eGuide Archives: Choosing child care

Choosing child care

Leaving a young child with someone else while heading off to work is already a traumatic experience for most new parents. Unfortunately, in addition to the separation anxiety and other worries you’re already experiencing, you also need to consider the possibility of your child being physically or sexually abused while at daycare. As difficult as thinking about this is, doing so is the critical first step in protecting your child from this risk.

Every time your child is out of your personal care he or she is at risk. That risk, however, can be greatly minimized.

Simply put, your child is at risk anytime (however briefly) that he or she is alone with a pedophile. Minimizing this risk involves minimizing the opportunity for someone to be alone with your child, and minimizing the risk that the person in question is a pedophile.

The first three questions to ask yourself are:

(1) Do I really have to put my child in daycare? After taxes, how much am I really keeping?

(2) If the answer is yes, do I have a safe, family care option? A grandparent I know and trust? Having someone who already knows and loves your child care for the child provides extra piece of mind. Some working families have even hired grandparents, who may have worked part time previously, as their child’s nanny.

(3) If you do have to utilize daycare, does it have to be every day?

Assuming that you wouldn’t be reading this if you didn’t need to choose daycare, the next question is which of the three types of daycare is best and safest for my child?

The first type is in-home care where you hire a nanny to care for your children in your home. In this case, the individual you select is alone with your child 100% of the time, but only one person has access to your child.

The second type of care is single provider group home daycare. This is generally a stay at home mom who, in most states, cares for up to five other children in her home. She is most likely, but not necessarily, licensed, and will, undoubtedly be alone with your children for most of the day. Additionally, you need to consider who else may be in the home when your children are there—her husband/significant other? Teenage kids? (And their friends?)

The third type of care is a traditional daycare setting or pre-school. This center will have multiple adults with larger groups of children. It also is the setting that has produced several high profile child abuse cases.

So which setting is the safest?

A study entitled "Abuse and Neglect in Nonparental Child Care: A Risk Assessment" published in The Journal of Marriage and the Family, (v53 n3 p694-704 Aug 1991) "indicated children were significantly less likely to be abused in day care center or preschool than in home-based child care. Strongest correlates of neglect were child's age, caregiver's age, and child care setting." Read more.

The reason is because you do not necessarily control who else is entering a private home in which your child is receiving care.

So how do I choose a daycare center?

The first thing you are looking for in daycare center is the ability to drop in anytime unannounced. That means you may well be looking for a center closer to where you work than where you live.

The University of Minnesota suggests that you start by interviewing potential centers by phone, selecting the best ones for a visit. Read more.

You need to visit at least three to five different places before making a choice. The first time you visit, do it alone. (Bring your child on the follow up visit.) If anything at the center makes you feel uncomfortable, even if, in fact, especially if, you cannot put your finger on what exactly makes you feel uncomfortable, keep looking. Remember, this is the one of the most important decisions you will make.

The American Academy of Pediatrics recommends that one adult should have the primary responsibility for no more than one baby under 12 months of age in any care setting. Read more.

These young children need positive, consistent caregivers who learn to recognize their unique cues for hunger, distress, and play. This kind of nurturing interaction contributes significantly to an infant's social and emotional growth. For infants, the AAP recommends a child to staff ratio of 3:1.

Parents.com offers 8 specific tips on how to size up a daycare provider, in addition to asking the questions recommended by the University of Minnesota. Read more.

Specifically, they are:

1. Look down. When you're visiting a potential site, pay attention to how the staff interacts with the children. Ideally, a caregiver should be on the floor playing with the kids or holding one on her lap. In their early years, babies need close, loving, interactive relationships with adults in order to thrive. That's why it's especially important that babies' first caregivers be warm and responsive, and that even in group care, infants and older babies get a healthy dose of one-on-one time.

2. Ask for a commitment. Babies need consistent, predictable care. It helps them to form a secure attachment to their caregivers, according to Debra K. Shatoff, a family therapist in private practice in St. Louis. Find out how long the current caregivers have been working there and how much turnover the center usually experiences.

3. Do a policy check. Find out whether you share parenting philosophies on topics such as discipline (Do the caregivers use time-outs, scoldings?); television (Is the TV on all day or used sparingly, if at all?); feeding (What snacks or drinks are provided for older babies?); sleeping (When are naps offered? How are fussy babies put to sleep?); and so forth. Inquire about the sick-child policy (What symptoms prevent a child from attending?). The more questions you ask early on, the less likely you are to be unpleasantly surprised later.

4. Drop by and spy. While word-of-mouth referrals from other parents or trusted resources are important, you need to look at a place for yourself to assess whether it meets your needs. Of course, any child-care environment should be kept clean, childproofed, and well stocked with sturdy books and toys that are age-appropriate. Other details to consider: Ideally, infants and babies should have their own area where they won't get "loved" too much by older toddlers. A room or separate area dedicated solely to swings and bouncers may look appealing at first glance, but keep in mind that growing babies need plenty of floor time to develop and strengthen their muscles. If possible, try to visit the same centers at different times of the day to get a sense of how the staff interacts with the children and what the routine is. You may want to consider popping in unannounced a few times after you've enrolled your child, just to see how things are going. Sometimes your visits will confirm that the place is right for you, but sometimes they'll be a real eye-opener.

5. Keep talking. Until your baby can talk, you will be relying on what the caregiver tells you about your child's day. Make sure you can communicate comfortably with each other. When you first hand off your child in the morning, you should tell the caregiver how your little one slept the night before, if he is teething, and whether he ate breakfast. At the end of the day you'll want to know similar information, such as the number of diapers he went through, when he napped, and if he seemed happy overall. It's always preferable to speak to the caregiver in person. If that's not possible, ask if there's a convenient time to phone, perhaps at nap time.

6. Problem-solve pronto. It's inevitable that you'll experience conflicts with your caregiver, both large and small. Address problems right away rather than ignoring them until they grow out of proportion. Some issues can be resolved quickly; others may require more discussion. Whatever the conflict, treat the caregiver in a respectful manner, but don't be afraid to speak up, says Deborah Borchers, MD, a pediatrician in private practice in Cincinnati. When broaching a difficult subject, ask the caregiver's opinion, and hear her out. You're more likely to elicit cooperation if the caregiver knows she has been heard. For example, instead of demanding an earlier nap time to make bedtime easier, ask the caregiver if she has ideas about how to adjust your baby's schedule so he won't grow so overtired in the evening.

7. Trust your gut. Every parent knows when something doesn't feel quite right. You may be turned off by a center everyone in town raves about or clash with a highly recommended sitter. If that happens, keep searching. Babies deserve, and thrive under, good, nurturing care. If something just doesn't feel right about your situation, investigate other options.

8. Be open to change You're not married to a particular person or situation, and if things don't work out, you can always make a switch. Yes, you want consistency for your baby, but that doesn't mean you can't alter arrangements. Babies are resilient; as long as they're having a positive experience with their new caregiver, they'll be just fine, points out Dr. Shatoff.

Reminder of the week:Even after placing a child in daycare, your work is not done. Review your decision periodically, at least every six months. The time to do so is now. Ask yourself the same questions that you did before you placed your child in care. Do you still need to place your child in daycare? Is she old enough now for a preschool? Do I have grandparents or an aunt who might be a better option?