Child care positions aren't usually thought of as high-paying jobs . But with wealthier families seeking nannies that are trained in newborn care, child development or languages, it's becoming more common to see in-home caregivers earning six-figure salaries.

In demand are top-tier, career nannies who have specializations, certifications and loads of experience.

"We've seen a lot of requests for Mandarin and French speakers in the nanny role," says Keith Greenhouse, chief executive of the household staffing company Pavillion Agency. "Lately more than ever people want someone who is tech savvy and nannies who can move into a family assistant role."

Such nannies work long hours or overnights and may even travel with the family. But they can make between $150,000 to $180,000 a year in places like New York or Los Angeles. Sometimes even more in the Bay Area.

"Families are paying over $220,000 a year in San Francisco," says Anita Rogers, president and founder of British American Household Staffing. "There's a value in paying well for your employees, especially in your household."

The six-figure nanny

With more skills come higher rates. At Educated Nannies, a staffing agency in Los Angeles, nannies need to have college degrees and families appear to be most interested in candidates with backgrounds in child development.

"Many of our families don't want any screen time for the kids," says Ryan Jordan, founder of Educated Nannies. "So that's the time the nanny needs to bring in preschool curriculum and adventures."

But while a preschool teacher makes $13 to $15 an hour, or around $30,000 a year according to the Bureau of Labor Statistics, skilled nannies are commanding double that at $25 to $40 an hour. Some newborn care specialists in Los Angeles can even earn $70 an hour, says Ryan. At that rate, specialists working a schedule that some keep -- 9 or 10 hour shifts, six-days-a-week -- find it possible to earn $200,000, including overtime or travel pay.

Heidi Joline has worked as a nanny for nearly 20 years. But she wasn't always so sure childcare was the right career for her.

"Saying you're a nanny doesn't get that 'Oh! You're a nanny? That's so exciting!' reaction from people," she says. "It's like "Oh, you're a nanny. When are you going to get a real job?"

But after trying office work for a bit, she returned to nannying and realized she could grow in a way that was interesting to her, valuable to her families and a lot more lucrative than teaching preschool.

She has passed the International Nanny Association Exam, taken Yale courses on child rearing and Stanford courses on health across the gender spectrum. She has studied child psychology, newborn care and resilience following trauma.

Currently working with a family in Los Angeles, Joline prepares a curriculum every month for the preschooler she cares for. This month's theme is bugs, and she has planned a lineup of songs, stories and activities along with learning words in Spanish, French and Mandarin. She and the child even released 3,000 ladybugs into the wild.

"In this field, things change all the time," Joline says. "What we did with our children five years ago is not what we're doing now with regard to nutrition, socialization, education and overall well-being. You have to keep up with that to help inform the parents."

And her skills have not gone unnoticed: she was named 2019 Nanny of the Year by the International Nanny Association.

"As a nanny you have to have those specialties and you have to continue your education," Joline says. "In other places, it may be fine to just have CPR training, but if you're in the bigger markets, where you are expecting higher pay and working with higher-profile people, you need specialized skills to stand out."

She earns at least $30 an hour with additional pay for overtime, overnights or travel, allowing her to earn more than $100,000 a year. And now, as the child is spending more time at school, Joline is transitioning into a family assistant role, handling the organizational side of the family's life including grocery shopping, cooking meals, picking up dry cleaning, handling pool cleaners and housekeepers and making sure the family's dog has vet visits and a stock of food.

The newborn care specialist

Marly Higgins Driskell is a certified master newborn care specialist in Houston.

For some affluent families, bringing home a new baby may involve not just a nanny or two, but also a lactation consultant and a newborn care specialist.

That's where Marly Higgins Driskell comes in. After 23 years as a traditional nanny, she was looking to stay in a career she loved, but expand her work. Her full title is now, "Certified Credentialed Master Newborn Care Specialist," and her expertise is with high-order multiples like triplets, quadruplets and even quintuplets.

"I come in and help empower and educate the parents," she says. "If there are other caregivers in the house, I will take the lead. What happens during the day impacts what happens at night."

Working with families for three to four months right after the birth, she sleep conditions the baby with gentle, non-cry-it-out methods. But don't confuse her with a night nanny, who is taking instructions from the parents. Higgins Driskell's role is more like a consultant.

She says that after a couple of months she often has babies sleeping 10 to 12 hours through the night with no feedings. Her fees, which in Houston are lower than those in New York or Los Angeles, start at $35 an hour, and she will sometimes work up to 80 hours a week.

Like many professionals earning six figures and working long hours, she has help. She has her own personal assistant for correspondence, a social media assistant and a housekeeper to clean her home.

"I run better when I have help," she says.