A Parent’s Guide to Choosing Child Care
As a parent of a young child, one of the most important decisions you'll make is choosing who will care for your child while you’re at work. Here’s how to get started.
Do you want your child to be cared for at home? Or, does it make more sense to bring your child to the caregiver? Once you’ve made this decision, the National Association of Child Care Resource & Referral Agencies says, you should investigate common types of settings:
In-home care. Having a nanny or babysitter come to your home allows your child lots of one-on-one attention. It may give you a more flexible schedule, too. But, it can be expensive. Keep in mind that most states don’t regulate this type of care. So, you may need to do more of your own research on the sitter’s background.
Family child care. This type of care takes place in the caregiver’s home instead of yours. One adult may take in up to six children. But, that number may rise to 12 if a qualified assistant is on hand to help. All family child-care providers must meet minimum health, safety, and nutrition standards. But, not all states require them to be licensed, undergo background checks, or have regular home inspections.
Center-based care. Children usually are grouped by age in a classroom setting, often with a set schedule of activities. Centers that handle large groups of children must be licensed by their state. This means that they're required to meet certain health and safety standards, as well as make sure caregivers receive appropriate training. Other regulations also may apply in your state.
Signs of quality
What makes a caregiver a good choice for your child? Parents are encouraged to look for:
A safe, stimulating environment
A low ratio of children to staff
Consistent, warm relationships between caregivers and children
See for yourself
Don’t make a choice before visiting the site. Most places allow parents to drop in unannounced.
Feel free to ask a caregiver about any specific concerns. If you’re happy with the answers you get, you just may have found a great place for your child.
Reducing the risk for SIDS
Some parents may be concerned about SIDS occurring in a childcare setting. Here are recommendations from the American Academy of Pediatrics on how to reduce the risk for sudden infant death syndrome (SIDS) and sleep-related deaths from birth to age 1:
Get prenatal care. Routine prenatal care is critical for reducing the risk for SIDS.
Breastfeed your infant. The AAP recommends breastfeeding exclusively for at least six months. However, even some breast milk gives your baby more protection from SIDS than none.
Make sure your baby is immunized. An infant who is fully immunized can reduce his or her risk for SIDS by 50 percent.
Place your infant on his or her back for sleep or naps. This can decrease the risk for SIDS, aspiration, and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, allow your child time on his or her tummy as long as you are supervising to help your child develop strong trunk and neck muscles. This may also help prevent flattening of the back of the head.
Always talk with your baby's doctor before raising the head of their crib if he or she has been diagnosed with gastroesophageal reflux.
Offer your baby a pacifier for sleeping or naps, if he or she isn't breastfed. If breastfeeding, delay introducing a pacifier until breastfeeding has been firmly established, usually within 3 to 4 weeks..
Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. This can decrease the risk for entrapment, suffocation, and SIDS.
Share your room instead of your bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment, and SIDS. Bed or crib sharing is not recommended for twins or other higher multiples.
Avoid using infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.
Avoid using illicit drugs and alcohol, and don't smoke during pregnancy or after birth.
Avoid overbundling, overdressing, or covering an infant's face or head. This will prevent him or her from getting overheated, reducing the risks for SIDS.
Avoid using loose bedding or soft objects—bumper pads, pillows, comforters, blankets—in an infant's crib or bassinet to help prevent suffocation, strangulation, entrapment, or SIDS.
Avoid using cardiorespiratory monitors and commercial devices—wedges, positioners, and special mattresses—to help decrease the risk for SIDS and sleep-related infant deaths. Special devices that are sold to prevent SIDS such as wedges or positioners are not proven to work and may increase the risk of suffocation.
Always place cribs, bassinets, and play yards in hazard-free areas—those with no dangling cords or wires—to reduce the risk for strangulation.