Nannies perform their child care duties in the homes of the families that employ them. Unlike other kinds of household help, nannies are specifically concerned with the needs of the children in their charge. Nannies prepare the children's meals, making sure they are nutritious, appealing, and appetizing. They may do grocery shopping specifically for the children. Nannies may attend to the children during their mealtimes and oversee their training in table manners and proper etiquette. They also clean up after the children's meals. If there is an infant in the family, a nanny will wash and sterilize bottles and feed the infant. It is not part of a nanny's regular duties to cook for the adult members of the household or do domestic chores outside of those required for the children.

Nannies are responsible for keeping order in the children's quarters. They may clean the bedrooms, nursery, and playrooms, making sure beds are made with clean linens and sufficient blankets. Nannies may also wash and iron the children's clothing and do any necessary mending. They make sure that the clothing is neatly put away. With older children, the nanny may begin instructions in orderliness and neatness, teaching children how to organize their possessions.

Nannies bathe and dress the children and instill proper grooming skills. Children often seek the assistance of their nanny in getting ready for family parties or holidays. As the children get older, nannies help them learn how to dress themselves and take care of their appearance.

Not only are nannies responsible for the care and training of their charges, but they also act as companions and guardians. They plan games and learning activities for the children and supervise their play, encouraging fairness and good sportsmanship. They may be responsible for planning activities to commemorate holidays, special events, or birthdays. These activities may center on field trips, arts and crafts, or parties. Nannies may travel with families on trips and vacations, or they may take the children on short excursions without their families. Nannies must be detail oriented when it comes to the children entrusted to their care. They keep records of illnesses, allergies, and injuries. They also note learning skills and related progress as well as personal achievements, such as abilities in games or arts and crafts. Later, they relate these events and achievements to the parents.

Nannies act as the parents' assistants by focusing closely on the children and fostering the behavior expected of them. They are responsible for carrying out the parents' directions for care and activities. By setting good examples and helping the children follow guidelines established by their parents, nannies encourage the development of happy and confident personalities.

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