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Home > Health Library > Choosing Child Care
Child care is short-term care by someone other than a parent. There are two basic types of child care: individual and group.
These providers care for only your child or children. The provider may be a family member or friend, a nanny, an au pair, or a babysitter.
These providers care for your child and other people's children. Your child may attend a small or large home day care, a child care cooperative, or a child care center such as a preschool or Montessori school.
Finding good child care can seem overwhelming and a bit scary. It is an important decision. But if you take your time and do some research, you can find a place where your child can play, learn, and be well taken care of.
When choosing child care, consider your child's safety, how much you can afford to pay, and your daily routine.
When choosing child care, make sure that it is:
Check that it is licensed with your state (also called registration or certification). Licensing guidelines vary by state. So make sure that all care providers know how to handle emergencies and are trained in first aid and CPR. Also, ask for references. Get the names of people and agencies you can talk to about the care center's safety record.
Ask what ages of children go to the care center. Think about whether your child would do best at home, in a family home setting, or in a group center. For example, a child who makes friends easily may do well in a group center. A shy child may do better in a small, home-based center.
Ask what kind of learning programs the center has. Think about whether these fit with your family's beliefs and values.
Make sure there are enough staff members to care for the number of children at the center. Ask if caregivers are able to give each child one-on-one attention as needed. Check that the main caregivers and program directors are trained in child development and have a college degree or are otherwise highly experienced. Also, find out how long staff members have worked there. It can be upsetting for a child if the staff changes often.
Watch how the staff works with the children and if they are kind and caring with them. A good caregiver helps your child learn, interact, and solve problems while protecting him or her from making choices that could be harmful.
In the United States you can deduct part of child care costs from your state and federal income taxes. Your employer also may offer benefits or help with child care. Or you may qualify for a reduced rate at some child care centers.
You'll want to know that your provider will be available when needed. Have written agreements outlining specific hours, holidays, and other breaks.
Think about the location of the care center and whether the hours work well with your schedule.
Federal and state laws allow equal access to public education and other services such as speech and physical therapy for children with disabilities or certain conditions that require special care. Find out which laws apply to your child and how to get available services. Contact your local government's health office or your state department of education.
When you start looking for child care, narrow down your choices by considering practical issues as well as your child's needs.
Do you need an individual or group care provider? Or do you need an after-school program or camp to fill in gaps between school hours and your work schedule? Here are some other questions to consider:
Visit the facility or caregiver's home, and get involved in any special activities. Watch the interaction between caregivers and children. Make sure you feel comfortable with your decision.
The types of individual child care include:
Babysitters provide informal in-home care for your child, such as when you need to run errands or have planned an evening out. They are usually paid hourly and maintain general household order. But they are not expected to do housekeeping chores. A mother's helper is similar to a babysitter but is someone who watches your child while you are home.
When you have a relative or family friend care for your child, the formality of the arrangement is up to you. Some parents need help on occasion or part-time. Others have a detailed arrangement that may or may not include payment.
Usually a nanny cares for one or more children of a single family. Nannies usually have at least a high school education. Many have college degrees in childhood education or have completed a special training program. Nannies are considered employees. They may work part-time or full-time in the family's home. For more information, contact the International Nanny Association at www.nanny.org.
Au pairs are child care providers from a foreign country. They typically live with a family for around 12 months. Au pairs usually are young adults (18 to 26 years of age) and often have completed a college degree or are pursuing further education. Families usually are matched with an au pair through an agency.
Here are some steps that can help you find an individual care provider.
It may be helpful to:
There are two basic ways to find an individual child care provider:
Talk with your neighbors and friends about the kind of person you are looking for. Post an advertisement in places where people in your community look for jobs or services, such as newspapers, local colleges, churches, or community bulletin boards.
Some organizations will help you find child care. Many nannies and most au pairs are hired with agency help.
Use a phone interview for the initial screening. Ask questions about their work experience, their references, and whether they have questions for you.
When you have narrowed down your selection, conduct a personal interview with each of your top choices. Allow enough time for the applicant to be introduced to your child.
Ask each reference how long he or she has known the provider, specifics of the provider's duties, and why the employment ended.
Know your responsibilities. If you use an individual care provider for your family on a regular basis, you may be obligated to comply with employer rules and regulations of the federal, state, and local governments. Call the United States Department of Labor (1-866-4-USA-DOL [1-866-487-2365]) for information about your responsibilities.
Choose a babysitter or mother's helper by asking friends and other caregivers you trust. You may also want to ask for recommendations from a local organization, such as the YMCA.
Before you hire a teen to watch your child:
Schedule a meeting with the caregiver and your child, and watch how they interact. Some caregivers may not have confidence. This doesn't mean they will not ever be able to watch your child. But it may mean that you will need to have a few babysitting dates while you are present before leaving them on their own.
Classes help babysitters prepare for the responsibilities of watching your child. They can also provide valuable skills in case of an emergency, such as first aid and CPR (cardiopulmonary resuscitation) training. Classes often are available through local agencies, churches, hospitals, or schools.
The types of group child care include:
Child care cooperatives or babysitting cooperatives are set up and run by parents, usually for occasional child care. But some cooperatives provide regular child care for their members. Parents usually take turns watching each other's children instead of paying money for child care. This often works well for parents who have a flexible schedule, work part-time, or work at home.
Family child care may offer more flexibility than larger group care centers, but quality varies among providers. All family child care operations should be registered or licensed in the state, even if it is not legally required. (Some states exempt family child care operations from licensing requirements.) Although the U.S. Department of Health and Human Services has recommendations for safe child-to-teacher ratios and group size, each state creates its own regulations.
Centers that provide care for groups of children vary in size, setting, programs, and types of activities. Get a list of child care centers in your region from your state licensing bureau. Each state sets its own licensing standards. Some are lax, and others are very strict. Child care centers are sometimes called nursery schools, preschools, Head Start, Montessori schools, or day care centers.
Begin your search by asking friends and family and using your local library and newspaper. You also may want to contact referral organizations and your doctor.
Write down the questions you have. Do a first screening over the phone and take notes.
Ask about or consider:
Meet with the director of each facility or home setting that passes your first screening. Plan enough time to take a tour and talk about their policies, such as when payment is expected and scheduled closures. Make sure you are shown the entire facility or home. Notice whether the children appear happy and playful, and notice how they are treated by the care providers.
The facility should be safe, healthy, and clean. Make sure that staff are knowledgeable about preventing safety hazards and responding to emergencies.
There should be:
Here are some things to consider:
At the start of a new child care routine, it's common for a child to show some signs of anxiety, such as clinging or crying when you leave. With your child's needs in mind, try to ease the transition.
If you are enrolling your child in care for the first time, it may be helpful for you both to get used to spending time apart. Hire a babysitter or ask a friend or relative to help watch your child for short periods, and gradually extend these sessions.
An older toddler or preschool-age child may understand at least some of what you tell him or her about the new situation. Talk about playing with new friends and the kinds of activities he or she will do. Remind your child that you will come back to pick him or her up.
You may keep the first visit short and stay with your child, adding time slowly. Over the course of a few days, you and your child may feel more comfortable when you leave. But follow your child's lead. Try to focus on dealing separately with any of your own anxiety that you may feel about leaving your child.
Some children will be ready and eager for the new routine. A simple extra minute or two to get your child involved in a new project or with a group of children may be all that is needed.
If it's allowed at the facility, let your child bring something with them, such as a family picture or a small toy.
Make sure your child is immunized. Illnesses and disease can spread easily among a group of children. Keep your child's immunizations up to date and give a copy of the record to your child care provider.
If at any time you suspect your child may not be safe, immediately remove him or her from the situation. Notify the proper authorities if you suspect abuse.
Budgeting for child care takes work. Plan ahead and think about your future child care expenses as far in advance as possible. Keep in mind that it may take time to process applications or that there may be a waiting list, especially if you are trying to qualify for financial assistance.
Child care referral agencies or other experts (such as some state or federal government agencies) can help you research your options for child care financial aid. Some general options may include:
Guidelines vary by state, but generally low-income families who are working or in school may be eligible for assistance.
United Way, local government, community groups, and faith-based organizations are all potential sources of financial help.
Some employers and universities offer child care scholarships, child care discounts, or reduced rates at on-site facilities.
Some group child care providers offer scholarships, discounts, or pricing according to your income.
Many school districts offer free or low-cost educational programs for 3- and 4-year-olds.
Federal and state-funded programs may offer part-time or full-time free child care and other services for families who meet federal income guidelines.
You may be allowed state and federal tax credits for child care expenses. Specific programs and amounts depend on your household earnings, family size, and other factors.
This is a program offered by some employers that allows you to have money taken out of your paycheck tax-free each year. The money is put in a special account for you to be reimbursed for child care expenses as they are billed.
Brainstorm ideas about ways you might be able to reduce the number of hours of child care you need or about ways to pay for it, such as:
Different issues can arise with child care. Considering what types of problems you might encounter and how you can manage them can help you prepare.
Ask providers if they require a written contract. If you pick a provider who doesn't use a contract, prepare one yourself. Include the hours of care, payments, and other details that are important to you. Keep a copy with your records.
Whether you choose an individual care provider or a group care setting, make sure you communicate and have an understanding with your care provider about expected behavior, discipline methods, and appropriate activities.
Child care changes will occur and will require careful planning. As children grow, their needs change. Also, personal preferences, a move, or other life events may require a different arrangement. Allow time for both you and your child to adjust by talking about it ahead of time. You may want to plan something special for your child's last day at the child care center, such as bringing treats and taking pictures.
Talk with your child about what to expect. Stress the positive parts of the change, but acknowledge the challenges.
Some parents worry that the relationship with their child will suffer for having another caregiver. Another common concern of parents is whether children will develop and learn to their potential in a child care setting.
The quality of the child care, the type of care (for example, group or individual), and how much time a child spends in child care have an effect on a child's development. But it is not as great as the effect that you have on your child. You have a big impact during the times that you are with your child. Spend quality time with your child whenever you can. For example, have meals together and do fun things that help your child learn and grow in healthy ways.
Your child is more likely to become ill when he or she is frequently with other children. The spread of many diseases can be reduced by practicing healthy hygiene habits regardless of what type of child care arrangement you have.
Plan what you will do if your regular provider cannot keep your child or if your child is sick. Children with mild upper respiratory illnesses such as minor colds usually can attend child care. (Usually, mild upper respiratory illnesses are spread before symptoms develop.) Keep your child at home if he or she has a condition that prevents attending child care, such as a fever or a rash.
Some cities have child care centers just for sick children.
Current as of:
September 20, 2021
Author: Healthwise StaffMedical Review: John Pope MD - PediatricsKathleen Romito MD - Family Medicine
Current as of: September 20, 2021
Author: Healthwise Staff
Medical Review:John Pope MD - Pediatrics & Kathleen Romito MD - Family Medicine
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