?
Your newborn’s stomach is only between the size of a walnut and an apricot in the first week of life. Understanding this helps both breast and bottle-feeding parents understand feeding expectations.
Here’s why:
If you’re nursing and it seems like baby is always on the breast, that’s perfectly normal! As long as babies are producing wet and soiled diapers, that means they’re getting enough to eat. Remember that skin-to-skin contact is crucial in establishing milk supply too so if it feels like baby is attached to you, that’s not only healthy, it’s helpful!
Formula feeding parents: don’t let even the tiniest bottle of pre-made formula fool you! Even the 2 ounce bottles the hospital gives away are usually way too big for at least the first week of your newborn’s life. Babies will continue drinking even if they’re full. Like adults, their tummies don’t receive the signal to stop until our stomachs hurt.
Slow, patient feeding, with lots of time to burp is key. Like babies who are fed from the breast, small, slow and frequent feeds are the norm when bottle feeding.
What do I need to know about Infant Weight Loss?
Now that we’ve talked about how very small, frequent feeds are the norm for newborns, we should note that even with all that eating, it’s actually expected for babies to lose weight in the first few days of life. Babies are born with some extra fluid, so a healthy newborn is expected to lose 7% to 10% of the birth weight.
So if it seems like your baby is eating all the time but losing weight, don’t worry because that weight will come back on within about the first 2 weeks after being born. Of course you should always drop by your pediatrician for a weight check if you want to be sure baby is developing normally.
I’m breastfeeding…when will my milk come in?
It can take 3-5 days for your milk to come in and these days are usually the hardest because your newborn is waking up and hungry. Common -but not always- reasons for a delay in milk production are c-section, complicated delivery or obesity.
Here are tips to help stimulate milk production:
Have friends and family take care of you, so you can feed the baby. Stress, hunger and sleep deprivation can delay lactation. Friends and family can be overwhelming, but it’s important to have someone whose job is to look after you. They need to be sure you’re eating, drinking and resting. (Not adding more work!)
No time at the breast is wasted time. Even if it’s just a little bit at a time, breast milk can be transferred to baby drop by drop, even if the baby is primarily getting nutrition from formula.
Don’t wait until baby is screaming to nurse – Allowing baby to be skin to skin with you before latching can make nursing calm and give your body a chance to get ready for feeding. Non-feeding caregivers should also learn the signs of hunger to be ready to hand baby over!
Skin to skin – You and your baby are literally a feeding dyad…skin to skin works when increasing milk supply.
Check your latch– Nursing should never hurt. If it’s painful for you, contact La Leche League, your pediatrician or a lactation counselor who can check baby’s latch.
Hand express or pump – Pumping both breasts after baby has finished nursing can help stimulate milk.
Your First Week Home with Baby: the Ultimate Q&A on Newborn and Infant Sleep
Is my newborn sleeping too much?
There is a wide range of “normal” when it comes to infant sleep. Babies don’t develop regular sleep cycles until about 6 months of age. There may be a few long stretches of sleep while baby is still in the sleepy newborn stage but they typically wake up every 2-3 hours because they’re hungry.
Babies of healthy weight don’t usually need to be woken up to feed. Unless you have specific directions from the hospital or doctor to wake your newborn, it’s okay to allow them to feed on demand. They will typically make up for a “lost” feed with cluster feeds later.
Where should my baby sleep?
The American Academy of Pediatrics (AAP) recommends room-sharing but not bed-sharing for the first 6 months. This means that your baby is sleeping in the same room as you, but not in the same bed. A flat bassinet next to your bed is an ideal set-up. Baby should be alone (no blankets or stuffed animals), on a flat, firm mattress and flat on their back to adhere to safe sleep recommendations.
What should my baby wear to sleep?
The rule of thumb is that baby should wear what you would be comfortable in, plus 1 layer. For example, a recommended outfit for baby to sleep in would be a onesie, footed pajamas and a snug swaddle. At this age baby’s movements are not always purposeful and the reflexive movements they have can keep them awake. A snug swaddle will help.
We always like to remind parents of what RN Rachelle said in this Mom.com article about baby hats. I see hats move a lot while babies are sleeping! Take them off if you’re both going to sleep.
Your First Week Home with Baby: the Ultimate Q&A about Soothing Your Baby
Whoa, this child is LOUD…is it normal for my baby to make this much noise?!
Yes! Grunting and newborn “squawks” are perfectly normal during sleep. Babies typically make these noises because their bodies are getting used to digesting milk or formula…something they never had while in the womb! To put it another way, your baby is having bowel movements for the first time in their life and that can cause them to strain. Of course if you are ever worried or something doesn’t feel right, contact your pediatrician.
How do I swaddle?
There’s a reason every baby looks like a little burrito in the hospital- swaddling is very soothing and comforting to them. Swaddling mimics the feeling of the womb and also keeps babies from waking themselves as their arms and legs experience unintentional reflexes. Here’s how to do it!
Remember to use an actual swaddle blanket, which is larger than the towels and baby blankets we typically see for sale. Swaddle blankets also have a bit more stretch in the fabrics to keep babies snug. Do not use a weighted swaddle blanket as they are not proven safe for sleep.
I’ve tried everything and my newborn is still crying! What should I do?
First, trust your instincts. Remember that you are your baby’s primary caregiver and the expert in your baby. If something doesn’t feel right or if you have concerns, don’t hesitate to contact your pediatrician or primary care provider.
Second, be sure your baby isn’t hungry. Since newborns can only eat less than an ounce at a time, they might be hungry even though they just ate a little while ago. If they’re not hungry there are soothing methods you can try!
There are lots of newborn care experts out there but you are the expert in YOUR baby. If you feel that something isn’t right, contact your pediatrician. Newborns are typically “sleepy” for several weeks so if your baby is crying and inconsolable it’s best to rule out any medical issues. And if baby is crying and you feel like you’re losing your patience, it is okay to place them safely in a crib while you contact the doctor or regain your patience.
