Long before you take your new baby home, you need to think about a crucial issue: Who will take care of her at times when parents are otherwise occupied? Whether you're staying at home or quickly going back to work, you can make sure your baby spends all day, every day, in a safe, nurturing environment. Many factors will influence your choice, including cost, convenience, and, most of all, your baby's needs. Here's a look at some possible options.

The first year of your baby's life is a critical time for attachment and bonding. And no bond is more important than the one she forms with her parents. If she spends most of her time at somebody else's house, she may have trouble connecting with the people who matter most. According to a report from the University of Minnesota's College of Human Ecology, bonding problems can be kept to a minimum if you can stay home with your baby for at least one year. You'll know she's in good hands, and you'll be giving your relationship the best possible start.

Staying at home might even make good financial sense, especially if you have a partner with a good job. When you consider the costs of going to work -- childcare, commuting, business clothes, meals on the go, higher taxes, and so on -- you might actually save money by caring for your baby yourself. Several Web sites offer calculators to help you compare the relative costs of staying home vs. going to work.

Of course, staying home just isn't an option for many parents, including most single moms. Don't feel guilty if you have to return to work. Research shows that children can thrive even when placed in childcare at a very young age. For example, a large study from the National Institute of Child Health and Human Development found that by age 3, there was no significant difference in the language, social, and thinking development of toddlers who had spent their early years in day care and those who had not -- and the better the child care, the better the outcomes.

If you have to hire a caregiver before your child turns 1, part-time would be better than full-time. Whatever type of care you choose, it should be stable and consistent. Frequent shuffling from one caregiver to another can make it harder for a baby to form attachments.

Remember: Your child's care will only be as good as the caregiver. It's your job to make sure she ends up in the right place.

A trusted grandparent or other relative is often the best caregiver you could find -- not to mention the most affordable. Ideally, the relative would come to your house. It's the place where your baby feels most at ease, and you can personally guarantee that it's baby-proofed.

If a relative isn't available and you have the money, consider hiring a part-time sitter or full-time nanny to come into your home. This can be more expensive than a daycare center -- an experienced nanny may cost as much as $1,000 a week -- but your baby will be getting one-on-one care in a familiar environment. You can put an ad in the newspaper or check with your local Child Care Resource and Referral Agency.

The sitter or nanny should have experience with infants, a list of references, and training in infant CPR. Check the references carefully, and ask about her approach to baby care. She should be willing to hold and comfort your baby whenever she's fussy, and she should understand that it's impossible to "spoil" an infant. Don't be afraid to ask hard questions, and pay attention to your gut feelings. If a sitter or nanny doesn't seem right, she probably isn't.

In order to become recognized by the International Nanny Association, a caregiver has to have a high school diploma and be at least 18 years old. Some nannies have extensive training in child development and see childcare as a life calling; others are naturally warm and loving caregivers. But you should investigate your nanny thoroughly before hiring her. According to the INA, about 5 percent of people who apply to become nannies have criminal records. If you use an agency to find a nanny, make sure they conduct thorough criminal background checks.

After hiring a sitter or nanny, pay close attention to any signs of trouble. If you notice the caregiver ignoring your child or leaving her unsupervised, it's time to find someone else. As your child gets older, she may give you signals of her own. If your child becomes withdrawn, has trouble sleeping or eating, or suddenly becomes upset when you leave, she may be trying to tell you something. Listen.

Family daycare is a popular option for parents with very young children. Here, a caregiver will watch anywhere from two to six children of various ages in her own home, ideally with the help of another adult. In general, children in family daycare get a fair amount of attention. Look for a family daycare center that is licensed by the state (only Arkansas, Idaho, and New Jersey fail to license and monitor family daycare.) For daycare licensing requirements in your state, see http://nrc.uchsc.edu/STATES/states.htm.

A good family daycare operation will go far beyond any state requirements. It will have clearly written policies on sick children and discipline, and the owner will seek out accreditation with the National Association for the Education of Young Children (NAEYC) or the National Association for Family Child Care (NAFCC).

Take a close look at the situation before making your decision. According to the American Academy of Pediatrics, there should be no more than three children under 2 for every adult, and no more than six at a time. All caregivers should know CPR and have some training in childhood development. Look around to make sure the childcare area is baby- and childproof, and that there's enough room for your baby to crawl around. Daycare centers can be breeding grounds for childhood illnesses, so be sure to ask the staff about their approach to hygiene. The provider should require all children and workers to be up-to-date on immunizations, staff should wash their hands and the children's hands frequently, they should wear disposable gloves when changing diapers, and they should regularly disinfect toys.

Even the youngest babies need a stimulating, nurturing environment. The daycare provider should be willing to soothe your baby when she cries and interact with her throughout the day. She should talk, sing, play with your child, and spend some time with her outdoors -- not prop her in front of the television or leave her to fend for herself in her crib or a walker for long periods of time. She shouldn't have a rigid timetable for feeding and napping, either. Babies have their own schedules, and the caregiver should be willing to accommodate them.

Pay a visit or two before you make up your mind. The daycare should have an open-door policy that allows you to pop in at any time. Again, your instincts will be a valuable resource.

A daycare center is a more professional operation than family daycare in a home, but it may not always be the best choice for your baby. In some states, daycare centers can have 30 kids or more at a time, so your baby may not get as much individual attention as she needs. Staffing levels make a difference, and state laws mandate minimum ratios of caregivers to children. In addition, many centers divide children into small groups so that they are with the same five or six infants or toddlers all the time; the fewer kids per group, the better, because staff members can spend more time with each child.

You may want to consider a daycare center if there's one at your workplace. Easy access to your kid at lunchtime and breaks is an amazing job perk. But even if the place looks promising from the outside, take the time to check it out first. The staff should be friendly and competent, and the babies should get plenty of cuddling and attention.

The same criteria for a good family daycare operation apply to daycare centers. The staff should have basic training in child development and CPR, they should be warm and loving, and they should be committed to hygiene. Again, visit once or twice before making up your mind. According to the National Network for Child Care, you should be wary if you see babies left crying for long periods of time or spending long stretches in playpens, walkers, high chairs, or cribs. Caregivers should hold and cuddle infants while they're feeding, so the sight of babies propped up with bottles on pillows is another warning sign, according to the NNCC. Caregivers who don't talk, sing, or play with the infants when they're carrying them, feeding them, or changing diapers should also raise a red flag.

Be aware that top-quality daycare centers often have long waiting lists, sometimes a year or more. Ideally, you should get your name on the list well before your baby is born.

-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive and was a staff writer at Hippocrates, a magazine for physicians. His reporting for CHI on occupational health earned him an award from the Northern California Society of Professional Journalists.

References

First published August 23, 2005
Last updated April 3, 2008
Copyright © 2005 Consumer Health Interactive

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