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Making the Daycare Decision

If you work, one of the most important choices you'll make will be deciding who will care for your child while you're on the job. To help you find the right option for your family, the American Academy of Pediatrics (AAP) has the following advice, from its recently updated guidelines.

? Consider your options. First, decide what type of childcare would best meet your family's needs. There are three types: in-home care, where the caregiver comes to your home (usually the most expensive option); family care, where you bring your child to a caregiver's home; and center-based care, where you take your baby to a place that's organized to handle groups of children. Consider how flexible you'll need the provider's hours to be, how conveniently located it is to your home or job, and what will fit your budget.

? Do your research. Once you know what type you're looking for, contact Child Care Aware (800-424-2246), an organization that can help you track down providers in your area (through detailed lists of referral agencies) and explain your state's licensing requirements. Once you've compiled a list of options, call to find out if the provider is licensed by the state and ask about child-to-staff ratios, fees, caregiver training, and how to get references from other parents.

? Check it out. Seeing, as they say, is believing, so make sure you visit the places you're seriously considering. (If they don't allow you to come and observe, move on to the next on your list.) The AAP has a Child Care Checklist that you can bring with you. One of the most important things to check is the child-to-staff ratios. For babies up to 12 months in center-based care, that means no more than three babies per adult. For older babies, the recommended ratio is four babies to each adult. (No caregiver working alone should handle more than two children younger than 2 years old.) Also, check the caregiver's background and training, which should include child development, recognizing signs of illness (such as change in appetite), safety standards (such as putting a baby to sleep on his back), and first aid. Finally, watch to see if caregivers are washing their hands after changing diapers and wiping runny noses and before handling any food or bottles, which prevents the spread of illness.

? Get to know each other. As with other relationships, communication is key. Talk to your caregiver about your preferences for your baby, how your child expresses his needs, and how you or your partner can be reached in the event of an emergency.

? Calm your anxiety (and your guilt). If your baby is under 7 months, the separation will likely be harder for you than for him. Most babies adapt well to a consistent, nurturing caregiver. An older baby, however, may experience separation anxiety. If your child does, spend a little extra time helping him adjust to the new arrangement, and give him a memento of you and your partner, such as a photo that you can tape above his crib to look at during nap time. Parents often feel guilty about not being with their children, but research has shown that high-quality care can promote healthy development.

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