The State of Newborn Care in the United States: Gaps in Oversight and the Need for Standardization

A workforce policy paper by Denise Iacona Stern, Founder of Let Mommy Sleep, January 2026.

Full paper available on SSRN | Learn about the NAPS Night Doula Certificate

The industry has grown but the standards have not.

The global postpartum products and services market is projected to reach $3.90 billion by 2030 and Medicaid now covers birth and postpartum doulas in 26 states and Washington, DC. Employers are also offering overnight newborn care as part of family leave packages, and independent caregivers are choosing in-home family support as a career path in growing numbers.

Yet the profession has no national standards. There is no required training and no oversight body.

That is the argument at the center of The State of Newborn Care in the United States, and it is not a theoretical one. It is the daily reality for families hiring overnight newborn care, for caregivers working without a recognized credential framework and for the healthcare providers who refer families to services they cannot independently evaluate.

The State of Newborn Care in the United States: Key Takeaways

• The first 12 weeks of life represent a high-risk period for newborns and families. 
• In-home newborn care as a profession has grown rapidly driven by unmet demand during the postpartum phase and private sector growth.
• Despite increased use by families, employers and Medicaid, the sector lacks national standards.
• Newborn care training and certification vary widely, creating preventable safety and professional issues. 
• Aggregation and accountability are necessary to protect families and providers alike.

What the paper documents

The State of Newborn Care examines the in-home newborn care profession at the moment it is becoming mainstream; adopted by Medicaid programs, offered by employers, and increasingly treated as a clinical adjacent service, while operating entirely without the standards that mainstream adoption requires in every other healthcare setting.

The paper documents four interconnected gaps:

The first weeks of life are high-risk. The period immediately following hospital discharge is among the most medically significant for both newborns and postpartum parents. Weight, feeding, jaundice, postpartum recovery, and mood are all in active flux.

The profession has grown without accountability. In-home newborn care has expanded rapidly, driven by genuine unmet demand. But growth without standards creates risk. Unlike licensed healthcare professions, where state nursing boards investigate complaints, monitor credentials, and mandate remediation, in-home newborn care has no equivalent oversight body. There is no formal complaint process. No credential that can be suspended. No mechanism for accountability for caregivers and families alike, when something goes wrong.

Training and certification vary widely. The credentials caregivers present to families range from rigorous evidence-based programs to self-issued certificates with no clinical foundation. Families have no real way to evaluate the difference. The absence of a recognized national standard means the word “certified” carries no consistent meaning in this profession.

Aggregation and accountability are necessary. The paper makes the case that meaningful voluntary credentialing tied to a verifiable public registry is the first achievable step toward protecting families and elevating the profession. Regulatory frameworks take years. A credentialing infrastructure with real accountability can be built now.

Why this paper exists

Let Mommy Sleep has operated a coordinated newborn care model since 2010 where Registered Nurses conducting postpartum home visits in the first week, working alongside NAPS-certified overnight specialists. The model was built around a premise that has always been true and has never been codified at the industry level: that families deserve to know who is caring for their newborn, and that caregivers deserve a credential that means something.

The State of Newborn Care is the formal documentation of that premise. It does not advocate for Let Mommy Sleep specifically. It advocates for standards that the entire profession needs regardless of who provides the care.

The NAPS Night Doula Certificate and the National Night Doula Registry are offered as the existing infrastructure: a tested, evidence-based credential with clinical advisory board oversight, available in English and Spanish, required across 26 Let Mommy Sleep territories and open to all qualified caregivers regardless of employer.

If you refer families to in-home postpartum support, or if your patients ask you whether the overnight caregiver they hired is qualified, this paper documents the gap you have likely already observed clinically. There is no equivalent of a nursing license to check.

The National Night Doula Registry at newborncarecertified.com is currently the only publicly verifiable directory of credentialed in-home newborn care professionals in the United States. Families and providers can search it to confirm a caregiver’s NAPS certification independently.

If you are interested in discussing the paper’s findings, the coordinated RN + NCS care model, or partnership opportunities with your practice or hospital system, contact us directly through Let Mommy Sleep.

For policy researchers and journalists

The State of Newborn Care in the United States is available in full on SSRN and is the first published policy paper to document the workforce standards gap in the in-home newborn care profession. It is available for citation, reference, and republication with attribution.

If you are writing about postpartum care, maternal health workforce policy, the fourth trimester, Medicaid expansion into doula services, or the employer benefits landscape around family leave and newborn support, this paper provides the only systematic documentation of the profession’s oversight gap currently available in the published literature.

Contact for press and research inquiries: Let Mommy Sleep

For newborn care professionals and certification seekers

The paper’s argument for standards is the argument behind the NAPS Night Doula Certificate — the evidence-based certification required across all 26 Let Mommy Sleep territories and open to all qualified caregivers. If you are a practicing newborn care specialist, night nanny, postpartum doula, or night doula who wants to work within a credentialed framework, the NAPS certificate is the direct path.

Learn more at Newborn Care Certified.

Read the full paper on SSRN | Learn about the NAPS Night Doula Certificate | Find a certified specialist