Like Stern, many new mothers  1.7 million, in fact, or a full 57 percent with children who are under a year old are now in the workforce, placing their most precious treasure in the care of others. And like Stern, many parents are worried about childcare’s effect on their baby’s social and intellectual well-being and how it will affect the infant-parent bond.
Over the years, research has delivered mixed messages about this relationship. However, an ongoing study conducted by the National Institute of Child Health and Development reported that childcare doesn’t threaten the bond between infants and their mothers, as long as a baby is getting sensitive care at home. Most experts agree, too, that infants can thrive in childcare under the right conditions, which include plenty of attention, affection, rich language experiences, and playful interaction with caregivers.
This type of quality care is generally easier to find in a one-on-one or small-group setting. But because of factors such as cost, availability, and flexibility, most parents rely on group care, where the child-to-adult ratios are higher. (The ratio recommended by the National Association for the Education of Young Children is one adult to three babies, birth to 12 months, in a group of six.) This means choices for quality care are limited  but they do exist. What to look for?
Infants' Special NeedsWhether babies are at home or in childcare, their requirements are simple in the first year of life. "They need to be safe and well fed and kept comfortable, and they need to feel valued," says Nancy Balaban, director of the Infant and Parent Development Program at Bank Street Graduate School of Education in New York City. "They need certainty, and to know that the person who is there for them today will be there tomorrow, too."
During the first months, an infant slowly develops an awareness of the world around her through sensory exploration and interactions with people. "A very young baby is just beginning to understand where she ends and someone else begins," says Penelope Leach, author of Children First. "She develops her essence from the way someone reacts to her, so that person must be familiar with the baby’s habits. If a 3- or 4-month-old puts her finger in my mouth, for instance, I need to know: Is she thumb sucking? Is she teething? A quality caregiver wants to find out."
Lisa Sachs of Oak Park, IL, knew she had found excellent care for her son, Noah, when the prospective caregiver whom she was interviewing noticed something Noah was doing and immediately reacted. "She responded even before I did," Sachs says.
A sensitive caregiver will also feel comfortable expressing affection. Infants in childcare for eight to ten hours a day need to form secure relationships  if they click with their caregiver, they’re more likely to form friendships with other children as well. "There are myriad ways of expressing affection," says Sandra Twardosz, a professor of child and family studies at the University of Tennessee. "Smiling, touching, using endearments, physical contact  all are important."
Gauging just how a caretaker relates to a child isn’t always easy. Sheila Mackie of Meriden, CT, thought she’d found the ideal provider for her daughter, Kara, who entered family childcare at 4 months. "The woman had an early childhood degree, good references, and lots of educational toys in her home."
But Kara didn’t fare well. "She cried the whole time she was there," says Mackie, "and not for lack of affection. They just didn’t click. Kara wasn’t being stimulated the way she needed to be." Once Mackie switched her daughter to a childcare center, Kara thrived. "She seemed to be in the lap of her provider constantly, and the other kids were always cuddling and tickling her," Mackie says.
Along with expressing affection, it’s important for a caregiver to be playful. After all, she is a baby’s guide to the world of social interaction. By the middle of the first year, babies take great pleasure in games such as peekaboo and finger rhymes. "A child is learning to look for cues, to take turns, to pay very close attention to her partner," says Fergus Hughes, a professor of human development and psychology at the University of Wisconsin, Green Bay and the author of Children, Play, and Development. "Adults who are playful will smile more and make a lot of eye contact."
Keep It ConstantOften, though, a caregiver just doesn’t stick around. Turnover rates of infant-care providers  whether in-home or at a center  are depressingly high, at around 40 percent. There are simply no guarantees of continuity and reliability. Studies indicate that infants who must deal with a succession of caregivers eventually feel less comfortable in social situations, so it’s best to seek out centers with low turnover. What’s more, it’s important to check references of family caregivers carefully, to see how long they’ve been providing continuous care.
And, of course, a quality childcare center understands the value of the bond between babies and caregivers. Some centers embrace a primary caregiver system  one caregiver (or just a few) largely responsible for the same kids each day. At the very least, caregivers should honor the close relationships that babies form and try to ensure as much continuity as possible.
When Michelle Holback of San Jose, CA, enrolled her son, Zachary, in a center when he was 6 months old, he immediately bonded with one of the caregivers. "Taly is the only one who can calm him," says Holback. The center encouraged their relationship from the beginning. "Whenever Zachary gets upset, Taly always comes over and helps him through it," Holback says.
Likewise, at the Rockefeller University Children’s School and Infant-Toddler Center in Manhattan, children stay with the same caregiver for a full year instead of moving into a new age group simply because they’ve had a birthday, which is typical practice at many childcare centers. "We want babies to develop bonds with the caregivers," says director Marjorie Goldsmith. It’s important that children not change caregivers when they learn a new skill such as sitting up. If you move a child then, Goldsmith says, "you end up turning a developmental milestone into a separation experience."
Family NeedsBeyond what’s best for their baby, many other factors influence an individual family’s choice: How much can they afford to pay? Do they prefer family childcare, where one person cares for mixed-age children in her home, or a childcare center, which tends to group kids of the same age? Patty Craft and her husband, Don Hall, of Pennsauken, NJ, spent a lot of time thinking about childcare for their daughter, Cameron, who began childcare at 5 weeks. Dead set against placing her in full-time care, they chose to split the care between themselves and a caregiver. Craft spends two days at home with Cameron, Hall stays home one day, and the baby spends the rest of the week in family childcare.
One of the most difficult decisions parents face is whether to choose family childcare or a center. For Lisa Sachs, who took her 5-month-old daughter, Mara, to a local provider, the initial choice was easy. "I thought family childcare would be more stable and personal," she says. But her caregiver, who was in the midst of a divorce, soon left town, forcing Sachs to enter another unstable family childcare situation. Not long afterwards, however, she enrolled her daughter in a childcare center at a local college.
Can childcare centers offer the same intimacy as family care? Sherilynn Kimble, who oversees The Caring Center in Philadelphia (which enrolls 133 children, including 20 infants), believes it can. "We make it as family-like as possible," she says. "Moms who are close by can come in and nurse."
Still, as accommodating and stable as it may be, a large facility might not satisfy a parent’s desire for an intimate atmosphere with children of different ages. Licensing regulations often require childcare centers to segregate infants, toddlers, and preschoolers; family childcare, on the other hand, usually offers a wider age span. "Because younger babies are more demanding, it makes sense to mix ages to maximize the caregiver’s time," says Jay Belsky, a professor of human development at Pennsylvania State University and the author of The Transition to Parenthood. "But you don’t want so many older kids that they’ll literally run over the younger ones."
And, of course, parents can’t assume that just because a family provider offers a homier atmosphere, the care will be outstanding. After all, if one provider has six or eight children of different ages in her charge, she still won’t be able to give quality care. Perhaps the best idea, according to Ellen Galinsky, president of the Families and Work Institute, an organization that researches work-family issues, is for parents to examine both childcare options as objectively as possible. "Although a home may seem like a more nurturing environment," she says, "you can’t assume that it’s going to be more caring or stable, or that a center is going to be more bureaucratic or remote."
Starting Your SearchMost communities have resource and referral agencies that provide lists of licensed childcare facilities. Child Care Aware, a national hotline, provides referrals to local resource agencies. Recommendations from fellow parents, friends, and co-workers are especially useful.
Childcare professionals advise parents to look for centers that have been licensed, although they also point out that a license is no guarantee of quality. Regulations  which generally cover such issues as health and safety, group size, maximum ratios of children to staff, and liability insurance  vary tremendously from state to state. And standards for family childcare are much less stringent than those for centers. "Most people would agree that licensing is baseline, the minimum standards to ensure health and safety of children. Parents should always try to find something better than the regulations," says Gina Adams, a childcare specialist at the Children’s Defense Fund in Washington, DC. Both the National Association for the Education of Young Children and the National Association for Family Child Care offer lists of childcare facilities with standards beyond those required by state licensing.
Armed with a list of available sites, the next step is to study the options. Phone calls help in the prescreening process, but only on-site visits reveal the true flavor of the care being offered. "I walked into one center," says Danna Perlowski, a Dallas mother of a 7-month-old, "where it was too loud and there were toys strewn everywhere. I thought, 'I can walk away from this one.’" When Perlowski visited the center that she ultimately chose, it felt right immediately. "The caregivers had all been there for a long time," she says. "The place was calm and structured, and the caregivers seemed to know every baby’s personality and needs."
In the case of family care, experts advise making an appointment for a half-hour chat with the provider. Many centers host open houses, with particular times for tours. Visits are the perfect time to ask about the phasing-in process, feeding and napping schedules, attitudes about breastfeeding, how caregivers and parents communicate, and policies on unannounced visits by parents.
Parents should also question potential providers about their child-rearing philosophies. "Caregivers come from all different cultures," says Alison Clarke-Stewart, a professor of psychology and social behavior at the University of California, Irvine and the author of Daycare. "They may not have the same attitudes as you about picking up a crying baby, for instance."
Phasing InThe first days of relinquishing the care of their infants to others are the hardest on parents. New mothers, in particular, are likely to be weepy and worried and to need lots of support. "It was really hard for me," says Perlowski. "I cried. It took me two weeks to realize I wasn’t harming him. I felt so guilty."
High-quality providers acknowledge these feelings by encouraging parents to visit during the adjustment period, ranging from a day to several weeks. Before Gail Stern left 10-week-old Nikolai at his center, for instance, his caregivers had not only watched how she held him but also asked her to mimic his hunger cry so that they could distinguish it from other needs. "Their whole philosophy is to help the parent," she says.
The relationship between childcare providers and parents is a delicate one and requires nurturing. Barely initiated into the mysteries of their new baby, first-time parents may lack the confidence to speak with authority about their child’s needs. "Caregivers have the larger responsibility in reaching out to parents," says Jay Fagan, an assistant professor at Temple University. Frequent telephone contact helps ease the transition. "I remember one mother who, in the first week, called five times, the second twice, the third not at all. It takes time to develop confidence," says Deborah Eaton, president of the National Association for Family Child Care. Infants need time to get used to the separation, too. For a young baby who has been cared for primarily by one adult since birth, the switch to out-of-home care is dramatic. And for an older infant, who has had time to develop a strong attachment to her parents, anxiety may dominate the phasing-in period. "I almost wish I had started Teddy at a much younger age," says Anne Cardwell of Vallejo, CA, whose son began childcare at 6 months. "He had a hard time, but his caregiver really worked to ease the transition." When Cardwell left the center each morning, the provider would lift her baby up over the Dutch doors, Cardwell says, "so he could see me say good-bye."
For other parents who hand their babies over to someone else, jealousy often rears its ugly head. "It’s absolutely normal to feel competitive with your childcare provider," Galinsky says. "But as a parent, you have your children forever; you don’t have to worry. No study I’ve ever heard of has concluded that children are more attached to their providers than to their parents. So you can afford to be generous."