Several types of nurses work with babies, but the most recognized is the neonatal nurse, who specializes in caring for newborns in the hospital. Depending on where a baby is in its first hours, days, or weeks of life, different nursing specialists step in. Labor and delivery nurses handle the first moments after birth, newborn nursery nurses care for healthy infants, and neonatal intensive care (NICU) nurses manage premature or critically ill babies. Beyond bedside roles, neonatal nurse practitioners can diagnose conditions, prescribe medications, and perform advanced procedures.
Labor and Delivery Nurses
The first nurse most babies encounter is a labor and delivery (L&D) nurse. While their primary patient is the mother, they play a direct role in the baby’s earliest minutes of life. Immediately after birth, the L&D nurse helps assess the newborn using the Apgar test, a quick scoring system applied at one minute and five minutes after delivery. The test rates five signs: muscle tone, pulse rate, reflex response, skin color, and breathing effort. A score of 7 to 10 is considered normal.
L&D nurses also handle essential tasks like drying the baby to prevent heat loss, using warm blankets and heat lamps, and gently stimulating the newborn to cry so excess fluid clears from the lungs. If the baby shows signs of distress, the nurse works alongside the doctor or midwife to suction fluid from the nose and mouth and support breathing. If the situation is more serious, the baby may be transferred to a higher level of care.
Newborn Nursery Nurses
Once a healthy baby is born, a newborn nursery nurse (sometimes called a mother-baby nurse or postpartum nurse) takes over. These nurses care for infants who don’t need intensive intervention. In most hospitals, babies stay in the mother’s room rather than a separate nursery, and the nurse manages care for both.
Their responsibilities include reviewing the mother’s prenatal records to flag any risks for the baby, performing admission and discharge physical exams, and tracking the infant’s daily progress. They also coordinate newborn screenings, arrange any needed lab work or imaging, and educate parents on feeding, safe sleep, and what to watch for at home. Before discharge, they make sure the family has a follow-up appointment scheduled and understands any issues that need monitoring. If complications arise, such as jaundice requiring light therapy or signs of infection, the nursery nurse communicates changes to the parents and coordinates a transfer to the NICU when necessary.
NICU Nurses
Neonatal intensive care unit nurses are the specialists most people think of when they picture a nurse who works with babies. They care for the most vulnerable newborns: premature infants, babies born with birth defects, and those with critical illnesses or other conditions requiring close monitoring.
On a typical shift, a NICU nurse monitors vital signs continuously, administers IV fluids and medications, manages feedings (often through a tube for very premature babies), and provides comfort care. Because their patients can’t communicate what’s wrong, NICU nurses rely heavily on subtle cues and monitoring equipment to detect sudden changes. Nurse-to-patient ratios in NICUs are deliberately low, often one nurse to one or two babies, because the level of attention required is so high.
NICU nurses work with babies across a range of acuity levels. Some infants need help with breathing for a few days, while others spend weeks or months in the unit. The emotional demands are significant. These nurses form close bonds with families during long hospital stays, celebrate milestones like a baby’s first bottle feeding, and sometimes support families through devastating outcomes.
Certification for NICU Nurses
NICU nurses start as registered nurses (RNs) with a bachelor’s or associate degree in nursing. To demonstrate specialized expertise, many pursue the RNC-NIC credential through the National Certification Corporation. Eligibility requires at least 24 months of specialty experience and a minimum of 2,000 clinical hours in neonatal intensive care. Nurses working in delivery settings also typically complete the Neonatal Resuscitation Program (NRP), which trains them to manage newborn resuscitations in both routine and high-risk situations.
Neonatal Nurse Practitioners
A neonatal nurse practitioner (NNP) is an advanced practice registered nurse with a master’s or doctoral degree who functions more like a physician within the NICU. NNPs practice autonomously in many settings. They diagnose and treat patients, order and interpret lab work and imaging, prescribe medications, and perform advanced invasive procedures. Their scope covers neonates, infants, and toddlers up to age 2.
What sets NNPs apart from bedside NICU nurses is their role in the delivery room itself. They direct resuscitation and stabilization of newborns immediately after birth, perform prenatal consultations with expectant parents facing high-risk deliveries, and manage the transition from delivery to the NICU. In many hospitals, the NNP is the first provider to evaluate and treat a baby in distress.
Pediatric Nurses
Pediatric nurses care for children from birth through adolescence, so they sometimes work with babies too, particularly in pediatric units, outpatient clinics, and pediatrician offices. The key difference is scope: a pediatric nurse is a generalist across all childhood ages, while neonatal nurses focus exclusively on the newborn period and early infancy. A baby who recovers in the NICU and later returns to the hospital at six months with a respiratory infection would likely be cared for by a pediatric nurse at that point.
Salary and Career Outlook
Pay for nurses who work with babies varies widely depending on role, location, and experience. Neonatal nurses earn between $79,000 and $127,000 on average, with the range stretching from around $54,000 to as high as $200,000 depending on the facility and cost of living. Neonatal nurse practitioners earn a mean salary of roughly $137,000, reflecting their advanced training and expanded clinical authority.
Demand for neonatal nurses tends to be steady because every hospital with a delivery unit needs them. NICUs, in particular, require specialized staffing around the clock. Nurses who hold the RNC-NIC certification or NRP credentials generally have stronger job prospects and more negotiating power on salary, since these credentials signal a verified level of expertise that hospitals actively seek out.