Choosing Child Care

Child Care Options

Individual child care

  • Babysitters and mother's helpers. Babysitters provide informal, periodic, 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.
  • Relative or family friend. 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 on a part-time basis. Others have a regular and detailed arrangement that may or may not include payments.
  • Nanny. 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. They have regular hours, usually between 40 and 60 hours a week in the family's home. Nannies often are responsible for taking children to different activities, such as sports practice, dance lessons, or visits to the library. Duties usually include chores directly related to the child, such as preparing meals, washing dishes, and doing laundry. Some nannies agree to do additional light household duties. A nanny is considered an employee. A formal contract usually is required, which includes:
    • A detailed schedule, including days off.
    • Pay rate. As an employer, you are obligated to pay the nanny a reasonable salary and comply with all rules and regulations of the federal, state, and local governments. These usually include withholding taxes; paying Social Security, workers compensation, and overtime; and complying with other provisions. Check with the United States Department of Labor (1-866-4-USA-DOL, or 1-866-487-2365) for details about these responsibilities.
    • Whether benefits are included, such as health or dental insurance.
    • Special requests of either party.
  • Au pair. Au pairs are child care providers from a foreign country. They speak English and 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. Agencies differ in their amount of involvement. At minimum, most agencies review an au pair's background and medical records, including proof of immunizations. Agency policies usually provide for problems that may develop, such as homesickness or finding a replacement. A family hosting an au pair is expected to:
    • Include the au pair in family events and weekend trips.
    • Provide the au pair with a private room, meals, use of a car, and a monthly stipend. Au pairs usually have an international driver's license.
    • Give the au pair regularly scheduled time off. Some agencies specify that an au pair may not work more than 45 hours each week.
    • Pay for up to 6 credit hours of class per year at a local college or university.

Group child care

  • Child care cooperative. Child care cooperatives or babysitting cooperatives are set up and run by parents, usually for occasional child care. However, 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. Most child care cooperatives have a director and a secretary to manage the operation. They are responsible for carrying out the governing policies made by the members.
  • Family child care. 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.) Licensing requirements usually do not allow more than 12 children to be cared for in a family home, including those who live with the caregiver. Family child care also may be nationally accredited by the National Association for Family Child Care (NAFCC). 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.
  • Child care center. Centers that provide care for groups of children vary in size, setting, emphasis of educational programs, and types of activities offered. 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, while others are very strict. Child care centers are sometimes called nursery schools, preschools, Head Start, Montessori schools, or day care centers. Some of these facilities have additional accreditation through national agencies that meet higher standards for child care than required by the state. Some child care organizations offer specialized education programs and activities, such as music and art classes. Each child care center has written policies about fees (including late fees, if charged), hours of operation, days when the center may be closed (such as holidays and staff education days), and guidelines for the care of sick children.

Other programs

Other types of child care are geared toward families that need to fill in gaps between school hours and parent work schedules. This may include programs that offer special activities during school breaks. This type of child care may include:


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Author: Debby Golonka, MPHLast Updated: December 1, 2006
Medical Review: Michael J. Sexton, MD - Pediatrics

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Topic Contents
 Topic Overview
Arrow PointerChild Care Options
 Selecting a Provider
 When to Call a Doctor
 What to Think About
 Other Places To Get Help
 Related Information
 References
 Credits