As a Newborn Care Specialist, you are hired to ensure the care and well-being of the newborn infant, and to make new parents’ transition into parenthood as easy as possible. In this role, you always want to respect the parents’ decisions regarding how they want to care for and raise their child, and to support their values, even if they differ from your own. With this in mind, NCS may feel like they have to say “yes” to every request that the parents make, however, that’s not the case. There are certain situations when it is appropriate, even essential, to say “no” to a parent’s request. We’ve listed some of these instances below.
Even if a parent asks, there are things that you should not do as a nanny:
Providing Medical Advice
You have been hired as a specialist and, as such, parents expect you to know everything there is to know about caring for a newborn. Parents will often ask NCS for their advice regarding medical procedures, including making decisions around infant vaccinations. You may have a wealth of knowledge and experience, but you are not a medical professional, so you must avoid giving parents medical advice, otherwise you are putting yourself at a liability risk. If a parent tries to engage you in such a conversation, it is perfectly okay to say “I am not a medical professional, so I can’t advise you one way or the other” and leave it at that.
Making a Medical Diagnosis
Once again, you are not a medical professional, so you aren’t able to diagnose conditions. Even if you’ve seen something similar before, and you’re 99% sure that’s what the infant is experiencing in this case, it’s always best to err on the side of caution and advise the parent to speak to a doctor, rather than making a diagnosis yourself. For instance, what looks like a common rash in one infant could actually be an indication of a serious allergic reaction in another. You may say something along the lines of “I’ve seen something like this before and it turned out to be __________, but you should speak to a doctor to be on the safe side”.
Preparing Alternative/Non-Traditional Formula
For infants that are bottle-fed, there are alternative/non-traditional formulas out there that may provide the infant with adequate nutrition. However, as the NCS, you should not be the one preparing those formulas for the infant. Factory-made formulas contain specific nutrients and have explicit instructions for how to properly prepare them, so it is okay for you to do the preparation in this case. Alternative/non-traditional formulas, on the other hand, do not come with the same nutritional information and instructions, and there is a risk that they will not be prepared properly and/or will not contain adequate nutrition for the growing infant. If parents choose to feed their infant alternative/non-traditional formulas, that is their decision and you must respect that decision, but you should not be the one preparing the formula, as it also puts you at a liability risk.
Dispensing Medication Without the Advice of a Physician and a Signed Liability Release Form
Any medications you give to an infant must be prescribed by a physician, following the exact dosage and means of administration prescribed, and only after you and the parents have signed a liability release form. Unless these conditions are in place, you should never give an infant medication, as it may put the infant at a physical risk and you at a risk of liability.
Checking an Infant’s Temperature Rectally Without the Parent’s Supervision
It is a known fact that the most accurate way to read an infant’s temperature is with a rectal thermometer. However, you should never take the infant’s temperature this way unless you are being supervised by the parent, as it involves inserting something into the infant’s body, which can pose multiple risks. If the parent is not available to supervise, it is best to check the infant’s temperature by other means, such as by using a temporal artery thermometer on the forehead, or by placing the thermometer in the infant’s armpit to get a reading. In the case that the parent is present, it is reasonable to ask them to check the infant’s temperature rectally themselves.
Trimming an Infant’s Nails
It may seem less obvious than the other examples, but it is important to decline when a parent asks you to trim their infant’s fingernails or toenails. Trimming nails involves using a sharp object (nail clippers) near very soft, fragile skin and can accidentally result in cuts and/or infections. It is best to avoid any risk of liability in this case and let the parent trim the infant’s nails themself.
Installing a Car Seat
Unless you are a certified Child Passenger Safety Technician (CPST), you should not be the one installing the car seat in the parent’s vehicle or your own vehicle. Car seats must be installed in a very specific way in order to ensure that they are safe for the infant to ride in. If you are not trained in proper car seat installation, or being supervised by a CPST while doing so, you should never install a car seat on your own. Once again, it becomes a liability risk if anything were to happen to the infant while riding in an incorrectly installed car seat.