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Second Nightmare - Hard
Third Nightmare - Very Hard
Fourth Nightmare - Overkill
Basically, a bunch of baby masks will spawn and grabbing the right one (random) will get you the achievement for that difficulty. The others are decoys. The decoys will not give you the achievement. Get the first four nightmare achievements and you will unlock the baby masks.
Once you get the vault open, you go upstairs and explore the whole map, grabbing any floating baby masks you can find. There is a small chance that they will down you, but once you've found either all of them, or a random specific one, you get the achieve and then the mask.
//edit: on a sidenote this witch is now starting to troll me hardcore seems to be 50-50 chance of getting her or the fails atm XD