The Benefits of an Overnight Postpartum Doula or Night Nanny

Overnight Doula/Night Nanny

Newborns will sleep anywhere from 17-22 hours in a 24-hour period.  However, it is very interrupted sleep with all the diaper changes and required around-the-clock feedings; sometimes taking up to an hour or more at a time, while getting the hang of it all. Somewhere around 3 weeks postpartum, things change.  Baby will have longer awake times between naps (30-45 min), and they will begin to cry more (3-6 hours cumulative); sometimes at certain times of the day, for what seems like no reason at all.  However, it is also around this time a healthy newborn will begin to get into a better sleep routine. 

On average baby's sleep cycle will start at 10PM-11PM and end between 7AM-8AM (if days and nights are not confused, which is an easy fix).  If baby is let be, he* will go longer stretches between late night/early morning feedings, which means longer stretches of sleep. The new parents are grateful to be getting these longer stretches of sleep. 
However, sleep is still not undisturbed; because while newborns are sleeping (very often in the parent's room, as recommended), they grunt, groan, squeak and cry in their sleep throughout the night.  These noises cause alarm to a new parent, jolting them awake.  Now at the ready for another feed or diaper change, the parents either sleep walk over to the baby to start the changing/feeding routine, before it's really needed; OR they lie very still, while silently and often grudgingly praying it's a false alarm, so they can get another 5 minutes of sleep. Add jumping up from a deep sleep to check once again if baby is still breathing; because Baby is, too quiet.

This routine happens several times a night, and doesn’t allow for a nice, long, deep, refreshing sleep cycle.  One day blends into the next, and the new parents never really feel refreshed and rejuvenated to take on the next round of feedings, diaper changes, fussy moments or the 8 to 5 workdays. Sleep deprivation depletes a parent’s mental and emotional capacity, shortens patience with themselves, with baby and other household members, heightens frustration levels, and has been significantly linked to symptoms of postpartum depression, (Dennis & Ross, 2005). 
 
“Mothers exhibiting major depressive symptomatology (EPDS > 12) at 4 and 8 weeks were significantly more likely to report that their baby cried often, be woken up 3 times or more between 10 pm and 6 am, have received less than 6 hours of sleep in a 24-hour period over the past week, indicate that their baby did not sleep well, and think that their baby's sleep pattern did not allow them to get a reasonable amount of sleep” (Dennis & Ross, 2005, 187). 
 
In addition to coaching, educating and providing encouragement and resources on various relevant topics, an overnight postpartum doula helps to support healing and recovery in the 4th trimester (first three months following birth); and helps to renew and strengthen the parent’s depleted mental and emotional capacity, allowing them to better adapt to their new role and new lifestyle.

HOW DO THEY DO THAT???
 
What responsibilities does an overnight doula actually have?
An overnight doula will often show up at the house around 10PM (or agreed upon time) and takes over the night-time duties of the baby for 8-10 hours.  She* stays in a separate room with baby, allowing parents uninterrupted sleep. She will bring the baby to Mama when it is time for a feeding (if she is breastfeeding), and immediately takes the baby away again to the other room to continue attending and caring for his needs.  Examples of overnight doula support services include:

1. Baby care, Mama self-care and breastfeeding support
2. Drinks and light midnight snacks prepared (if needed)
3. Feeding (bottle-fed), changing, swaddling, soothing, and putting your baby back to sleep
4. Light housekeeping such as baby laundry and dishes (as long as it doesn’t disturb sleeping household)
5. Re-stocking and tidying the nursery
6. Cleaning/sterilizing bottles and breast pump paraphernalia
7. Prepping bottles for the next day
8. Encouragement, emotional support, coaching and guidance
9. Between visits telephone support for questions or concerns
10. Resources and Referrals

 
This type of overnight support keeps parents: from being woken up from anxieties, knowing baby is being cared for by an experienced professional; as well as from every noise baby makes in the night.  This type of care also, often leads to baby sleeping longer, too; and helps him to develop better night-time sleep habits and patterns.
 
There are many changes to lifestyle and challenges encountered while adapting to the newborn during the 4th trimester.  Studies have shown that having the support of a postpartum doula increases the parent’s confidence in their parenting skills and instincts, increases breastfeeding success, and decreases the likelihood a mother will experience symptoms of postpartum depression, (McComish & Viscer, 2009).  
 
Dennis, C-L. & Ross, L. (2005). Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth, 32. 3, 187-193. doi: 10.1111/j.0730-7659.2005.00368.x

McComish, JF. & Viscer, JM, (2009). Domains of postpartum doula care and maternal responsiveness and competence. J Obstet Gynecol Neonatal Nurs, 38(2):148-156. doi: 10.1111/j.1552-6909.2009.01002.x