The Dark Underbelly of the Baby Sleep Industry
A review of the BBC News investigation into the Baby-Sleep Industry
Reporters from the BBC recently investigated individuals claiming to be “infant sleep experts” giving dangerous advice to new parents. Advice that directly goes against safe care recommendations or is beyond their scope of practice.
There are many titles people in this field use: Newborn Care Specialist, Sleep Trainers, Night Nanny, Infant Care Specialist, Baby Nurse, Night Nurse, Maternity Nurse, and sometimes even Postpartum Doula. In the USA, you can only use the title of nurse if you have a nursing license; it’s legally protected. The other titles are unregulated. An ethical professional will obtain training and certification - ideally from established, credentialed, and evidence-based educators - but it is not legally required. There are associations (e.g., NCSA, DONA, CAPPA) for the various professions in this field that aim to establish professional standards, a code of ethics, and a scope of practice to provide some level of accountability and regulation.
The newborn-care industry, the baby-sleep industry, and even the postpartum/new-parent support industry are woefully underregulated. It’s the responsibility of professionals in these industries to ensure we are well-informed on evidence-based and safe care practices for newborns (and infants and toddlers). The lack of regulation and lack of a recognizable certification means it’s up to the families to hire at their discretion, during a time when they may be desperate for sleep and seeking support and advice.
As a Newborn Care Specialist - and previously as a nanny for infants and toddlers - I know just how much sleep means to parents in these phases. I’ve had the privilege of supporting families during these phases. I’ve helped families achieve rest and recovery, supported them through their feeding goals and challenges, and educated them on typical newborn care and behavior. But with this privilege comes great responsibility.
According to the BBC, people, claiming to be professionals and experts with a track record of babies sleeping through the night, are telling parents they have the solution to make their baby sleep perfectly. This is a lie they sell to vulnerable families who just want to help their baby. Parents are seeking advice from people they believe to be experts. They expect the advice to not just be effective, but safe. And they should be able to trust the person they are paying hundreds or thousands of dollars to.
The lack of regulation in this field puts infants at risk of harm, or worse yet, death. People in this field should not take our roles lightly. Whether we offer virtual advice or in-person support, parents should be able to trust that we will uphold the health and safety of their child above all else. Even if families choose to go against the advice of medical associations, it is our job to educate them on the risks and follow the advised care practices unless otherwise directed by a healthcare professional. It is our job to stay up to date on the evidence-based care practices. Doing otherwise is a disservice at best and a disaster at worst. And if families choose to go against the recommended guidelines and demand you do the same, it’s also our duty to walk away. Parents can make the choices they want for their child, but we must recognize that we do not have the same rights as they do. Sometimes the best way to support a family is to decide you are not the best type of support for them.
More than just dangerous sleep advice, unless they are educated in and have the qualifications to diagnose (like doctors), no one should be diagnosing babies - especially not over a call! As a NCS with some education in lactation and a degree in child development, my role is to make parents aware of signs and behaviors that could potentially be symptoms of an underlying issue. And then refer them to their healthcare providers. I support my clients in advocating for their baby and working with their providers to come up with a care plan for their baby that they think is best. I cannot diagnose, no matter how much experience I may have with a specific issue. My scope of practice is to observe, document, refer to providers, and support.
Why is this happening?
The reporter made an accurate observation; the lack of support, resources, and protections for families of young children is exactly why so many parents reach out to “sleep experts”. The “professionals” giving unsafe advice or not staying within their scope of practice are symptoms of the system (government and society) failing families.
One of the reasons so many enter this field is that families of young infants lack support, especially overnight. Multi-generational homes are not as common. Families are waiting till they are older to have children, which means grandparents cannot support their children or care for their grandchildren as much. Families are much more separated than before. The “villages” of the previous generations are disappearing.
In the USA, we lack mandatory, paid parental leave. Parents are returning to work almost immediately because they financially do not have a choice. Many return to work as soon as their baby can go into care or stay at home with a relative/caregiver, if possible. This puts families, especially postpartum parents, in an impossible position. They need to rest overnight because they can’t afford to miss work. Beyond rest, the system is not designed to support feeding human milk/breastfeeding. If society and our government truly wished to encourage nursing, they would prioritize paid leave, lactation education, and continued lactation support/resources.
A Call to Action for Industry Professionals and Society
If this field is going to be taken seriously and eventually become a regulated profession, the professionals need to hold themselves not just accountable but to a higher standard than the bare minimum. The government and systems need to prioritize the well-being of all families. Families of young children need financial stability; they need leave to recover and bond. They need to know their rights and jobs are protected. They need to have support that helps them care for their child in a developmentally appropriate way. Families deserve better, babies deserve better.
As a profession, we need to strive for higher standards and hold each other accountable. As a society, we need to demand more protection and support for parents of young children.
I truly love being able to support families and care for babies. I love helping parents feel confident and well-rested. It brings me joy to support a parent in their nursing journey. Caring for babies in a biologically appropriate way and keeping them safe based on evidence-based practices is the bare minimum of my work. Being entrusted by parents to not only ensure their baby is safe and cared for overnight but also nurtured and loved is a GIFT to be treasured. I cannot accurately express how grateful I am to every family that allows me to be part of their support system.
Thank you to the BBC for this investigation and assessment. To those in this industry who are part of the problem, you are lucky if nothing catastrophically bad has happened yet.
